Long-term Employment Outcomes Research Articles

Living with resource booms and busts: Employment scenarios and resilience to unconventional gas cyclical effects in Australia

Recent research on unconventional oil and gas development (UOGD) proposes differences compared with established extraction of conventional energy, including the rise of shorter cycles of mini booms and busts. This paper builds on recent UOGD research discussing mini-booms/busts of the industry and considers factors affecting resilience of local businesses to cyclical effects using a case study of coalbed methane (coal seam gas) in Australia. The paper takes a mixed methods approach, combining qualitative interviews with local business communities and econometric modelling to quantitatively forecast potential changes in indirect employment under different scenarios for the period 2014–2034. The quantitative results demonstrate that, across all scenarios, employment rises in the sort to medium term then declines in the longer term. The scenario with the best economic resilience (long-term employment outcomes) involved decreasing dependence on the gas industry over time. The qualitative results show that experiences of local businesses did not readily align either to traditional long boom/bust nor the shorter periods of mini-booms and mini-busts, and many struggled to manage cyclical effects. In particular, local businesses had difficulty when an unforeseen lull in industry activity stretched out for several months before drilling eventually resumed. Taken combined, the qualitative and quantitative results indicate that the ‘bust’ part of UOGD is very much alive and may have been underestimated in recent literature. The findings emphasise that to manage unpredictable cyclical effects, there is a need for businesses to be flexible while retaining coping mechanisms for unforeseen circumstances. We conclude that economic effects of UOGD can vary considerably, noting that timing plays an important role as to how industry cycles play out and whether busts are relatively small corrections that can be absorbed by local economies or whether they are outside the realms of local resilience. We also draw attention to the role of intermediaries who play a critical role in providing trusted advice at a time of information overload and conflicting perspectives. We emphasise the need for policies to encourage economic resilience, based on diversification and assistance to local businesses to increase their adaptive resilience towards fluctuating periods of prosperity and recession.

Successful return to work during labor market liberalization: the case of Italian injured workers

We investigate the long term employment outcomes of Italian injured workers over a time period when the country introduced policy reforms that increased labor market flexibility but reduced job security. Using an employer-employee database matched with injury data, we observe that both before and after the reforms almost one-fourth of injured workers were no longer employed 3 years after their “first” return to work. We note a slight decrease in this share after the reforms (from 24 to 22%) while we find a decline in workers’ job security as measured by their probability of re-employment in permanent contracts. We use multinomial logit estimates to study how liberalization reforms were associated with a changing role of individual, firm, and injury characteristics in shaping long-term employment outcomes of injured workers after their recovery period. Heterogeneity analyses show that low wage employees, women, immigrants, and individuals who suffered a more severe injury were penalized more. Pre-injury individual characteristics became stronger predictors of long-term employment than firms’ characteristics. In particular, we find that the advantage provided by working in larger firms was significant before the liberalization reforms, but disappeared afterward, while the advantage provided by human capital became more relevant after the liberalization.

Using Decision Tree Methodology to Predict Employment After Moderate to Severe Traumatic Brain Injury.

Objective:To build decision tree prediction models for long-term employment outcomes of individuals after moderate to severe closed traumatic brain injury (TBI) and assess model accuracy in an independent sample.Setting:TBI Model Systems Centers.Participants:TBI Model Systems National Database participants injured between January 1997 and January 2017 with moderate to severe closed TBI. Sample sizes were 7867 (year 1 postinjury), 6783 (year 2 postinjury), and 4927 (year 5 postinjury).Design:Cross-sectional analyses using flexible classification tree methodology and validation using an independent subset of TBI Model Systems National Database participants.Main Measures:Competitive employment at 1, 2, and 5 years postinjury.Results:In the final employment prediction models, posttraumatic amnesia duration was the most important predictor of employment in each outcome year. Additional variables consistently contributing were age, preinjury education, productivity, and occupational category. Generally, individuals spending fewer days in posttraumatic amnesia, who were competitively employed preinjury, and more highly educated had better outcomes. Predictability in test data sets ranged from a C-statistic of 0.72 (year 5; confidence interval: 0.68-0.76) to 0.77 (year 1; confidence interval: 0.74-0.80).Conclusion:An easy-to-use decision tree tool was created to provide prognostic information on long-term competitive employment outcomes in individuals with moderate to severe closed TBI. Length of posttraumatic amnesia, a clinical marker of injury severity, and preinjury education and employment status were the most important predictors.

Patterns and Predictors of Return to Work After Major Trauma: A Prospective, Population-based Registry Study.

To characterize patterns of engagement in work during the 4-year period after major traumatic injury, and to identify factors associated with those patterns. Employment is an important marker of functional recovery from injury. There are few population-based studies of long-term employment outcomes, and limited data on the patterns of return to work (RTW) after injury. A population-based, prospective cohort study using the Victorian State Trauma Registry. A total of 1086 working age individuals, in paid employment or full-time education before injury, were followed-up through telephone interview at 6, 12, 24, 36, and 48 months post-injury. Responses to RTW questions were used to define 4 discrete patterns: early and sustained; delayed; failed; no RTW. Predictors of RTW patterns were assessed using multivariate multinomial logistic regression. Slightly more than half of respondents (51.6%) recorded early sustained RTW. A further 15.5% had delayed and 13.3% failed RTW. One in 5 (19.7%) did not RTW. Compared with early sustained RTW, predictors of delayed and no RTW included being in a manual occupation and injury in a motor vehicle accident. Older age and receiving compensation predicted both failed and no RTW patterns. Preinjury disability was an additional predictor of failed RTW. Presence of comorbidity was an additional predictor of no RTW. A range of personal, occupational, injury, health, and compensation system factors influence RTW patterns after serious injury. Early identification of people at risk for delayed, failed, or no RTW is needed so that targeted interventions can be delivered.

100 Post-Acute Care Setting is Associated with Employment After Severe Burn Injury

Despite the growing use of post-acute care in the United States, few studies have examined differences in long-term outcomes by specific post-acute care setting. Adult burn survivors represent a population that exhibit impaired long-term outcomes and often require post-acute care. Currently, limited data exist regarding which care setting provides the most benefit to this population. The purpose of this study is to examine differences in long-term employment outcomes of adult burn survivors by post-acute care setting. Data was obtained from the Burn Model System National Database between 1994 and 2016. Adult burn survivors who were alive at discharge and required post-acute care following acute care discharge were included. The population was divided into two groups - those who received post-acute care at an inpatient rehabilitation facility (IRF Group) and those who received post-acute care at a skilled nursing facility, long-term care hospital, or other extended care facility (Other Rehab Group). Employment status was assessed at 12 months post injury. Propensity score matching (controlling for 16 demographic and clinical variables) and logistic regression were used to determine the impact of post-acute care setting on employment status. This study included a total of 695 burn survivors (447 in the IRF Group; 248 in the Other Rehab Group). Individuals in the IRF Group had larger burns and were more likely to have an inhalation injury and to have undergone an amputation. Additional demographic and clinical characteristics can be found in Table 1. Logistic regression analysis using propensity score matching found the IRF Group had over 9 times increased odds of being employed at 12 months post-injury compared to the Other Rehab Group (p=0.046). Inpatient rehabilitation facilities provided a long-term benefit for burn survivors in terms of regaining employment when compared to other acute care settings such as skilled nursing facilities, long-term care hospitals, and other extended care facilities. Given the current lack of evidence-based guidelines on post-acute care decisions, the results of this study shed light on the potential benefits of the intensive services provided at inpatient rehabilitation facilities in this population. Demographic and clinical characteristics of the study population Demographic and clinical characteristics of the study population

Correlates of Perceived Job Performance Among Employed Adults With Multiple Sclerosis

BackgroundThe expectation to remain in the labor force is a powerful indicator of long-term employment outcomes for people with multiple sclerosis (MS), and it is determined in part by perceived current job performance.ObjectiveThis study identified correlates of perceived job performance among working adults with MS.MethodParticipants included 611 members of nine National Multiple Sclerosis Society chapters representing 21 states and Washington, DC. Participants were employed, and primarily female (81%), older (average age of 48 years), and White (77%).ResultsHierarchical multiple regression analysis revealed that males, Whites, people without or with low levels of cognitive impairment, and those who reported stronger job/person matches and higher levels of job satisfaction were more likely than other participants to positively evaluate their own job performance. The aggregated predictors explained 20% of the variability in participants’ job performance self-ratings.ImplicationsFindings show the complexity in predicting how satisfied employed people with MS are with their overall job performance, which in turn shapes their expectations and intentions about staying in or disengaging from the workforce. The implications of the findings for rehabilitation counseling interventions and for identifying adults with MS who would benefit from early intervention are discussed.

Making School Attendance a Vital Sign: A Cross-Sector Collaboration

Program Goals: Education is an important determinant of health. Educational achievement has been shown to improve long-term health, economic and employment outcomes. Educational achievement depends on school attendance and having children in school and ready to learn each day. However, many school districts struggle with chronic absenteeism, defined as missing 10% or more of school in an academic year. Little is known about the impact of cross-sector sharing of school attendance data …

Borderline Personality Disorder Features Are Associated with Concurrent Pain-Related Disability in a Chronic Pain Sample.

To determine whether core features of borderline personality disorder are associated with increased rates of being on disability benefits due to chronic pain conditions. A total of 147 patients currently in treatment for chronic pain at a multimodal chronic pain clinic. We tested for a concurrent relationship between borderline personality disorder features and employment status using self-report measures. Borderline personality disorder features were associated with increased likelihood of currently being on disability due to pain conditions (odds ratio [OR] = 23.13, 95% confidence interval [CI] = 1.68-318.73), on disability due to other conditions (OR = 33.65, 95% CI = 2.15-526.13), and unemployed (OR = 20.14, 95% CI = 1.38-294.93), even while controlling for pain severity and interference, depression, and trait anxiety. A follow-up analysis revealed that these associations were due to the negative relationships facet of borderline personality disorder features. Borderline personality disorder features, particularly negative relationships, are associated with increased rates of pain disability, general disability, and unemployment in a chronic pain sample. Future research should examine mechanisms by which the maladaptive interpersonal behaviors and cognitions of borderline personality disorder might result in worse long-term employment outcomes of chronic pain.

Employment Outcomes From a Randomized Controlled Trial of Two Employment Interventions With Homeless Youth.

Limited research exists on how employment interventions contribute to employment outcomes for homeless youth. This study examines the comparative efficacy of 2 interventions-Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS)-provided to homeless youth with mental illness in a randomized controlled trial. Participants were recruited from 1 homeless youth agency in Los Angeles, CA, and randomized to the SEI (n = 36) or IPS (n = 36) conditions. Over 20 months, SEI participants received 4 SEI components, and IPS participants received IPS services based on 8 principles. Data were collected at baseline and follow-up for the primary employment outcome (paid employment) and 5 secondary employment outcomes. Over 20 months, 39% of SEI participants and 32% of IPS participants reported any paid employment. Across both groups, participants who reported working at baseline had nearly 8 times the odds of working at follow-up (OR = 7.91, p < 0.05). No statistically significant differences were detected across the full sample or between groups on the primary or secondary employment outcomes. Future effectiveness research is needed to compare the long-term employment outcomes of the SEI and IPS with a more heterogeneous sample of homeless youth using customized homelessness support services and more nuanced employment outcomes.

Effect of the tools of the mind kindergarten program on children’s social and emotional development

Social-emotional competence in early childhood and the elementary grades is foundational for children’s short- and long-term academic, social, mental health, and employment outcomes. This study examined the effects of a large-scale (N=715) cluster randomized controlled trial of a comprehensive kindergarten program, Tools of the Mind, on teachers’ reports of children’s social-emotional competence at the end of kindergarten with follow-up in first grade. Results indicated that at the end of kindergarten, children in classrooms in schools randomly assigned to the treatment condition had reduced teacher reported behavior problems and aggression and improved self-regulation, social-emotional competence, and positive teacher-child relationships relative to children in classrooms in schools randomly assigned to the control condition. No differences were detected for teacher-reported academic competence. Sustained effects in first grade were seen only for first grade teachers’ reports of aggression and conduct problems. This study adds to a growing literature demonstrating positive effects of educational programs focusing on children’s social-emotional as well as academic competence.

Working to Reduce Poverty

Subsidized employment programs that increase labor supply and demand are a proven, underutilized strategy for reducing poverty in the short and long term. These programs use public and private funds to provide workers wage-paying jobs, training, and wraparound services to foster greater labor force attachment while offsetting employers’ cost for wages, on-the-job training, and overhead. This article proposes two new separate but harmonized federal funding streams for subsidized employment that would expand automatically when and where economic conditions deteriorate. Participating states and local organizations would be offered generous matching funds to target adult workers most in need and to secure employer participation. The proposal would effectively reduce poverty among workers during work placements, and improve long-term unsubsidized employment and other outcomes for participants and their families.

Long-Term Economic and Employment Outcomes Among Partners of Women With Early-Stage Breast Cancer.

Work loss is one of many personal costs for patients with cancer and their families. Many women with breast cancer face long-term job loss that stems from their diagnoses. However, little is known about the economic and employment outcomes of partners of women with breast cancer. Women with nonmetastatic breast cancer identified by the Detroit and Los Angeles SEER registries between June 2005 and February 2007 were surveyed at both 9 months and 4 years after diagnosis. Partners were surveyed 4 years after patients' diagnoses. Nonretired partners were asked about employment and financial consequences that stemmed from the patients' breast cancer diagnoses and treatments. A total of 517 (67%) of 774 eligible partners completed the survey; 32% reported worsened financial status attributed to patients' breast cancers. Two hundred forty nonretired partners worked during the year after the patients' diagnoses; 90% were still working 4 years postdiagnosis. A total of 32% of partners decreased their work hours as a result of patients' breast cancer diagnoses and treatments; 64% of partners reported that, as a result of patients' breast cancer diagnoses and treatments, it was very/extremely important to keep working to keep health insurance. Overall, 51% of partners reported that it was very/extremely important to avoid changing jobs, because they were worried about loss of health insurance. Nearly one third of partners reported that their financial status was worse because of the patient's breast cancer, although most remained working 4 years after a diagnosis. Partners may continue to work longer than desired to compensate for a loss of financial resources in the family.

Long-term employment outcomes following rehabilitation for significant neurological impairment in UK military personnel: a 3-year study

BackgroundReturning to employment is a major modifiable factor affecting long-term health in brain injury which neurological and vocational rehabilitation attempts to address. In military patients, little is known about long-term...

Employment Status of Depressed Individuals in an 11-Year Follow-up: Results From the Finnish Health 2011 Survey.

The aim of this study was to describe the employment and mental health status of persons with depressive disorders after an 11-year follow-up, and identify individual and work-related factors that predict adverse outcomes. Two nationally representative health surveys, Health 2000 and its follow-up, Health 2011 were used, and persons with depressive disorders at baseline (n = 275) were re-interviewed after 11 years. Information on employment status was available for all 263 participants in 2011. About 15.7% had been granted disability pension by 2011, while 55.5% were employed and 18.2% on old-age pension. High job control was the only statistically significant predictor of lower probability of disability pension (adjusted odds ratio 0.42, 95% confidence interval [95% CI] 0.23 to 0.77). Being unmarried (adjusted odds ratio 2.99, 95% CI 1.19 to 7.52) was associated with persistent depressive disorder. Job control emerged as an important predictor of long-term employment outcomes among depressed individuals.

Long-term impacts of artistled songwriting workshops with individuals in regional Australia: A pilot study

Abstract Young people in regional communities demonstrate poorer long-term economic, health and employment outcomes than do youth from urban areas. Active participation in creative arts has the potential to improve educational performance, enhance personal development and improve social cohesion in socially excluded communities. The Musomagic programme represents a creative arts partnership model between school, community and artist, engaging young people in regional and remote communities in songwriting and music video workshops. This retrospective study used inductive and iterative thematic analysis of interviews with seven Musomagic mentors to examine the long-term impacts on the lives of young people and the community. The results show that Musomagic can deliver long-term positive impacts. These impacts were most strongly apparent in personal and community themes, and somewhat less so in the school theme. The researchers discovered that development of confidence was perceived as a key enabler that led to the personal, school and long-term impacts.

Persons with brain injury and employment supports: Long-term employment outcomes and use of community-based services

ABSTRACTObjectives: To understand how employment services (ES) are provided to persons with brain injuries (PWBIs) in Ontario, Canada, and the impact service delivery has on competitive-employment outcomes.Design and methods: A mixed-method case study of one community-based agency that provides specialized services to PWBIs. Relationships between demographic, service-related variables and employment outcomes (2009–2014) were analysed using chi-squares and analyses of variance. In addition, 14 interviews were conducted and analysed using thematic analysis.Results: PWBIs accessed services on average of 16 years post injury; 64% secured at least one competitive-employment job, which was how employment success was defined in this study. Average job tenure was 368 days, and average job intensity was 3.8 hours/day. Employment success was significantly associated (p < 0.05) with use of job development, job coaching, case management and job retention services. Interviews revealed that PWBIs were provided five services: job goal(s) identification, assessment of work-related abilities/skills, job development, on-the-job supports and job retention assistance. Challenges to ES delivery included lack of suitable jobs and hiring incentives, and difficulties in establishing natural supports at the workplace.Conclusions: PWBIs’ employment outcomes may be supported through provision of ES to assist with: the development of realistic job goals and job-finding skills, securing work, on-the-job coaching and advocacy with employers.

Long-term employment among people at ultra-high risk for psychosis

BackgroundPsychotic disorders are associated with high rates of sustained unemployment, however, little is known about the long-term employment outcome of people at ultra-high risk (UHR) of developing psychosis. We sought to investigate the long-term unemployment rate and baseline predictors of employment status at follow-up in a large UHR cohort. Method268 UHR patients recruited from the Personal Assessment and Crisis Evaluation clinic in Melbourne, Australia were followed-up over 2–14years after initial presentation to the service. Individuals in no form of employment or education were classed as unemployed. Logistic regression analyses were used to examine predictors of employment outcome. ResultsA high rate of unemployment was present at follow-up in this UHR sample (23%). At baseline, those who were unemployed at follow-up had a longer duration of untreated illness, more severe negative symptoms, lower IQ, poorer social and occupational functioning and reported more childhood trauma than the employed group. At follow-up, unemployed individuals exhibited significantly more severe symptoms on all measures and were more likely to have been diagnosed with a mood, anxiety, psychotic or substance use disorder. Childhood trauma and the duration of untreated illness at baseline were significant independent predictors of employment status at follow-up in the multivariate analyses. ConclusionsNearly a quarter of this UHR sample was unemployed at long-term follow-up. The duration of untreated illness and the effects of childhood trauma are potentially modifiable risk factors for long-term employment outcome in this group. Vocational support may be beneficial for many UHR patients presenting to services.

Long-term work participation among cystic fibrosis patients undergoing lung transplantation

BackgroundPatients with cystic fibrosis (CF) experience obstacles to employment, regardless of whether they have undergone lung transplantation (LTx). We investigated socioeconomic and clinical factors predicting long-term employment outcomes in CF patients receiving LTx. MethodsData from the United Network for Organ Sharing registry were used to identify CF patients 18–59years-old who received LTx between 2000 and 2010 and survived greater than 5years. Long-term employment status was determined by center-reported follow-up data on patients working for income, collected at the 5th transplant anniversary. After multiple imputation to complete missing data on covariates, multivariable logistic regression was used to identify associations between characteristics at or after LTx and long-term work participation. ResultsThere were 745 patients who met inclusion criteria and contributed employment data within 365days of their 5th LTx anniversary. In this cohort, 48% (358/745) were working for income 5years after LTx. Younger age, male gender, better pulmonary function attained post-transplant, pre-transplant work participation, and private health insurance (compared to government Medicaid or Medicare insurance) at the time of transplant predicted greater odds of post-transplant employment. ConclusionsLack of work experience and reliance on government health insurance at the time of transplant predict lower long-term work participation among LTx recipients with CF. By contrast, long-term employment outcomes were not negatively affected by comorbidities at or after transplantation in this cohort. Despite resolving some physiological obstacles to employment in patients with CF, LTx may introduce new socioeconomic barriers to employment.

Job Coaching and Success in Gaining and Sustaining Employment Among Homeless People.

Objective: People who are homeless experience many barriers that affect their ability to gain and sustain work. In this study, we investigate whether personal job coaching support contributes toward employment success. Methods: The short- and long-term employment outcomes of 2,480 clients participating in a labor market program were analyzed. Results: Clients being supported by a job coach have significantly higher chances of gaining employment than those not being supported. This holds particularly true for the youngest age-group. Furthermore, results also indicate that job coaching improves clients’ chances of successfully sustaining employment. Conclusions: Personal approaches and individual coaching seem to be promising strategies in social work practice and specifically in return to work programs for people who have experienced homelessness.

Maintaining my employment: Learning from people living and working with mental illness

IntroductionEngagement in occupation, including employment, is central to mental health recovery. However, evidence demonstrates that people living with mental illness struggle to maintain their employment. The aim of this qualitative study was to gain a rich understanding of the experiences of people living with mental illness who have managed to maintain their employment, and specifically, the strategies they actively choose and use to stay in work.MethodSemi-structured interviews explored the perspectives of 10 people living with mental illness who were successfully maintaining their employment. Data were analysed using constant comparative analysis.ResultsParticipants described maintaining employment through a conscious and active process of using individualised combinations of specific strategies within the broader categories of: identifying and connecting with helpful people; looking after all of me; having a job that fits with who I am; staying motivated; positive reflection and re-framing; and choosing and using strategies in the workplace.ConclusionOccupational therapists might better support long-term employment outcomes for people living with mental illness by adopting a more recovery-oriented approach, facilitating people to actively identify, choose and use their own strategies to maintain employment.