Relationship Between Comorbidities and Employment Among Veterans with Spinal Cord Injury

Abstract

Objective: To determine the relationship between medical and mental health comorbidities in a large cohort of veterans with spinal cord injury (SCI). Methods: Data were collected from interviews and electronic medical records of veterans with SCI (N = 1,047) who received care at 7 geographically diverse SCI centers within the Department of Veterans Affairs across the country (https://ichgcp.net/clinical-trials-registry/NCT01141647). Employment, medical, functional, and psychosocial data underwent cross-sectional analysis. Results: Lack of any documented mental health diagnosis correlated strongly with being employed at the time of enrollment. No single comorbidity was associated with employment at enrollment, but an increased number of medical and/or mental health comorbidities ("health burden") were associated with a decreased likelihood of employment at the time of enrollment. Conclusion: Further investigation is needed to clarify whether comorbidity severity or combinations of specific comorbidities predict rehabilitation outcome, including employment.

Keywords: comorbidity; employment; mental health; outcomes; rehabilitation; spinal cord injury; supported employment; veterans; vocational rehabilitation.

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1.

CONSORT flow diagram showing recruitment of veterans with spinal cord injury (SCI) to participate in a study of employment after SCI.