Browsing by Subject "employment"
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Item Open Access Do Public Works Programs Have Sustained Impacts? A Review of Experimental Studies from LMICs(The World Bank Research Observer, 2024) Bagga, Aanchal; Holmlund, Marcus; Khan, Nausheen; Mani, Subha; Mvukiyehe, Eric; Premand, PatrickAbstract Many low- and middle-income countries (LMICs) have introduced public works programs that offer temporary cash-for-work opportunities to poor individuals. We review experimental evidence on the impacts of public works programs on participants over the short and medium run, providing new insights on whether they have sustained impacts. Our findings show that public works mainly increase employment and earnings during the program. Short-term positive effects tend to fade in the medium run, except in a few cases in which large impacts on savings or investments in self-employment activities are also observed. We find evidence of improvements in psychological well-being and women's empowerment in some cases, but not systematically, and with limitations in measurement. In some contexts, public works programs also improve market wages, affecting both participants and non-participants. We conclude by outlining directions for future research.Item Open Access The Influence of Unemployment and Disability Status on Clinical Outcomes in Patients Receiving Surgery for Low Back-Related Disorders: An Observational Study.(Spine surgery and related research, 2021-01) Cook, Chad E; Garcia, Alessandra N; Shaffrey, Christopher; Gottfried, OrenIntroduction
Employment status plays an essential role as a social determinant of health. Unemployed are more likely to have a longer length of hospital stay and a nearly twofold greater rate of 30 day readmission than those who were well employed at the time of back surgery. This study aimed to investigate whether employment status influenced post-surgery outcomes and if so, the differences were clinically meaningful among groups.Methods
This retrospective observational study used data from the Quality Outcomes Database Lumbar Registry. Data refinement was used to isolate individuals 18 to 64 who received primary spine surgeries and had a designation of employed, unemployed, or disabled. Outcomes included 12 and 24 month back and leg pain, disability, patient satisfaction, and quality of life. Differences in descriptive variables, comorbidities, and outcomes measures (at 12 and 24 months) were analyzed using chi-square and linear mixed-effects modeling. When differences were present among groups, we evaluated whether they were clinically significant or not.Results
Differences (between employed, unemployed, and disabled) among baseline characteristics and comorbidities were present in nearly every category (p<0.01). In all cases, those who were disabled represented the least healthy, followed by unemployed, and then employed. Clinically meaningful differences for all outcomes were present at 12 and 24 months (p<0.01). In post hoc analyses, differences between each group at nearly all periods were found.Conclusions
The findings support that the health-related characteristics are markedly different among employment status groups. Group designation strongly differentiated outcomes. These findings suggest that disability and unemployment should be considered when determining prognosis of the individual.