Work disability in the United States, 1968-2015: Prevalence, duration, recovery, and trends

The Job Leeway Scale: Initial Evaluation of a Self-report Measure of Health-Related Flexibility and Latitude at Work

Purpose Evidence suggests that workers manage health-related challenges at work, in part, by using available leeway to perform work differently. The purpose of this study was to evaluate the reliability and validity of the Job Leeway Scale (JLS), a new 18-item self-report questionnaire designed to assess worker perceptions of available flexibility and latitude to manage health-related challenges at work. Methods Workers seeking assistance for workplace difficulties due to chronic medical conditions (n = 119, 83% female, median age = 49) completed the JLS along with other workplace and health measures. Construct validity was assessed using exploratory factor analysis (EFA), and concurrent validity was assessed by associations with related measures. Results Mean item scores ranged from 2.13 to 4.16 within a possible range of 0-6. The EFA supported three underlying factors: organizational leeway (9 items), task leeway (6 items), and staffing leeway (3 items). Internal consistency (alpha) ranged from 0.78 to 0.91 for subscale scores and 0.94 for the total score. The JLS showed moderate correlations with other work outcome measures including work fatigue, self-efficacy, engagement, and productivity. Conclusion The JLS is a promising new measure with initial support for its reliability and validity to assess worker beliefs of available flexibility to manage health symptoms at work, and this construct may have organizational implications for worker support and accommodation.

Restrictions on persons with disabilities for participating in family and community activities

OBJECTIVE

To identify the influence of functional impairments and limitations activities for persons with disabilities to particípate in family and community activities.

METHODS

This is a cross-sectional study with 4 044 persons with disabilities, selected using probabilistic sampling and a door-to-door active search model in 5 towns in the District of Barranquilla. The data were processed with univariate analysis and bivariate analysis to determine the relationship between the study variables.

RESULTS

55.9% of the population were males, 41.6% were between 15 and 44 years of age, and 92.9% belonged to the lower socioeconomic stratum. 82.9% reported mobility limitations and 99% reported barriers to access non-formal learning activities, 98.6% to access public activities, and 97.5% to access productive activities. Individuals with that a lower limitation in exercising the power of reason, particularly thinking, can increase participation in activities with family and friends (OR, 0.8; 95% CI, 0.6-0.9), with the community (OR, 0.7; 95% CI, 0.6-0.9), religious or spiritual activities (OR, 0.8; 95% CI, 0.7-0.9).

CONCLUSIONS

There is a directly proportional relationship between structural impairment with the development of dependency and limited family, social, and work participation in the persons with disabilities.

Midlife Work Limitations are Associated with Lower Odds of Survival and Healthy Aging

OBJECTIVES

Health conditions that limit work are associated with myriad socioeconomic disadvantages and around half of Americans could face a work limitation at some point in their working career. Our study examines the relationship between midlife work limitations and two aging outcomes: longevity and healthy aging.

METHODS

Using longitudinal data from the Panel Study of Income Dynamics and restricted mortality data, multivariate logistic regressions estimate the odds of desirable aging outcomes around age 65 for individuals with various midlife work limitation histories in samples of around 2,000 individuals.

RESULTS

Midlife work limitations are consistently linked with a lower likelihood of desirable aging outcomes. Temporary limitations are associated with 59% and 69% lower survival and healthy aging odds, respectively. Chronic limitations are associated with approximately 80% lower survival odds and 90% lower healthy aging odds at age 65.

DISCUSSION

Even temporary work limitations can be highly disadvantageous for aging outcomes, emphasizing the need to understand different work limitation histories. Future research should identify underlying mechanisms linking midlife work limitations and less desirable aging outcomes.

Raising employment and quality of life among people with disadvantages - results of a Hungarian project

BACKGROUND

People with disadvantages are a high-risk group of unemployment or underemployment. Disadvantages include disability, under-education, or being a member of a minority, etc. Effective labor market programs could be a key in raising employment and quality of life among this high-risk group of society. The TOP 6.8.2.-15-NA1 project is one of the main Hungarian labor market programs. The project's primary aims are increasing the employability of disadvantaged unemployed and supporting the efficiency of job-seeking.

METHODS

Our goal was to analyze the effects and methodology of the TOP 6.8.2.-15-NA1 project in Hungary. The sample of our study contains participants of the project (n = 300), based in Zala County, Hungary.

RESULTS

After 28 days, 53.3% of participants had a job. At the 180th day status, the rate of employed people was 47.3%. We could identify low-educated participants and older participants as higher-risk groups of long-term unemployment.

CONCLUSIONS

We emphasize the role of these services (job-seeking clubs, organization of job fairs, and mentorship) in the long-term individual success of participants. Improving the employment rate for people with disadvantages is a critical factor for enhancing the quality of life for individuals with disadvantages.

Association of the global activity limitation indicator with specific measures of disability in adults aged below 65

BACKGROUND

health measures as the global activity limitation indicator (GALI) or self-rated health (SRH) allow to quantify and monitor the health of the population. The GALI is widely used in the European Union; however, evidence of its construct validity is still limited. We examine whether the GALI reflects disability in specific living contexts such as self-care, domestic life and work activity, whether it does so consistently across gender and age and its added value concerning SRH.

METHODS

We used the subsample of adults aged 16-64 years (N = 15 934) from the 2009 European Health Interview Survey in Spain and analyzed the data with logistic regression models using the GALI and SRH as response variables.

RESULTS

The GALI was strongly and significantly associated with the three measures of disability: self-care (OR = 22.8, 95% CI: 15.9-32.7), domestic life (OR = 16.3, 95% CI: 13.6-19.5) and work activity (e.g. impossibility to work: OR = 41.9, 95% CI: 30.3-57.8; prolonged sick leave: OR = 10.7, 95% CI: 9-12.7). There were significant interactions with age on all three disability measures and with the gender on one (domestic life), although they were small. SRH was also strongly associated with all three disability measures, but to a lesser extent than the GALI.

CONCLUSIONS

The GALI reflects well and better than SRH, disability in self-care, domestic life and work activity. It is unknown whether the GALI performs equally in other living contexts such as social relations and community life.

Working and disability expectancies at older ages: The role of childhood circumstances and education

The ability to work at older ages depends on health and education. Both accumulate starting very early in life. We assess how childhood disadvantages combine with education to affect working and health trajectories. Applying multistate period life tables to data from the Health and Retirement Study (HRS) for the period 2008-2014, we estimate how the residual life expectancy at age 50 is distributed in number of years of work and disability, by number of childhood disadvantages, gender, and race/ethnicity. Our findings indicate that number of childhood disadvantages is negatively associated with work and positively with disability, irrespective of gender and race/ethnicity. Childhood disadvantages intersect with low education resulting in shorter lives, and redistributing life years from work to disability. Among the highly educated, health and work differences between groups of childhood disadvantage are small. Combining multistate models and inverse probability weighting, we show that the return of high education is greater among the most disadvantaged.

Rising Income Inequality Through a Disability Lens: Trends in the United States 1981-2018

OBJECTIVES

In a context of rising income inequality and policies to improve rights and inclusion for persons with disabilities, this paper examines income inequality trends by household work limitation status in the United States from 1981-2018.

METHODS

Data comes from the March Supplement of the Current Population Survey using the work limitation disability measure to estimate decomposable Generalized Entropy measures of income inequality, and progressivity of government transfers and disability payments.

RESULTS

Over the 1981-2018 period, inequality within the group of households with work limitations has been around 30 percent higher than inequality within the group of households without work limitations. Both households with and without work limitations have seen a similar 70 percent rise in income inequality since 1981. Progressivity of government transfers and disability payments increased among households with limitations, but not among other households.

CONCLUSIONS

Income inequality is higher within the group of households with work limitations compared to other households and has been rising for both groups. Policies aimed to enhance the economic and social participation of persons with disabilities over this period may have mitigated this rising trend. Disability considerations should be part of research and policy on income inequality.

An Enduring Health Risk of Childhood Adversity: Earlier, More Severe, and Longer Lasting Work Disability in Adult Life

Objectives

Childhood adversity has been linked with adult health problems. We hypothesized that childhood adversity would also be associated with work limitations due to physical or nervous health problems, known as work disability.

Method

With data from the Panel Study of Income Dynamics (PSID) (1968-2013; n = 6,045; 82,374 transitions; 129,107 person-years) and the 2014 PSID Childhood Retrospective Circumstances Study, we estimated work disability transition probabilities with multinomial logistic Markov models. Four or more adversities defined a high level. Microsimulations quantified adult work disability patterns for African American and non-Hispanic white women and men, accounting for age, education, race, sex, diabetes, heart disease, obesity, and sedentary behavior.

Results

Childhood adversity was significantly associated with work disability. Of African American women with high adversity, 10.2% had moderate work disability at age 30 versus 4.1% with no reported adversities; comparable results for severe work disability were 5.6% versus 1.9% (both p < .01). Comparable results for whites were 11.3% versus 4.7%, and 3.5% versus 1.1% (p < .01). The association of childhood adversity with work disability remained significant after adjusting for diabetes, heart disease, obesity, and sedentary behavior (p < .05).

Conclusions

Childhood adversity may increase work disability throughout adult life.

Lifetime Disadvantages after Childhood Adversity: Health Problems Limiting Work and Shorter Life

We examine how childhood adversity relates to work disability and life expectancy, using 1999-2015 data from the Panel Study of Income Dynamics. We estimate the probabilities of work disability and death, adjusting for age, sex, race/ethnicity, and education in a nationally representative sample of African American, Hispanic, and white women and men. We find that people in all these groups who experienced high adversity childhoods (individuals with four or more of six adversity indicators) had significantly more work disability and shorter lives than those who experienced no adversity. These findings provide evidence that childhood adversity is associated with substantial disability, and a reduction in life expectancy of at least a decade. Childhood adversity was generally associated with more lost years of life for men than for women, and more disability for women than for men. The results are robust, even when controlling for diabetes, heart disease, depression, obesity, and sedentary behavior.