Abstract
BackgroundThe sudden occurrence of stroke often leads to impaired physical, emotional, and cognitive abilities. Many stroke survivors therefore require support from their family members. However, little is known about the effects of a stroke event on the spouses’ employment transition probabilities. The aim of this study was twofold 1) to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses and 2) to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect.MethodData for this population-based cohort study were extracted from Swedish national registries from 2005 to 2016. The national sample consisted of 1818 spouses of first ever stroke survivors during 2010 and 2011, and 7399 matched controls that were employed or unemployed during 5 years prior stroke onset. Effects of stroke on spousal employment transitions were analyzed using linear regression, stratified by employment status prior to stroke onset.ResultsEmployed spouses prior stroke onset reduced their employment by − 1.3 percentage points (95% CI, − 2.4, − 0.2). The data also indicated that employed spouses with lower age, comorbid conditions, and low educational attainment may be at even greater risk of transitioning to unemployment. On the other hand, stroke events appear to have limited impact on spouses that were unemployed prior to stroke onset.ConclusionThe risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk. Thus, it is important for policy-makers to implement interventions to ensure that these groups of spouses have the possibilities to combine their caregiving role and remaining in the labor market.
Highlights
In 2016, stroke was the second leading cause of death and third leading cause of disability [1]
Employed spouses prior stroke onset reduced their employment by − 1.3 percentage points
The risk of transitioning to unemployment appears to increase after stroke onset for spouses of stroke survivors, and disadvantaged groups may be at even greater risk
Summary
In 2016, stroke was the second leading cause of death and third leading cause of disability [1]. Previous studies have found little change in spouses’ employment after a partner’s health shock on average [15,16,17,18,19]. When assessing the average effect on spouses employment rates these two forces may cancel each other out when comparing the spouses’ employment to unexposed controls Such cancellations, if they exist, can be disentangled by studying employment transitions separately for spouses that were employed and unemployed before stroke onset. The aim of this study was twofold 1) to investigate whether a first ever stroke has an effect on employment transition probabilities for employed and unemployed spouses and 2) to analyze whether heterogeneity with respect to age, gender, education and comorbidities influence the size of the effect
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