Employment as a Social Determinant of Health: Exploring the Relationship Between Neurocognitive Function and Employment Status

Abstract

Purpose:To explore employment as a social determinant of health through examining the relationship between neurocognitive function and employment status.Method:The authors explored the causal relationship between employment status and neurocognitive function by conducting a systematic review of 15 longitudinal studies. The identified studies were conducted in Australia, Denmark, Norway, and the United States.Results:Five neurocognitive function domains were identified (i.e., complex attention, executive function, learning and memory, language, perceptual-motor function) across diagnosis (i.e., bipolar disorder, first-episode psychosis, human immunodeficiency virus, major depression, schizophrenia-spectrum disorders, traumatic brain injury). Unemployment was correlated with poorer attention, executive function, learning and memory, perceptual-motor function, and language. Employment was correlated with better attention, executive function, learning and memory, perceptual-motor function.Conclusion:The acknowledgment of the relationship between neurocognitive function and employment status can assist service providers in assessing and developing strategies to enhance and maintain employment outcomes. The assessment of neurocognitive function could be further explored by identifying standard measures and assessment timelines to assess the six domains across diagnosis. Vocational rehabilitation services could integrate cognitive interventions (cognitive rehabilitation, cognitive enhancement therapy, cognitive remediation) to explore the effect on neurocognitive function and employment outcomes. Further longitudinal research studies are needed, for both persons with disabilities and persons without disabilities, to elucidate the relationship between employment status and neurocognitive function.