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BMC Public Health
Published in: BMC Public Health 1/2020

01-12-2020 | Stroke | Research article

Employment transitions for spouses of stroke survivors: evidence from Swedish national registries

Authors: Josefine Persson, Gunnel Hensing, Carl Bonander

Published in: BMC Public Health | Issue 1/2020

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Abstract

Background

The 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.

Method

Data 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.

Results

Employed 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.

Conclusion

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. 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.
Literature
1.
GBD 2016 Lifetime Risk of Stroke Collaborators, Feigin VL, Nguyen G, Cercy K, Johnson CO, Alam T, et al. Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016. N Engl J Med. 2018;379:2429–37.
2.
3.
Sudlow CL, Warlow CP. Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. Int Stroke Incidence Collaboration Stroke. 1997;28:491–9.
4.
Lekander I, Willers C, Ekstrand E, von Euler M, Fagervall-Yttling B, Henricson L, et al. Hospital comparison of stroke care in Sweden: a register-based study. BMJ Open. 2017;7:e015244.PubMedPubMedCentralCrossRef
5.
Blomgren C, Jood K, Jern C, Holmegaard L, Redfors P, Blomstrand C, et al. Long-term performance of instrumental activities of daily living (IADL) in young and middle-aged stroke survivors: results from SAHLSIS outcome. Scand J Occup Ther. 2018;25:119–26.PubMedCrossRef
6.
Persson J, Levin L-Å, Holmegaard L, Redfors P, Svensson M, Jood K, et al. Long-term cost of spouses’ informal support and its associasion with midlife stroke survivors’ dependency. Brain Behav. 2017;7:e00716.PubMedPubMedCentralCrossRef
7.
Mackenzie A, Greenwood N. Positive experiences of caregiving in stroke: a systematic review. Disabil Rehabil. 2012;34:1413–22.PubMedCrossRef
8.
Bergstrom AL, von Koch L, Andersson M, Tham K, Eriksson G. Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3-6 months after onset. J Rehabil Med. 2015;47:508–15.PubMedCrossRef
9.
Haley WE, Roth DL, Hovater M, Clay OJ. Long-term impact of stroke on family caregiver well-being: a population-based case-control study. Neurology. 2015;84:1323–9.PubMedPubMedCentralCrossRef
10.
Persson J, Holmegaard L, Karlberg I, Redfors P, Jood K, Jern C, et al. Spouses of stroke survivors report reduced health-related quality of life even in long-term follow-up: Results from Sahlgrenska Academy study on ischemic stroke. Stroke. 2015;46:2584–90.PubMedCrossRef
11.
Krishnamurthi RV, Moran AE, Feigin VL, Barker-Collo S, Norrving B, Mensah GA, et al. Stroke prevalence, mortality and disability-adjusted life years in adults aged 20-64 years in 1990-2013: data from the global burden of disease 2013 study. Neuroepidemiol. 2015;45:190–202.CrossRef
12.
Garland A, Jeon SH, Stepner M, Rotermann M, Fransoo R, Wunsch H, et al. Effects of cardiovascular and cerebrovascular health events on work and earnings: a population-based retrospective cohort study. CMAJ. 2019;191:E3–E10.PubMedPubMedCentralCrossRef
13.
Becker GS. A theory of the allocation of time. Economic J. 1965;75:493–517.CrossRef
14.
15.
Bradley CJ, Neumark D, Luo Z, Bednarek HL. Employment-contingent health insurance, illness, and labor supply of women: evidence from married women with breast cancer. Health Econ. 2007;16:719–37.PubMedCrossRef
16.
Dobkin C, Finkelstein A, Kluender R, Notowidigdo MJ. The economic consequences of hospital admissions. Am Econ Rev. 2018;108:308–52.PubMedCrossRef
17.
Garcia-Gomez P, van Kippersluis H, O'Donnell O, van Doorslaer E. Long term and spillover effects of health shocks on employment and income. J Hum Resour. 2013;48:873–909.PubMedPubMedCentral
18.
Sreedharan SE, Unnikrishnan JP, Amal MG, Shibi BS, Sarma S, Sylaja PN. Employment status, social function decline and caregiver burden among stroke survivors. A south Indian study. J Neurol Sci. 2013;332:97–101.PubMedCrossRef
19.
Jeon S-H, Stepner M, Rotermann M, Fransoo R, Sanmartin C, Scales DC, et al. Effects of cardiovascular health Sshocks on spouses’ work and earnings a national study. Med Care. 2020;58:128–36.PubMedCrossRef
20.
Mincer J. Labor force participation of married women. In: Lewis H, editor. Aspects of labor economics. Princeton: Princeton University Press; 1962. p. 63–105.
21.
Bobinac A, van Exel NJA, Rutten FFH, Brouwer WBF. Caring for and caring about: disentangling the caregiver effect and the family effect. J Health Econ. 2010;29:549–56.PubMedCrossRef
22.
Ludvigsson JF, Otterblad-Olausson P, Pettersson BU, Ekbom A. The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research. Eur J Epidemiol. 2009;24:659–67.PubMedPubMedCentralCrossRef
23.
World Health Organization. The ICD-10 classification of mental and behavioural disorders : clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.
24.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef
25.
Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005;43:1130–9.PubMedCrossRef
26.
Noordzij M, van Diepen M, Caskey FC, Jager KJ. Relative risk versus absolute risk: one cannot be interpreted without the other. Nephrol Dialysis Transplant. 2017;32:13–8.CrossRef
27.
Papke LE, Wooldridge JM. Econometric methods for fractional response variables with an application to 401(k) plan participation rates. J Appl Econ. 1996;11:619–32.CrossRef
28.
Angrist D. A., Pischke J-S. mostly harmless econometrics - an empiricist's companion. Princeton: Princeton University Press; 2008.CrossRef
29.
Abadie A, Diamond A, Hainmueller J. Synthetic control methods for comparative case studies: estimating the effect of California’s tobacco control program. J Am Stat Assoc. 2010;105:493–505.CrossRef
30.
Trygged S, Ahacic K, Kareholt I. Income and education as predictors of return to working life among younger stroke patients. BMC Public Health. 2011;11:742.PubMedPubMedCentralCrossRef
31.
Glader EL, Jonsson B, Norrving B, Eriksson M. Socioeconomic factors’ effect on return to work after first stroke. Acta Neurol Scand. 2017;135:608–13.PubMedCrossRef
32.
Ashley KD, Lee LT, Heaton K. Return to work among stroke survivors. Workplace Health Saf. 2019;67:87–94.PubMedCrossRef
33.
Westerlind E, Persson HC, Sunnerhagen KS. Return to work after a stroke in working age persons. A six-year follow up Plos One. 2017;12:e0169759.PubMed
34.
Greenwood N, Mackenzie A, Cloud GC, Wilson N. Informal primary carers of stroke survivors living at home-challenges, satisfactions and coping: a systematic review of qualitative studies. Disabil Rehabil. 2009;31:337–51.PubMedCrossRef
35.
Grigorovich A, Forde S, Levinson D, Bastawrous M, Cheung AM, Cameron JI. Restricted participation in stroke caregivers: who is at risk? Arch Phys Med Rehabil. 2015;96:1284–90.PubMedCrossRef
36.
Di Castelnuovo A, Quacquaruccio G, Benedetta Donati M, de Gaetano G, Iacoviello L. Spousal concorance for major coronary risk factors: a systematic review and meta-analysis. Am J Epidemiol. 2008;169:1–8.PubMedCrossRef
37.
Nakaya N, Saito-Nakaya K, Bidstrup PE, Dalton SO, Frederiksen K, Wurtzen H, et al. All-cause mortality among men whose cohabiting partner has been diagnosed with cancer. Epidemiol. 2013;24:96–9.CrossRef
38.
Wang Z, Ji W, Song Y, Li J, Shen Y, Zheng H, et al. Spousal concordance for hypertension: a meta-analysis of observational studies. J Clin Hypertens. 2017;19:1088–95.CrossRef
39.
Appiah D, Schreiner PJ, Selvin E, Demerath EW, Pankow JS. Spousal diabetes status as a risk factor for incident type 2 diabetes: a prospective cohort study and meta-analysis. Acta Diabetol. 2019;56:619–29.PubMedPubMedCentralCrossRef
40.
Jansen NWH, Mohren DCL, van Amelsvoort LGPM, Janssen N, Kant I. Changes in working time arrangements over time as a consequence of work-family conflict. Chronobiol Int. 2010;27:1045–61.PubMedCrossRef
41.
Marshall IJ, Wang Y, Crichton S, McKevitt C, Rudd AG, Wolfe CD. The effects of socioeconomic status on stroke risk and outcomes. Lancet Neurol. 2015;14:1206–18.PubMedCrossRef
42.
Rosengren A, Smyth A, Rangarajan S, Ramasundarahettige C, Bangdiwala SI, AlHabib KF, et al. Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the prospective urban rural epidemiologic (PURE) study. Lancet Glob Health. 2019;7:e748–e60.PubMedCrossRef
43.
44.
National Board of Health and Welfare. Relatives who provides informal care - extent and consequences [Anhöriga som ger omsorg till närstående - omfattning och konsekvenser]. Stockholm: Socialstyrelsen; 2012.
45.
Metadata
Title
Employment transitions for spouses of stroke survivors: evidence from Swedish national registries
Authors
Josefine Persson
Gunnel Hensing
Carl Bonander
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-020-09625-1

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