title: A life course perspective to spinal cord injury and employment participation in Canada.
abstract: BACKGROUND
  Few studies have examined life course differences in the employment of Canadians with spinal cord injury (SCI).
  
  
  OBJECTIVE
  To compare employment participation of young/middle-aged and older adults with SCI and to examine the association between employment and demographic and health factors, SCI-related needs, and social role participation at the 2 life phases.
  
  
  METHODS
  A sample of young/middle-aged (18-54 years; n = 959) and older adults (55-64 years; n = 364) with SCI was recruited as part of a larger Canadian community survey. Pre- and postinjury employment were compared. Demographic and health factors, number of unmet SCI needs, and social role participation were collected and compared by life phase and employment status. Two multivariable logistic regression models were conducted and compared for young/middle-aged and older adults.
  
  
  RESULTS
  Close to one-third of participants with SCI were working post injury (32%), a decline from the 62% of respondents working prior to their injury. Participants were more likely to work in less physically demanding job sectors including business/administration or health/science/teaching. An examination of life phase differences showed that young/middle-aged adults were more likely to be employed post injury (36%) when compared to older respondents (12% employed) who were more likely to report being retired (43%). Multivariable analyses revealed that for young/middle-aged adults, being married, attaining a postsecondary education, and having fewer unmet SCI needs were related to employment. Among older adults, having a traumatic injury was related to involvement in paid work. For both young/middle-aged and older adults, participating in more social roles was related to working.
  
  
  CONCLUSIONS
  A life course perspective is important to understanding similarities and differences between young/middle-aged and older adults with SCI in their employment participation. Tailored programs and policies should be designed to promote labor force involvement at different phases of the working life course.
authors.affiliation: Liberty Mutual Research Institute for Safety , Hopkinton, Massachusetts ; Department of Work Environment, University of Massachusetts-Lowell.
authors.forename: Arif
authors.initials: A
authors.lastname: Jetha
authors.affiliation: Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.
authors.forename: Frédéric S
authors.initials: FS
authors.lastname: Dumont
authors.affiliation: Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.
authors.forename: Luc
authors.initials: L
authors.lastname: Noreau
authors.affiliation: Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and Université Laval , Quebec City , Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Leblond
keywords: employment; life course differences; spinal cord injury