Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Insurance Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
BMC Public Health. 2020 Oct 7;20(1):1522. doi: 10.1186/s12889-020-09625-1.
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.
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.
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.
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.
中风的突然发生常常导致身体、情感和认知能力受损。因此，许多中风幸存者需要得到家庭成员的支持。然而，人们对中风事件对配偶就业转换概率的影响知之甚少。本研究旨在：1）调查首次中风是否会影响在职和失业配偶的就业转换概率；2）分析年龄、性别、教育程度和合并症的异质性是否会影响效应的大小。
本基于人群的队列研究的数据来自瑞典全国登记处，时间为 2005 年至 2016 年。全国样本包括 2010 年和 2011 年首次中风幸存者的 1818 名配偶，以及在中风发作前 5 年内有在职或失业的 7399 名匹配对照。采用线性回归分析中风对配偶就业转换的影响，按中风发作前的就业状况进行分层。
中风发作前有在职配偶的就业减少了 1.3 个百分点（95%CI，-2.4，-0.2）。数据还表明，年龄较低、合并症较多、教育程度较低的在职配偶可能面临更大的失业风险。另一方面，中风事件似乎对中风发作前失业的配偶影响有限。
中风幸存者配偶的失业风险似乎在中风发作后增加，弱势群体的风险可能更大。因此，政策制定者有必要实施干预措施，确保这些配偶有机会兼顾照顾角色和继续留在劳动力市场。
