Characteristics Associated With Perceived Underemployment Among Participants With Spinal Cord Injury

James S Krause; Clara E Dismuke-Greer; Karla Reed

doi:10.1016/j.arrct.2022.100230

Characteristics Associated With Perceived Underemployment Among Participants With Spinal Cord Injury

Arch Rehabil Res Clin Transl. 2022 Sep 7;4(4):100230. doi: 10.1016/j.arrct.2022.100230. eCollection 2022 Dec.

Authors

James S Krause¹, Clara E Dismuke-Greer², Karla Reed³

Affiliations

¹ College of Health Professions, Medical University of South Carolina, Charleston, SC.
² Health Economics Resource Center, VA Palo Alto, Menlo Park, CA.
³ Spartanburg Methodist College, Spartanburg, SC.

Abstract

Objective: To identify job characteristics related to perceived underemployment among people with spinal cord injury (SCI), while controlling for demographic, injury, and educational factors.

Design: Cross-sectional, logistic regression with predicted probabilities of underemployment.

Setting: Medical University in the Southeastern United States.

Participants: 952 were adults with traumatic SCI, all of whom were a minimum of 1-year post-injury and employed at the time of the study. They averaged 46.7 years of age, the majority were male (70.5%), and over half (52%) were ambulatory (N=952).

Interventions: Not applicable.

Main outcome measures: Perceived underemployment was defined and measured by a dichotomous variable (yes/no).

Results: Demographic, injury, and educational factors explained only 4.8% of the variance in underemployment, whereas the full model explained 21.8%. Underemployment was significantly lower for women (odds ratio [OR]=0.66, 95% confidence interval [CI; .44, .98]), those who were either married or in a nonmarried couple (OR=0.63, 95% CI [.42, .93]), those with health benefits (OR=0.58, 95% CI [.37, .91]) and higher for those with lower earnings and occupations in the category of sales, professional/managerial. Postsecondary educational milestones, having received a promotion or recognition, and working full time were not identified as significant predictors in the multivariate model, although each was significantly related to a lower likelihood of underemployment when using a restricted model that controls only for demographics, SCI, and educational status (rather than all variables simultaneously). Age, years since injury, and injury severity were not significant.

Conclusion: Underemployment is a concern among people with SCI and is more prevalent in low-paying jobs, without benefits, and opportunities for recognition and promotion. Vocational counseling strategies need to promote quality employment, including jobs with recognition and benefits.

Keywords: Educational status; Employment; Rehabilitation; Spinal cord injuries.