Study defines risk factors for unemployment in working people with multiple sclerosis

Lauren Strober, Ph.D., at Kessler Foundation recently published results of the first prospective study of employment and multiple sclerosis (MS). Dr. Strober compared two groups of individuals with MS—those 'at risk' and 'not at risk' for unemployment, examining the influences of multiple factors on the likelihood of staying in the workplace. The article, "Determinants of unemployment in multiple sclerosis (MS): The role of disease measures, person-specific factors, and engagement in positive health-related behaviors" was epublished on September 2, 2020 by Multiple Sclerosis and Related Disorders.

Multiple sclerosis affects people aged 20 to 50 years, comprising the peak working years. More than 90% are in the workforce at the time of their diagnosis, but on average, only 30% to 45% are employed after diagnosis. Unemployment has a negative impact on individuals and their families, as well as on society, in terms of lost productivity. Moreover, there are several physical and mental health "costs" associated with one becoming unemployed. Examining the factors that contribute to individuals with MS leaving the workforce is essential to identifying people at risk, and finding ways to help them maintain employment.

For this prospective study, 252 individuals with MS aged 20 to 64, who were working full- or part-time, were recruited through the national and local chapters of the National MS Society. A survey administered at the outset of the study identified 67 participants at risk for unemployment, defined as considering reducing their hours or leaving their jobs in the near future. The 'at risk' and 'not at risk' groups were compared by disease measures, person-specific factors, and health-related behaviors.

"Individuals at risk tended to have progressive disease, more fatigue, poorer coping mechanisms, and less MS self-efficacy," reported Dr. Strober, senior research scientist in the Center for Neuropsychology and Neuroscience Research at Kessler Foundation. "They were also less likely to report engaging in positive behaviors such as healthful diets, exercise, and social and intellectual activities."

"Risk of unemployment is highest during the first three to five years after diagnosis, so we need to be able to intervene early to prevent job losses, and their subsequent impact on physical and mental health, as well as on personal and family finances. This study points to factors related to risk of unemployment that may be amenable to early intervention," said Dr. Strober. "While further research is needed, professionals who provide MS care should be aware of the potential impact of this diagnosis on future employment, and be prepared to intervene before individuals leave the work force."