Disability at Work: A Look Back and Forward

Small Empires: How Equipped are Small Business Owners to Hire People with Disabilities?

PURPOSE

This study explores small businesses' knowledge base and practices concerning interviewing and hiring job candidates with disabilities, as they are not required to comply with the provisions of the Americans with Disabilities Act (ADA).

METHODS

We first conducted 18 in-depth interviews with small business owners to explore their knowledge of the ADA, their practices surrounding hiring (for those with and without disabilities), and their sense of the best practices for how a candidate should navigate the interview and request for accommodations. Responses were then used to create a survey of an additional 110 small business owners.

RESULTS

Six themes arose from the interviews, illuminating the steep learning curve involved in each (1) hiring well, (2) the need to trust an employee's character as much as their skill set, (3) the need for an employee to fit within the small business's family-like environment, (4) the preference for job candidates to be transparent about their needs as early as possible, (5) the importance of personal experience with disability, and (6) the difficulty in obtaining precise information about the ADA. Survey responses supported the general findings of the interviews while also providing information about the relative rarity of encountering a job candidate with a disability.

CONCLUSION

Hiring employees with disabilities is challenging for small businesses, and bias is difficult to avoid. The availability of clear information on how to comply with the ADA and other laws and practices would be welcome by many small business owners.

Disproportionately High Rates of Burnout Among Disabled Caregivers During the COVID-19 Pandemic

Background

Burnout is exhaustion caused by exposure to chronic stress. Prior to the COVID-19 pandemic, people with disabilities experienced high levels of burnout due to discrimination, barriers to accessing resources, and lack of accommodations. Caregivers have also experienced high levels of burnout during the COVID-19 pandemic.

Background

While researchers have examined burnout among caregivers of disabled children, less research has focused on the experiences of disabled caregivers. We examined the association between caregiver disability and burnout during the pandemic.

Methods

We distributed an online survey to caregivers of children enrolled in socially vulnerable elementary and middle schools in San Diego County, California between September and December, 2022. Our survey included demographic questions, questions about pandemic experiences, and a continuous burnout measure. We analyzed survey data to test our hypothesis that caregivers with a disability experienced higher levels of burnout than their non-disabled counterparts during the height of the COVID-19 pandemic. We used multivariable linear regression analysis adjusting for household income and caregiver education level.

Results

Disabled caregivers self-reported higher levels of burnout than non-disabled caregivers (B = 0.72; p < 0.001) during the COVID-19 pandemic in bivariate and multivariable analyses. Caregivers with a higher household income (B = 0.04; p = 0.017) and more education (B = 0.13; p = 0.005) also reported higher levels of burnout.

Conclusion

The COVID-19 pandemic exacerbated existing difficulties faced by disabled caregivers who often struggle to balance the demands of caregiving with their available resources. Targeted programs and policies are needed to support disabled caregivers during health emergencies that exacerbate existing inequities in access to resources.

Employment equity groups' experience of inclusion and commitment to the CAF

The Canadian Armed Forces (CAF) are subject to the Employment Equity Act, which requires federally regulated employers to identify and eliminate barriers to the employment of designated groups (women, Indigenous peoples, persons with disabilities (PwD), and racialized members), and establish short-term, numerical goals to address underrepresentation. Addressing employment barriers experienced by these equity seeking groups is one of the CAF's key priorities. The objective of this study is to examine group differences in feelings of inclusion (i.e., relatedness, organizational inclusion, and microaggressions) and retention-related measures (i.e., job satisfaction, affective commitment, and intentions to leave), the contribution of feelings of inclusion to retention measures, and the effect of numerical representation and number of marginalized identities on these concepts. We analyzed data from the 2022 Your Say Matters survey, which was administered to a representative sample of CAF members, with oversampling of under-represented groups. Respondents included 4,483 Regular Force members (30.9% response rate). The groups under study included Indigenous members, persons with disabilities, racialized members, women not part of another group (non-Indigenous, non-racialized, women without disabilities), and everyone else (non-Indigenous, non-racialized, not women, without disabilities). Our hypotheses were supported overall, such that groups with less representation in the CAF scored lower on inclusion measures than groups with more representation. The number of marginalized identities held by military members predicted the inclusion measures, but did not predict retention-related measures. There were some group differences on retention-related measures, such that women not part of another group scored more favorably than other designated groups, and racialized members scored more favorably than PwD and Indigenous members. Inclusion measures predicted job satisfaction, affective commitment, and intentions to leave equally for all groups studied, suggesting that feeling included is important for all.

Employer-focused interventions targeting disability employment: A systematic review

There are a wide range of interventions that are designed to influence employer behaviour with respect to the employment of people with disabilities. This study presents the results of a systematic review looking at employer-focused interventions to improve disability employment, focusing on interventions or policies taking placing in high-income countries as per the OECD. This systematic review focuses on a broad range of potential employment-related outcomes, including the employment rate, time to return to work and length of sickness absence. The results of 71 papers that evaluate the effectiveness of a range of interventions were synthesised into a narrative review. Interventions are grouped into six broad categories: anti-discrimination legislation, quota systems, part-time sick leave, graded return to work and wage subsidy schemes. Anti-discrimination legislation is not effective at improving the employment prospects of people with disabilities. There is mixed evidence with respect to quota systems and wage subsidy schemes. However, the availability of part time sick leave or graded return to work are both consistently associated with improved work participation for people with disabilities.

A contemporary class structure: Capital disparities in The Netherlands

The academic and public debate on social inequality has recently been fuelled by large disparities in income and wealth, profound changes in the labour market, and other emerging cleavages in post-industrial societies. This article contributes to the discussion by arguing that class divisions are theoretically based on four types of capital: people's economic means, their social capital, their cultural resources, and the combination of their health and attractiveness ('person capital'). From this premise, the social structure of the Netherlands is examined. A dedicated survey was linked to microdata from the national population register, tax authorities and benefit agencies. Using latent class analysis, we assess contingencies in the distribution of the different resources, and identify a structure consisting of six capital groups. The established upper echelon (15.5% of the adult population) has the most capital, followed by the privileged younger people (12.7%), the employed middle echelon (26.9%) and the comfortable retirees (16.6%). Total capital is lowest among the insecure workers (13.5%) and the precariat (14.8%). Each social class has a distinctive mix of the four types of capital, highlighting the need to look beyond economic differences in order to comprehend structural inequality. The results of this study also indicate that resource disparities between classes coincide with other forms of social hierarchy and contrasts by age. Moreover, the contemporary class structure is associated with divergent views and experiences among the Dutch. Classes with little capital tend to rate politics, society, and their own social position more negatively. In addition, they value self-enhancement and hedonism less than today's upper classes and report lower levels of well-being.

No evidence that social-democratic welfare states equalize valued outcomes for individuals with disabilities

It is acknowledged that generous welfare states can provide better outcomes to their populations in terms of objective and subjective indicators of well-being, yet there is little comparative evidence of the role that the welfare state regime plays in lessening disability-based inequalities. Using a large comparative data set of most European societies, Tukey's honestly significant difference and generalized Hausman tests for six welfare state regimes, we examine the assumption that social-democratic countries perform better in mitigating disability-based inequalities than conservative, liberal, Southern, Eastern European, and the former Soviet Union welfare state regimes. We compare the valued outcomes for individuals with and without disabilities regarding their education, labour market participation, material well-being, and life satisfaction. The main finding of this study is that the most generous welfare states in Europe do not perform better, and in some cases, perform worse, than other less comprehensive welfare state regimes in closing the gap in valued outcomes between individuals with disabilities and the rest of the population. We discuss potential explanations of these inequalities such as the nature of expectations and changing characteristics of welfare state regimes, and difficulties related to measuring disabilities across European societies.

The Employment Quality of Persons with Disabilities: Findings from a National Survey

PURPOSE

Labour market integration is a widely accepted strategy for promoting the social and economic inclusion of persons with disabilities. But what kinds of jobs do persons with disabilities obtain following their integration into the labour market? In this study, we use a novel survey of workers to describe and compare the employment quality of persons with and without disabilities in Canada.

METHODS

We administered an online, cross-sectional survey to a heterogeneous sample of workers in Canada (n = 2,794). We collected data on sixteen different employment conditions (e.g., temporary contract, job security, flexible work schedule, job lock, skill match, training opportunities, and union membership). We used latent class cluster analysis to construct a novel typology of employment quality describing four distinct 'types' of employment: standard, portfolio, instrumental, and precarious. We examined associations between disability status, disability type, and employment quality.

RESULTS

Persons with disabilities reported consistently lower employment quality than their counterparts without disabilities. Persons with disabilities were nearly twice as likely to report low-quality employment in the form of either instrumental (i.e., secure but trapped) or precarious (i.e., insecure and unrewarding) employment. This gap in employment quality was particularly pronounced for those who reported living with both a physical and mental/cognitive condition.

CONCLUSION

There are widespread inequalities in the employment quality of persons with and without disabilities in Canada. Policies and programs aiming to improve the labour market situation of persons with disabilities should emphasize the importance of high-quality employment as a key facet of social and economic inclusion.

Return-to-work with long COVID: An Episodic Disability and Total Worker Health® analysis

A growing number of working individuals have developed long COVID (LC) after COVID-19 infection. Economic analyses indicate that workers' LC symptoms contribute to workforce shortages. However, factors that affect return-to-work from perspectives of people with LC remain largely underexplored. This qualitative study of people with LC conducted by researchers living with LC aimed to identify participants' return-to-work experiences using Total Worker Health® and Episodic Disability frameworks. 10% of participants who participated in a mixed-method global internet survey, had LC symptoms >3 months, and responded in English were randomly selected for thematic analysis using NVivo12. 15% of responses were independently double-coded to identify coding discrepancies. Participants (N = 510) were predominately white and had at least a baccalaureate degree. Four primary work-related themes emerged: 1) strong desire and need to return to work motivated by sense of purpose and financial precarity; 2) diverse and episodic LC symptoms intersect with organization of work and home life; 3) pervasiveness of LC disbelief and stigma at work and in medical settings; and 4) support of medical providers is key to successful return-to-work. Participants described how fluctuation of symptoms, exacerbated by work-related tasks, made returning to work challenging. Participants' ability to work was often predicated on job accommodations and support. Non-work factors were also essential, especially being able to receive an LC medical diagnosis (key to accessing leave and accommodations) and help at home to manage non-work activities. Many participants described barriers accessing these supports, illuminating stigma and disbelief in LC as a medical condition. Qualitative findings indicate needs for workplace accommodations tailored to fluctuating symptoms, continuously re-evaluated by workers and supervisors together. Reductions in medical barriers to access work accommodations is also critical since many medical providers remain unaware of LC, and workers may lack a positive COVID test result.

Prioritizing Solutions and Improving Resources among Young Pediatric Brain Tumor Survivors: Results of an Online Survey

Pediatric Brain Tumor Survivors (PBTS) often experience social, academic and employment difficulties during aftercare. Despite their needs, they often do not use the services available to them. Following a previous qualitative study, we formulated solutions to help support PBTS return to daily activities after treatment completion. The present study aims to confirm and prioritize these solutions with a larger sample. We used a mixed-methods survey with 68 participants (43 survivors, 25 parents, PBTS' age: 15-39 years). Firstly, we collected information about health condition, and school/work experience in aftercare. Then, we asked participants to prioritize the previously identified solutions using Likert scales and open-ended questions. We used descriptive and inferential statistics to analyze data, and qualitative information to support participants' responses. Participants prioritized the need for evaluation, counseling, and follow-up by health professionals to better understand their post-treatment needs, obtain help to access adapted services, and receive information about resources at school/work. Responses to open-ended questions highlighted major challenges regarding the implementation of professionals' recommendations at school/work and the need for timely interventions. These results will help refine solutions for PBTS and provide key elements for future implementation. Translating these priorities into action will need further work involving professionals and decision makers.

Is the disability wage gap a gendered inequality? Evidence from a 13-year full population study from Norway

Recent research has confirmed the employment disadvantages of disabled people, but disability wage gaps in interaction with gender have not been sufficiently explored. This article asks how the disability wage gap can be accounted for, how the unexplained disability wage gap has evolved over time and how the intersections of disability and gender relate to wage penalties. Norwegian nation-wide annual registry data from the period 2005-2017 (N = 8.5 million) are used to estimate longitudinal pay gaps of disabled men and women in relation to nondisabled workers. The analyses arrive at a persistent residual wage gap for disabled employees. Results confirm that gender is a defining predictor for income, and that disabled women are especially disadvantaged. Implications for intersectional theory are discussed. The current study is a reminder that antidiscrimination legislation and implementation of regulations has not been successful in levelling out injustices experienced by disabled people in the labour market.

Development, fabrication and mechanical characterisation of auxetic bicycle handlebar grip

The auxetic cellular structures are one of the most promising metamaterials for vibration damping and crash absorption applications. Therefore, their use in the bicycle handlebar grip was studied in this work. A preliminary computational design study was performed using various auxetic and non-auxetic geometries under four load cases, which can typically appear. The most representative geometries were then selected and fabricated using additive manufacturing. These geometries were then experimentally tested to validate the discrete and homogenised computational models. The homogenised computational model was then used to analyse the biomechanical behaviour of the handlebar grip. It was observed that handle grip made from auxetic cellular metamaterials reduce the high contact pressures, provide similar stability and hereby improve the handlebar ergonomics.

Evaluation of psychometric properties of Turkish version of assessment of work performance among adults with mild intellectual disabilities

BACKGROUND

Assessment of work performance (AWP) is a test for assessing work performance and can be utilised in matching person-work and applying effective interventions. It was aimed to adjust and to evaluate the validity and reliability of AWP in Turkish with individuals with mild intellectual disability (ID).

METHODS

The study was conducted with 243 individuals with mild ID. Of the 243 participants, data gathered from 105 individuals was used to conduct exploratory factor analysis (EFA) and remaining data (138 individuals) was used to conduct confirmatory factor analysis. Internal consistency, construct validity, test-retest reliability, criterion-related validity and inter-rater reliability were analyzed.

RESULTS

The AWP showed average to good reliability for individuals with mild ID. The construct validity and internal consistency of the AWP were confirmed with satisfying results; test-retest reliability (ICC >0.92) and inter-rater reliability (ICC >0.90) were excellent for all domains. The EFA resulted three factors, explaining 66.46% variance; and CFA resulted average fit.

CONCLUSION

AWP is valid and reliable for evaluating the working performances of individuals with mild ID.

Disability, workplace inclusion and organizational citizenship behavior: an exploratory study of the legal profession

Purpose –

Many workers with disabilities face cultures of exclusion in the workplace, which can affect their participation in decisions, workplace engagement, job attitudes and performance. The authors explore a key indicator of engagement-perceptions of organizational citizenship behavior (OCB)-as it relates to disability and other marginalized identities in the workplace.

Design/methodology/approach –

Using an online survey, legal professionals answered questions about their workplace experiences. Ordinary least squares (OLS) multivariate regression analysis with progressive adjustment was used to investigate the effect of demographic and organizational factors on perceptions of OCB.

Findings –

The authors find that employees with disabilities have lower perceptions of OCB, both before and after controlling for other personal and job variables. The disability gap is cut nearly in half, however, when controlling for workplace culture measures of co-worker support and the presence of an effective diversity, equity and inclusion (DEI) policy. Disability does not appear to interact with gender, race/ethnicity and LGBTQ + status in affecting perceptions of OCB.

Originality/value –

The results point to the workplace barriers faced by people with disabilities that affect their perceptions of engagement, and the potential for supportive cultures to change these perceptions.

Workplace accommodations during the COVID-19 pandemic: A scoping review of the impacts and implications for people with disabilities

BACKGROUND

The COVID-19 pandemic has led to widespread changes in the way people work. Some of these changes represent the same kinds of work modifications or adjustments that have often been requested as workplace accommodations, and which may improve labour market and employment outcomes for people with disabilities.

OBJECTIVE

The aim of this scoping review was to examine the literature on workplace accommodations in the pandemic and their impacts and implications for people with disabilities.

METHODS

Following a search of six international databases, articles were selected by two reviewers, and data were abstracted in accordance with scoping review methodology. A thematic analysis was used to report the relevant findings.

RESULTS

Thirty-seven articles met the inclusion criteria, and three main themes were identified: positive impacts of pandemic-related workplace accommodations on people with disabilities (e.g., improved accessibility, reduced stigma around workplace accommodations, rapid implementation of workplace accommodations, opportunities for advocacy); negative impacts (e.g., worsened physical and mental health, new accommodation needs); and action needed and recommendations (e.g., revisit legislation and policy on accommodations, ensure representation of people with disabilities). Overall, our review identified a mixed assessment of the impacts of pandemic-related accommodations on people with disabilities. However, there was a broader consensus regarding the importance of learning from the experiences of the pandemic to improve workplace accommodation policies in the future.

CONCLUSIONS

The pandemic may present opportunities for improving workplace accommodation policies, but our review also highlights the need for more research examining how workplace changes due to the COVID-19 pandemic have impacted people with disabilities.

Job satisfaction dynamics: how do they impact employment mode choice for people with a disability?

Background

To enhance economic participation for people with a disability in the labor market, a better understanding of how job satisfaction influences employment mode decisions is needed.

Methods

This study uses data collected from 8,345 People with Disability(PWD) workers from waves 3 to 19 of the Household, Income and Labour Dynamics in Australia (HILDA) survey to investigate the relationship between six domains of job satisfaction and employment mode (employee, solo self-employed, and employer) and covariates related to personal, health, socio-economic and employment-related attributes.

Results

Analysis of 25,169 individual-level observations show important differences in the level of job satisfaction across the different employment modes and for different covariates. PWD entrepreneurs reported higher levels of satisfaction with their work, flexibility, and overall satisfaction, whereas employees report higher levels of contentment with salary, job security, and work hours. The findings also highlight interesting differences due to personal, health, socio-economic and employment related attributes.

Conclusions

Collectively, these insights can guide policymakers to enhance entrepreneurial pathways for people with a disability.

Employment Consequences of COVID-19 for People with Disabilities and Employers

Purpose The COVID-19 pandemic has disproportionately affected the lives of people with disabilities (PWD). How the pandemic affects the employment of PWD and employers has yet to be determined. We aimed to investigate the employment consequences of the pandemic as experienced by PWD and employers. The research questions were: (1) What employment effects do PWD experience, and what business changes do employers encounter as a result of the COVID-19 pandemic? (2) What challenges have PWD encountered during the pandemic? Methods Cross-sectional online surveys of 733 PWD and 67 employers in the Midwestern United States. Results Compared to non-disabled peers, PWD encountered more challenges in employment during the pandemic. We found high percentages of both employers and PWD experiencing employment changes and business shutdown during the pandemic. For PWD whose employment was not affected, 14.6% of the participants (n = 107) expected a loss of income and worried about the economic uncertainty of the pandemic. Unemployment for PWD is high due to illness or disability, being laid-off or furloughed, business reductions, and not feeling safe to work. However, only about 18.6% of unemployed PWD (n = 16) received pay or benefits for the time they were not working even though more than half filed for unemployment benefits. Conclusions The pandemic adversely affected employment of PWD as reported by workers and employers. Findings parallel the experience of the non-disabled workforce, but reveal vulnerabilities that reflect disability consequences and the need for job accommodations. Results reveal emergent needs for policy supports to reduce the disparities experienced by PWD in the workplace.

The association of disability status with job tenure for U.S. workers

BACKGROUND: Job tenure is a useful economic indicator. To employees, longer job tenure creates higher rewards in pay, promotion opportunities, and job security. For employers, there are fewer costs in recruitment and retraining when job turnover is low. Marginalized populations, such as persons with disabilities, may find work in various economies, but retention is more difficult. They are often the first to be laid off in struggling economies. OBJECTIVE: The purpose of this study is to highlight differences in individual and employment-related factors associated with job tenure for American workers with and without disabilities. METHODS: Using newly available survey data (N = 1,538), OLS regression is used to estimate job tenure for workers with and without disabilities, controlling for worker sociodemographic characteristics, a job quality index, and job characteristics. All disability types are examined. RESULTS: Multivariate results show that workers with disabilities have shorter job tenure than others when controlling for job quality, individual characteristics and job characteristics. CONCLUSION: Employees with disabilities have shorter job tenure than those without. Given the benefits of lengthened job tenure, further efforts should be made to explore this issue and to develop effective strategies that help those with disabilities retain jobs long term.

Hearing impairment among workers and satisfaction with the use of hearing aids

BACKGROUND: Hearing problems can have adverse effects on an individual’s job performance, as well as on unemployment or underemployment and increased risk of stress-related sick leave. OBJECTIVE: To investigate hearing impairment among workers and satisfaction with the use of hearing aids. METHODS: Cross-sectional study with workers who are hearing aid users. Subjects underwent pure tone audiometry and answered the Hearing Handicap Inventory for Adults and the Satisfaction with Amplification in Daily Life questionnaires. RESULTS: Participants were 36 workers between 36 and 75 years old, with an average age of 53.47 years, 52.7% male and 47.3% female. There was a mild to moderate hearing handicap perception, with worse results for women in the emotional domain. As hearing loss increased, workers’ frustration increased when talking to coworkers. Everyone was satisfied with the use of their hearing aids. Satisfaction increased with increasing age and decreased with increasing hearing loss. The greater the frustration when talking to co-workers, the lower the overall satisfaction with hearing aid use; the lower the satisfaction with the competence of the professional who assisted in adapting the hearing aid; the lower the satisfaction in environments with background noise and overall worse personal image. The worse the attitudes and emotional responses of workers regarding their hearing impairment, the lower the overall satisfaction with the hearing aid. CONCLUSIONS: Despite the use of hearing aids, workers perceive having a hearing impairment, especially women. As hearing loss and frustration in talking with co-workers increased, satisfaction decreased.

Disability and remote work during the pandemic with implications for cancer survivors

PURPOSE

This article examines the extent to which employees worked from home because of the pandemic, focusing on differentials between people with and without disabilities with implications for cancer survivors.

METHODS

We use data on COVID-19 from the Current Population Survey over the May 2020 to June 2021 period. We present descriptive statistics and the results from regression and decomposition analysis.

RESULTS

While workers with disabilities were more likely than those without disabilities to be teleworking before the pandemic, they were less likely to be teleworking as a result of the pandemic. Differences in the occupational distribution account for most of this difference. People with disabilities experienced relatively more pandemic-related hardships as well, compared to people without disabilities, including a greater chance of not being able to work due to their employer losing business and more difficulty in accessing medical care.

CONCLUSIONS

Many people with disabilities benefit from working from home, and the pandemic has increased employer acceptance of these arrangements, but the potential is limited by the current occupational distribution.

IMPLICATIONS FOR CANCER SURVIVORS

While the CPS dataset does not have information on cancer survivorship, we use other data to impute that the average likelihood of cancer survivorship is 12.6% among people with disabilities, more than double the 6.1% rate among those without a disability. Hence cancer survivorship is partly picked up by the CPS questions on disability, and our results have implications for cancer survivors, especially because increased opportunities for telework have the potential to help cancer survivors maintain economic stability and avoid financial hardship.

Workplace improvements to support safe and sustained return to work: Suggestions from a survey of workers with permanent impairments

BACKGROUND

Roughly 10% of occupational injuries result in permanent impairment. After initial return to work (RTW), many workers with permanent impairments face RTW interruption due to reinjury, unstable health, disability, and layoff. This study used open-ended survey data to: (1) explore workplace factors identified by workers as important levers for change, some of which may previously have been unrecognized; and (2) summarize workers' suggestions for workplace improvements to promote sustained RTW and prevent reinjury.

METHODS

This study included data from workers' compensation claims and telephone surveys of 582 Washington State workers who had RTW after a work-related injury involving permanent impairment. The survey was conducted in 2019, about a year after claim closure. We used qualitative content analysis methods to inductively code open-ended survey responses.

RESULTS

The most frequent themes were: safety precautions/safer workplace (18.1%), adequate staffing/appropriate task distribution (16.2%), and safety climate (14.1%). Other frequent themes included ergonomics, rest breaks, job strain, predictability and flexibility in work scheduling practices, employer response to injury, social support, communication, and respect. Many workers reported that they were not listened to, or that their input was not sought or valued. Workers often linked communication deficiencies to preventable deficiencies in safety practices, safety climate, and RTW practices, and also to lack of respect or distrust. In counterpoint, nearly one-third of respondents reported that no change was needed to their workplace.

CONCLUSIONS

Policies and interventions targeting worker-suggested workplace improvements may promote safe and sustained RTW, which is essential for worker health and economic stability.

On the Importance of the Americans With Disabilities Act at 30

This article offers a glimpse of the Americans with Disabilities Act (“ADA”) of 1990, as amended by the ADA Amendments Act of 2008 (“ADAAA”), at its 30th anniversary. It considers current issues before the courts, primarily legal cases from 2020 and 2021, and new questions in light of the COVID-19 pandemic, such the latitude of the ADA’s antidiscrimination protections and its definition of disability. It provides a quick primer on the basics of the ADA: employment discrimination under Title I, antidiscrimination mandates for state and local governments under Title II, and commands to places of accommodation offering services to the public under Title III. The ADA at 30 remains a beacon for a future in which all people, regardless of individual difference, will be welcomed as full and equal members of society.

The role of nonstandard and precarious jobs in the well-being of disabled workers during workforce reintegration

BACKGROUND

Nonstandard employment arrangements are becoming increasingly common and could provide needed flexibility for workers living with disabilities. However, these arrangements may indicate precarious employment, that is, employment characterized by instability, powerlessness, and limited worker rights and benefits. Little is known about the role of nonstandard and precarious jobs in the well-being of disabled persons during workforce reintegration after permanent impairment from work-related injuries or illnesses.

METHODS

We used linked survey and administrative data for a sample of 442 Washington State workers who recently returned to work and received a workers' compensation permanent partial disability award after permanent impairment from a work-related injury. Multivariable logistic regression models were used to examine associations between nonstandard employment and outcomes related to worker well-being and sustained employment. We also examined associations between a multidimensional measure of precarious employment and these outcomes. Secondarily, qualitative content analysis methods were used to code worker suggestions on how workplaces could support sustained return to work (RTW).

RESULTS

Workers in: (1) nonstandard jobs (compared with full-time, permanent jobs), and (2) precarious jobs (compared with less precarious jobs) had higher adjusted odds of low expectations for sustained RTW. Additionally, workers in precarious jobs had higher odds of reporting fair or poor health and unmet need for disability accommodation. Workers in nonstandard and precarious jobs frequently reported wanting safer and adequately staffed workplaces to ensure safety and maintain sustained employment.

CONCLUSIONS

Ensuring safe, secure employment for disabled workers could play an important role in their well-being and sustained RTW.

Entrepreneurship for People With Disabilities: From Skills to Social Value

Entrepreneurship has undoubted social value as it contributes to socio-economic development of the context where entrepreneurship takes place. When the entrepreneurial activity is undertaken among especially vulnerable groups in the labor market, the multiplying effect of this value is made explicit in society, in general, and in the collective of people with disabilities (PWDs), in particular. The objective of this research study is to explore under which conditions this happens through the analysis not only of the relationship between the competencies that PWDs attribute to themselves and their development of the entrepreneurial activity but also of that between entrepreneurship and certain conditions that potentially create value by increasing the autonomy among this collective. A quantitative methodology based on the analysis of the survey carried out on a sample of 224 entrepreneurs with physical, sensory, or organic disabilities throughout Spain has been used. According to the results, entrepreneurs with disabilities (EWDs) have a higher self-evaluation competency. Furthermore, significant results concerning the link between the form of autonomous cohabitation of this collective and entrepreneurship have been obtained.

Workplace Organizational and Psychosocial Factors Associated with Return-to-Work Interruption and Reinjury Among Workers with Permanent Impairment

OBJECTIVES

Roughly 10% of occupational injuries result in permanent impairment and a permanent partial disability (PPD) award. After initial return to work (RTW) following a work injury, many workers with permanent impairment face RTW interruption (breaks in ongoing employment due to reinjury, poor health, disability, lay-off, etc.). Most RTW and reinjury research has focused on worker-level risk factors, and less is known about contextual factors that may be amenable to workplace or workers' compensation (WC)-based interventions. The aim of this study was to identify modifiable organizational and psychosocial workplace factors associated with (i) RTW interruption and (ii) reinjury among workers with a permanent impairment.

METHODS

This retrospective cohort study included WC claims data and survey data for 567 injured workers who RTW at least briefly after a work-related injury that resulted in permanent impairment. Workers were interviewed once by phone, 11-15 months after WC claim closure with a PPD award. Logistic regression models were used to estimate associations between each workplace factor of interest and each outcome, controlling for whole body impairment percentage, gender, age, nativity, educational level, State Fund versus self-insured WC coverage, employer size, union membership, industry sector, and employment duration of current/most recent job.

RESULTS

Twelve percent of workers had been reinjured in their current or most recent job, 12% of workers were no longer working at the time of interview, and <1% of workers reported both outcomes. The most frequently reported reason for RTW interruption was impairment, disability, and/or pain from the previous work injury. Lower reported levels of safety climate, supervisor support, and ability to take time off work for personal/family matters were significantly associated with both RTW interruption and reinjury. Inadequate employer/health care provider communication, perceived stigmatization from supervisors and/or coworkers, and lower levels of coworker support were significantly associated with RTW interruption but not with reinjury. Discomfort with reporting an unsafe situation at work, absence of a health and safety committee, and higher job strain were significantly associated with reinjury, but not with RTW interruption. Inadequate safety training and lack of needed job accommodations were not significantly associated with either outcome. There were no notable or statistically significant interactions between workplace factors and degree of impairment, and no consistent direction of association.

CONCLUSIONS

This study provides evidence that several potentially modifiable organizational and psychosocial factors are associated with safe and sustained RTW among injured workers with work-related permanent impairment. The lack of interaction between any of these workplace factors and degree of impairment suggests that these findings may be generalizable to all workers, and further suggests that workplace interventions based on these findings might be useful for both primary and secondary prevention. Though primary prevention is key, secondary prevention efforts to sustain RTW and prevent reinjury may reduce the considerable health, economic, and social burden of occupational injury and illness.

Initial return to work and long-term employment patterns: Associations with work-related permanent impairment and with participation in workers' compensation-based return-to-work programs

BACKGROUND

Roughly 10% of injured workers experience work injuries that result in permanent impairment and a permanent partial disability (PPD) award. This study aimed to characterize and quantify long-term employment outcomes for injured workers, by the degree of whole body impairment (WBI) and by participation in several workers' compensation (WC)-based return-to-work (RTW) programs.

METHODS

A retrospective cohort of 43,968 Washington State workers were followed for up to 10 years after WC claim closure (2009-2017). Degree of impairment was classified as: (1) no PPD award, (2) PPD award with WBI < 10%, or (3) PPD award with WBI ≥ 10%. State wage files were used to construct employment outcomes for regression, modeling: (1) time to first RTW, (2) time to first RTW interruption, (3) RTW volatility, and (4) employment gaps.

RESULTS

Wage patterns and employment outcomes differed significantly by the degree of impairment. Compared to other workers, workers with WBI ≥ 10% had delayed RTW, shorter average times to first RTW interruption, and higher rates of both RTW interruptions and quarters without wages. Time to first RTW averaged over a year, increasing with the degree of impairment. About 9% overall-and 27% of workers with ≥10% WBI-had no observed wages after claim closure. In adjusted models, workers with WBI ≥ 10% had significantly poorer employment outcomes, compared to workers with no PPD award (p < 0.001).

CONCLUSIONS

State wage files provide an efficient approach to identifying RTW patterns. Workers with permanent impairment were at substantially higher risk of poor employment outcomes. WC-based RTW programs may promote better employment outcomes.

Telework After COVID: A "Silver Lining" for Workers with Disabilities?

Purpose The COVID pandemic was a severe blow to all workers, but it may ultimately have a silver lining for some workers with disabilities if it makes work from home easier and more acceptable. In addition, the pandemic is shaking up traditional workplace structures and causing employers to rethink how essential tasks can be done, which may broaden their views of workplace accommodations. We assess the potential for the pandemic to improve employment opportunities for people with disabilities. Methods This article analyzes pre-COVID data on disability and home-based work from three representative data sources-the American Community Survey, American Time Use Survey, and Current Population Survey. We employ both cross-tabulations and regressions to predict work at home. Results We find that workers with disabilities are more likely than those without disabilities both to work primarily from home and to do any work at home. This is true for both employees and self-employed workers. Workers with disabilities face similar wage gaps in on-site and home-based work, indicating that while increased availability of home-based work may create more employment opportunities for workers with disabilities, it is unlikely to erase wage disparities. While workers with disabilities are currently more likely to be working primarily from home, only 34% are in occupations with high potential for home-based work, compared to 40% of workers without disabilities. Conclusions Workers with disabilities are currently more likely to work from home and many may benefit from expanded work-at-home opportunities, but the types of jobs they hold constrain this potential. Research is needed to see how home-based work evolves as the economy recovers from the pandemic over the next several years.

Job Satisfaction and Turnover Intention Among People With Disabilities Working in Special Employment Centers: The Moderation Effect of Organizational Commitment

With the goal of contributing to the growth of research on people with disabilities in employment, in particular in relation to their job satisfaction (JS), organizational commitment (OC), and turnover intention (TI), this study explores the effect of JS on TI among employees with disabilities and the moderation effect of OC and its four dimensions on this main relationship. A total of 245 Special Employment Center (SEC) employees in Spain answered a questionnaire. To analyze the results, a descriptive analysis with bivariate correlations across the variables was performed, and the moderation model was tested subsequently using macro PROCESS for SPSS by Hayes. For the significant effects, a pick-a-point approximation was used to interpret the results. The results show that OC and its dimensions have no significant effect on the direct relationship. However, some components of JS, such as the relationship with co-workers and with supervisors, play a significant role in the relationship with TI when moderated by affective and value commitment. Our results show that it is important that human resources departments create conditions favoring a work environment with positive interpersonal relationships between employees and managers in order to minimize TI at SECs.

Decision support system for designing and assigning ergonomic workplaces to workers with disabilities

Workers with disabilities are still lagging in employment rates compared to the healthy workforce. Those workers are also more sensitive for stress at work and possible injuries that are usually connected with non-adequate workplace design. Generally, absenteeism presents high costs for companies and costs can be even higher if injuries at work occur. Therefore, companies face the problem of identifying a suitable workplace for workers with disabilities and supplying the needed requirements. The purpose of our research was to develop a decision support system that would aid in the process of identifying and categorising disabilities of workers, and assigning the most suitable workplace with needed requirements in an integrated work environment to ensure high safety, productivity and satisfaction. The developed decision support system is also a step toward prevention of injuries at work. The usefulness of the system has been shown in a case study of a large-sized production company. Practitioner summary: The purpose of our research was to develop a decision support system that would aid companies to identify a suitable workplace for workers with disabilities with needed requirements in an integrated work environment to ensure high safety, productivity and satisfaction with lower costs. Abbreviations: OSHA: occupational safety and health act; UN Convention: The United Nations Convention; EU Directive 89/654/EEC: European Union directive concerning the minimum safety and health requirements for the workplace; ICF: The International Classification of Functioning, Disability and Health; ICD: The International Statistical Classification of Diseases and Related Health Problems; RULA: rapid upper limb assessment; OWAS: ovaco working analysing system.

Association of employment status and income with self-rated health among waged workers with disabilities in South Korea: population-based panel study

OBJECTIVE

This study aimed to examine the association of employment status and income with self-rated health among waged workers with disabilities in South Korea.

METHODS

This study used the Panel Survey of Employment for the Disabled from 2011 to 2015. A total of 951 waged workers with disabilities were selected as baseline subjects in 2011 and were followed up for 5 years. This study used a generalised linear mixed model after adjusting for covariates.

RESULTS

Among 951 waged workers with disabilities, the results showed that 39.3% of workers with disabilities reported poor self-rated health. Workers with disabilities with a precarious employment status and lower income were 1.22 (95% CI 1.21 to 1.23) and 1.81 (95% CI 1.80 to 1.83) times more likely to have poor self-rated health than those with permanent employment and higher income, respectively. A subgroup analysis found that precarious workers with disabilities in lower income households had higher possibilities of poor self-rated health.

CONCLUSION

This study suggests that precarious employment and lower income of waged workers with disabilities are significantly associated with poor self-rated health compared with those with permanent jobs or higher income.

Examining the intersection of policy and occupational therapy: A scoping review

Background.

Policy has direct bearing on occupational therapy practice and is a key dimension of the environment. To date, there has not been a synthesis of how policy is addressed in the occupational therapy literature.

Purpose.

The purpose of this review is to identify and analyze the ways that policy is addressed in the occupational therapy literature.

Method.

We conducted a scoping review of literature on policy and occupational therapy. Articles were analyzed deductively using a policy framework and inductively to identify overarching themes.

Findings.

Sixty-four papers were included for analysis. We present the descriptive information of the included articles according to policy type, sphere of action, stage of policy development, level, and actors. The qualitative analysis uncovered two broad concepts: “awareness” about the relationship between policy and practice and messages pertaining to “action.”

Implications.

There are numerous areas for further research into the policy–occupational therapy nexus, as policy has numerous pathways to shape practice. Practitioners will benefit from better understanding these pathways and actively engaging to align policy with the values of the profession.