The Decline in Employment of People with Disabilities: A Policy Puzzle
Industrial & Labor Relations Review DOI:ilrreview/vol57/iss4/90
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ABSTRACT: When patients start dialysis, their employment rate declines and disability benefits are an option. With patient sociodemographic and clinical characteristics including disability income status controlled, we investigated the significance of depressed mood and usual activity level as predictors of patients' continued employment after dialysis start. Incident patients from 296 randomly selected dialysis clinics were surveyed in the Comprehensive Dialysis Study (CDS). Participants provided information about employment status, disability income status, education, depressive symptoms measured by the Patient Health Questionnaire-2 (PHQ-2), and usual activity level/energy expenditure measured by the Human Activity Profile. Age, gender, race, insurance, diabetes, inability to ambulate or transfer, chronic obstructive pulmonary disease, cardiovascular conditions, and hemoglobin and serum albumin values at treatment start were obtained from US Renal Data System files. Dialysis modality was defined at time of interview. Among 585 CDS participants who worked in the previous year, 191 (32.6%) continued working after dialysis start. On the basis of the PHQ-2 cutoff score ≥3, 12.1% of patients who remained employed had possible or probable depression, compared with 32.8% of patients who were no longer employed. In adjusted analyses, higher Human Activity Profile scores were associated with increased likelihood of continued employment, and there was a borderline association between lower PHQ-2 scores and continued employment. Screening and management of depressive symptoms and support for increased activity level may facilitate patients' opportunity for continued employment after dialysis start, along with generally improving their overall quality of life.Clinical Journal of the American Society of Nephrology 09/2010; 5(11):2040-5. · 5.23 Impact Factor
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ABSTRACT: Do non-employed people with disabilities want to work, and if so, what types of jobs do they want? Researchers seeking to explain the low employment rate among people with disabilities have focused primarily on skill gaps, employment disincentives from disability income, accommodation mandates, and (to a lesser extent) employer attitudes and unwelcoming corporate cultures. There has been little attention paid to the attitudes of non-employed people with disabilities. This paper uses the 2006 General Social Survey, a representative national survey of US adults that has disability information and a special supplement on worker preferences, to examine the above question. We find that, relative to their non-disabled counterparts, non-employed people with disabilities are (a) as likely to want a job but less likely to be actively searching, (b) as likely to have prior job experience, and (c) similar in their views of the importance of income, job security, and other valued job characteristics. The results, which vary little by type of impairment, indicate that the low employment rate of people with disabilities is not due to their reluctance to work or different job preferences. Combined with evidence that a large share of new jobs can be performed by people with disabilities, the findings point toward the value of dismantling barriers to employment facing many people with disabilities.Journal of Occupational Rehabilitation 10/2010; 21(2):199-210. · 2.80 Impact Factor
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