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HHS Logo Eagle IconU.S. Department of Health and Human Services

Barriers to and Supports for Work Among Adults with Disabilities: Results from the NHIS-D

Publication Date

U.S. Department of Health and Human Services

Barriers to and Supports for Work Among Adults with Disabilities: Results from the NHIS-D

Pamela Loprest and Elaine Maag

The Urban Institute

October 2001

This report was prepared under contract #HHS-100-97-0010 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and the Urban Institute. For additional information about the study, you may visit the DALTCP home page at http://aspe.hhs.gov/daltcp/home.htm or contact the ASPE Project Officer, William Marton, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. His e-mail address is: William.Marton@hhs.gov.

The authors would like to thank participants at presentations of early versions of these results at ASPE and the NHIS-D conference for helpful comments. The views expressed are those of the authors and should not be attributed to the Urban Institute or its sponsors.

EXECUTIVE SUMMARY

Employment rates for adults with disabilities are significantly lower than for adults without disabilities. This leads many to ask how government policies and programs can better support work for the 11.3 million working-age adults with disabilities. This study investigates what policies might successfully increase work for adults with disabilities by comparing the situation of those 37 percent of adults with disabilities who are working to those who are not.

To investigate this question we focus on three main areas for potential policy intervention:

  • Job search difficulties;
  • Need for specific work accommodations; and
  • Access to and use of transportation systems.

The importance of these three areas is clear. Reducing impediments to finding a job is a necessary first step to increase employment. We explore the reasons adults with disabilities have difficulty finding work. Once on the job, the need for work accommodations, an important aspect of the Americans with Disabilities Act (ADA), becomes critical. We examine the extent to which non-workers report needs for specific accommodations, and how that differs from workers with disabilities. In addition to accommodations on-the-job, other services may make work possible. Transportation to work is especially critical and we address it separately here, examining the role of special and public transit systems for people with disabilities.

To examine these factors, we use information from the 1994 and 1995 Disability Supplements to the National Health Interview Survey (NHIS-D), nationally representative surveys of persons with disabilities that collect information on disability, work, and service needs. We define disability among adults ages 18 to 65 using their self-reports of specific activity limitations supplemented by reports of serious difficulty seeing or hearing, or mobility limitations. By this definition, there are 11.3 million working-age adults with disabilities, 37 percent of whom are working in 1994/1995.

We separate those adults with disabilities who are not working into two categories relative to their likelihood for working: “high likelihood” to work which includes those who either believe accommodations will enable work or report their disabilities are not work limiting, and “low likelihood” to work, which includes those who report they are retired from working or cannot work even with accommodations. Almost a quarter of adults with disabilities who are not working fall under the former classification, the focus of this analysis. The high likelihood to work group has, on average, more activity limitations than adults with disabilities who are working, but far fewer than those in the low likelihood to work group. On the other hand, 17 percent of adults with disabilities who are working have severe activity limitations.

We limit our analysis to workers and non-workers with high likelihood to work in order to focus on the group that is, in a sense, closer to working and who may most easily benefit from policy efforts explored in this analysis -- assistance in looking for work, the provision of accommodations, and appropriate transportation. All references to non-workers in this summary are limited to non-workers in the high likelihood to work group.

Findings

Looking for Work

Difficulties in looking for work are widespread, encountered by more than half of non-working adults with disabilities. The most frequently cited reason for being discouraged from looking for work is the lack of available, appropriate jobs, reported by 53 percent of those with difficulty looking. Lack of transportation (29 percent) and lacking information about jobs (23 percent) are also frequently cited difficulties. Adults with disabilities who have the most difficulty looking for jobs are those who have less education or who lack recent work experience.

Work Accommodations

One-third of non-workers report needing some type of accommodation to work. The other two-thirds either do not need accommodations to work or may be unaware of how specific accommodations might make work possible. This could be particularly true of those who have never worked or have not worked in the recent past.

While a greater proportion of non-workers need accommodations than workers, the types of accommodations most frequently needed are similar. Both workers and non-workers report needing special worksite features, such as accessible parking or transportation stop, elevators, and specially designed workstations, or special work arrangements, such as reduced work hours for more breaks and job redesign, most frequently. Among workers, approximately three-fourths of all needs are met, although special worksite features are the most frequently unmet need.

Overall, need for accommodations limits employment prospects among adults with disabilities. Even after adjusting for differences in severity of disabilities across workers and non-workers, those reporting a need for accommodations have a much lower probability of working than adults with disabilities not reporting an accommodation need.

Transportation and Work

Although public transportation and special transit systems are widely available, use among adults with disabilities is low. About 80 percent of adults with disabilities have one of these systems in their community. However, only about 20 percent of non-workers use public transportation and about 5 percent use special transit systems. Rates of usage are higher for non-workers than workers, even when considering only people who have severe activity limitations. This suggests that use of these systems is not a key difference in employment.

Low use of transit systems is for the most part not because of health or disability-related reasons. Only 12 percent of non-workers and 4 percent of workers with disabilities report they are limited in use of public transportation because of a health problem or impairment. Few reported cost, accessibility, inconvenient hours, unreliability, or difficulties in understanding how to use public or special transportation as reasons for not using them. Among those not using special transit systems, the majority said it was neither needed nor wanted.

Policy Implications

What are the implications of these findings for policy? First, before work can be supported, people need to find jobs. Programs helping with job search or even preparation for job search may alleviate the difficulties some adults with disabilities are having finding work. Programs can provide information about where jobs are or serve as an intermediary between employers and people with disabilities seeking jobs. Programs could be targeted to those with the most difficulty looking for jobs, those who have less education or those who are lacking recent work experience.

Some needs for accommodations among workers and non-workers are not met. Although the ADA should decrease the negative impact that needing an accommodation may have, at the time these data were collected -- five years after ADA’s passage -- need for accommodations appears to decrease the likelihood of work. Additional effort on provision of accommodations and perhaps enforcement of the ADA may increase work. Even among workers, one-quarter of the needs for work accommodations are unmet, accommodations that might open up new employment possibilities.

Public transportation and special transit systems are widely available but few people with disabilities use them. The difficulties people report with transportation systems give some clues to what are not the problems. These results could indicate that workers have other modes of transportation available. But given the high reports of transportation needs, it seems likely that changes that would boost usage in these transportation systems might allow increased work. It could be that public transportation systems do not go where the jobs are or that special transit systems are not set up with provision of regular rides to work as the goal. Further study of the non-disability-related reasons for low usage and exactly how to increase usage is necessary.

I. INTRODUCTION

Reducing barriers to work is an integral part of helping persons with disabilities live up to their full potential. In our society work not only serves as a basic source of income for most families, but also a form of social connection and status in the community. Yet the employment rate of persons with disabilities is extremely low. In 1997, less than a third of working-age adults with disabilities were working, compared to more than three-quarters of all working-age adults.1 Low employment rates result from many factors including disability-related work limitations, lower levels of education and experience (possibly resulting from disability-related limitations), discrimination by employers in hiring or provision of accommodations, difficulty sustaining employment after the onset of a disability, and lack of access to necessary support services.

A number of actions by the Federal Government have sought to increase employment by decreasing barriers to work. The Americans with Disabilities Act (ADA) of 1990 seeks to make work possible by decreasing discrimination against people with disabilities and mandating employer provided work accommodations. In 1998, President Clinton established the Presidential Task Force on the Employment of Adults with Disabilities with a mandate to evaluate existing federal programs to determine what changes, modifications, and innovations may be necessary to remove barriers to employment opportunities faced by adults with disabilities.

Other Federal Government policies have focused on limiting the disincentives to work built into disability benefit programs. The loss of Supplemental Security Income (SSI) or Disability Insurance (DI) benefits, including health insurance coverage, while attempting to transition into the labor force has long been a concern of the policy and advocacy community. In response, the Social Security Administration (SSA) implemented a number of programs to address these issues and encourage the transition to work. Most recently, the Ticket to Work and Work Incentives Improvement Act, enacted in 1999, increases beneficiaries’ choices in obtaining rehabilitation and vocational services. It also allows states to extend public insurance coverage to people with disabilities after they begin working. Other SSA initiatives allow beneficiaries to “try out” work while easing return to benefits, if necessary, and to set-aside resources toward a work goal while receiving assistance. The Department of Labor also supports competitive employment for people with disabilities who are not working with various initiatives.

All of these policies, and others at the federal, state and local level, focus on ways to increase employment among adults with disabilities. This study seeks to add to our knowledge about the factors behind these low employment rates to inform policies supporting work. We ask the question,”What helps or hinders work among persons with disability?” In particular we focus on three main areas for potential policy intervention:

  • Job search difficulties;
  • Need for specific work accommodations; and
  • Access to and use of transportation systems.

Clearly, reducing impediments to finding a job is a necessary first step to increase employment. We explore the reasons adults with disabilities have difficulty finding work. The need for work accommodations, an important aspect of the ADA, is also critical. We examine the extent to which non-workers report needs for specific accommodations by type, and how that differs from workers with disabilities. In addition to accommodations on-the-job, other services may make work possible. Transportation to work is especially critical, important in both looking for work and maintaining work, and we address it separately here, examining the role of special and public transit systems for people with disabilities.

To examine these factors, we use information from the 1994 and 1995 Disability Supplements to the National Health Interview Survey (NHIS-D). The NHIS-D is the only nationally representative survey focused on persons with disabilities. The relatively large sample of working-age persons interviewed in this supplement, over 16,000, allows for more detailed analyses than other data. In addition, these data contain unique information not available from other sources. This includes not only great detail on disability, but work history, need for and use of services, and specific need for and use of work accommodations. While all information is self-reported, allowing for some differences in interpretation across individuals, these data are a unique source of valuable information.

Throughout the study, where possible, we compare results for working and non-working adults with disabilities. This allows us to focus not only on why some adults with disabilities are not working, but ask what is making work possible for those adults with disabilities who are employed. We include a discussion of the differences in work-related characteristics across these two groups, including education and prior work experience.

In addition, we recognize the great variance in situations of those adults with disabilities who are not working, including health, disability, family, and resources. A contribution of this study to the current body of literature surrounding work and disability is to acknowledge this heterogeneity and attempt to focus on those adults with disabilities who have a higher likelihood of employment and may derive greater benefit from the policy interventions we discuss. The next section of the paper discusses our definition of disability and our categorization by likelihood of employment.

How Do We Define Disability?

Before discussing how to support work among adults with disability, we must define who we include in the group. There are many ways to define a sample of working-age adults with disabilities. For example, definitions can rely on sets of conditions or impairments, receipt of disability benefits, use of assistive technology or personal aids, or self-reported limits on work. Each definition will undoubtedly include different groups of individuals. In this research, we sought a definition that was relevant to ability to work, but could be implemented with similar results among those who are working and not working.

The work in this paper begins with a definition of disability based on adults ages 18 to 64 with some level of difficulty in performing at least one of a specific set of activities or unable to perform at least one of a set of functions. This definition is useful because it includes those individuals whose condition or impairment has manifested itself as a limitation in one of a wide range of daily activities that likely impact employment. The specific activities considered include standard measures of activities of daily living (ADLs) and instrumental activities of daily living (IADLs)2, and physical functions that include lifting 10 pounds, walking up 10 steps, walking a quarter mile, standing for 20 minutes, bending down from a standing position, reaching up over the head or out to shake a hand, using fingers to grasp, and holding a pencil. These activity-type questions are freer of bias than questions that identify disability by asking about a person’s ability to work. Prior research has shown that unemployed people are more likely to report a work disability than workers with the same level of limitation, potentially because disability is a more socially-acceptable reason for being out of work. But even more important, because we want to compare working and non-working people with disabilities, we need to identify the presence of a disability by a characteristic other than a person’s ability to work.

Activity-based definitions may exclude some individuals who report no activity limitations but might be considered by employers to have a disability, such as those who are blind or deaf. Since employer perceptions affect hiring, promotion, and accommodation decisions, this is an important consideration. For example, by the definition outlined above, we would exclude about half (52 percent) of those who report having serious long-term difficulty seeing even when wearing glasses, because they do not report any limitations in this set of activities and functions. Excluding this (and similar) groups could be eliminating the most successful group of adults with disabilities, those with disabilities but no self-reported activity limitations. For this reason, we add to the function-based definition those who report serious difficulty seeing or hearing, or use of mobility aids expected to last at least 12 months.

We do not explicitly include people with mental health problems. While the NHIS-D includes questions to help identify this group, there is disagreement about how well the available questions capture this group. However, persons with mental health problems who have trouble with the activities discussed above are included.

By this definition, we find that 11.3 million adults ages 18 to 64 have a disability, 7 percent of all working-age adults. Among working-age adults with a disability, 20 percent have a disability but report no activity limitations, 47 percent have a moderate limitation (defined as limited in some activities but not entirely prevented in any activities), and 33 percent have a severe limitation (unable to perform at least one activity) (exhibit 1).

Our estimates are within the range of estimates based on other commonly used data and definitions. Defining disability as reporting a limitation in the amount or kind of work that can be performed due to a chronic condition or impairment, the1990 Current Population Survey shows 10.1 percent of the population from age 16 to 64 has a disability.3 Using a definition that includes only people with ADL and IADL difficulties based on 1993 Survey of Income and Program Participation data, researchers estimate the prevalence of disability for working-age adults to be 6.5 percent.4

Who is Most Likely to Become Employed?

Prior studies find lower employment rates among adults with disability than among adults without disabilities. Results from the NHIS-D confirm this. While 79 percent of adults without disabilities were working at the time they were interviewed in 1994 or 1995, only 37 percent of those with disabilities were employed5 (exhibit 2). Among workers, a smaller proportion of people with disabilities work full-time (35 or more hours per week) than people without disabilities -- 74 percent compared to 84 percent.

For policy makers searching for ways to increase employment rates among adults with disabilities, it is important to distinguish among the diverse groups of non-working adults with disabilities. The extremely low employment rates cited above mask some important differences in the likelihood that a person with a disability will work.

In this paper, we distinguish between those non-working adults with disabilities who have a high likelihood of future work and those with a low likelihood of future work, focusing on the former. These groupings are based on a person’s self-reported retirement status and their perception of whether there is any accommodation that could make work possible.

We categorize about a quarter of non-working adults with disabilities as having a high likelihood for work, and about three-quarters as having a low likelihood for work (exhibit 3). We define high likelihood of work as those who report they are not prevented or limited in work by their health or report they could work with accommodations. Of all non-working adults with disabilities, 8 percent report they are neither prevented nor limited in work due to health or disability, 4 percent report they are entirely prevented from working but could work with accommodation and 12 percent report they are limited in work due to health or disability, but could work with accommodations. It is likely that not all of this group are involuntarily out of work. For example, some are parents who are choosing to stay home with their children similar to some people without disabilities who are not working.

A person’s retirement status or perception that accommodations will not help them work defines the group of low likelihood to work people. A large number of adults with disabilities who are not working classify themselves as retired (exhibit 3). Most say they are retired for disability or health reasons (43 percent of all non-working adults with disabilities), while another 5 percent say they are retired for non-health reasons. Although some of these former workers could return to work with appropriate supports, the probability is likely lower than for non-retired adults with disabilities who are not working. Only about 4 percent of those saying they are retired report that they could have continued working at the time of retirement. Because only about a third of those who said they could have continued working retired in the last five years, it is unclear how effective support policies now could be. For those retiring for other than health or disability reasons, retirement connotes a voluntary decision to change work status that also reduces their likelihood to return to work.

Significant work-related limitations -- people who felt that even with accommodation they could not work -- are less common than retirement. Among adults with disabilities who are not working, about a quarter are not retired and say they are entirely prevented from work and would not be able to work even with accommodations (exhibit 3). An additional 2 percent are entirely prevented from working and do not know if accommodations would help.

As we would expect, severity of disability strongly correlates with whether an adult with disability is working, or has high or low likelihood for work. Measuring severity of disability by the level of limitation in the set of daily activities described earlier, we find that workers have the least severe disabilities, followed by those non-workers with high likelihood, and then those with low likelihood (exhibit 4). For example, only 17 percent of workers with disabilities have severe activity limitations compared to 26 percent of those with high likelihood of work and about half of those with low likelihood of work. This highlights the somewhat obvious fact that part of the answer to what makes work possible for some adults with disabilities and not others is that their disabilities are, on average, less severe. This fact must be remembered in interpreting all the results described in the remainder of this report. Even among those with high likelihood of work, disability is more severe than those who are already working. On the other hand, these results also reveal that almost a quarter of those with severe activity limitations are working.

Other major differences between those categorized as low likelihood to work compared to high likelihood to work include sex, age, education, work experience, and benefit receipt (exhibit 5). A smaller percent of those with low likelihood to work have graduated from high school and many more have never worked (25 percent compared to 12 percent). About half as many in this category are currently doing volunteer work than those in the high likelihood to work group. In addition, far more of the low likelihood to work group are receiving SSI or DI government disability benefits, 58 percent compared to 23 percent. All of these characteristics are connected to lower probability of work for the low likelihood to work group.

In the rest of this paper we limit our analysis to those non-workers with disabilities who fall into the high likelihood to work category. This division allows us to examine the particular needs of the group that appears, in a sense, “closer” to working. They may benefit most from help in finding jobs, specific work accommodations or transportation services, which is the focus of this paper.

We are not suggesting that those in the low likelihood to work group would not benefit from work support policies. Since our categorization relies on self-reports, it is possible that some non-working persons with disabilities do not think they can work because they lack information on potential accommodations or services that might make work possible. Provision of this information and services could increase work. In fact, many current policies to help people with disabilities move into the labor force are aimed at government disability benefit recipients, more of whom are in the low likelihood group. However, we do think that additional policies can be developed that might have greater benefit for the high likelihood to work group.6 In the rest of the paper, for ease of presentation, when we refer to non-workers we mean non-workers with a high likelihood to work.

How Do Workers and Non-Workers with Disabilities Differ?

Differences in characteristics across workers and non-workers point out some factors that may play a key role in work activity and are important to note before examining other potential policy interventions. Sex, race, age, and marital status of adults with a disability varies across current workers and non-workers (exhibit 5). Non-workers are much more likely to be female (71 percent) than current workers (53 percent). This could in part reflect the greater likelihood across all populations of women choosing to remain out of the labor market, at least for some period of time. But since women tend to earn less than men, it may also reflect a “dual” discrimination -- being female and having a disability -- that limits women with disabilities’ participation more than men’s. The same could be argued for the percentage of workers versus non-workers that are not white (13 percent versus 20 percent). While this differential is smaller than for sex, it may also represent some “dual” discrimination based on disability and race. If this is true, policies focusing on supporting non-workers moving to work should take race and sex discrimination into account.

Workers and non-workers have similar age distributions, meaning age is not a likely barrier to this groups’ ability to work. Current workers with disabilities are more likely to be married (64 percent) than those not working (56 percent). A spouse may make work easier by providing assistance in preparing for or getting to work. Having another adult in the household might serve the same purpose. We find that the percentage of workers and non-workers with another adult in the household is similar, 69 percent compared to 67 percent.

Higher levels of education and greater prior work experience are likely to increase work either by making finding work easier or by increasing the stability of work after entering the labor force. This increased stability comes from the higher wage rates received by those with more education and work experience as well as the lower overall turnover rates of jobs in the “more-skilled” sector of the labor market.

One of the largest differences we find among workers and non-workers is their level of education (exhibit 5). Only 18 percent of workers have less than a high school education compared to almost a third of non-workers. One-fifth of workers have at least a college education compared to only 8 percent of non-working adults with disabilities. The lower education levels of non-workers could be reflecting education interrupted or made more difficult by the relatively more severe disabilities of people in this group. However, it seems clear that increasing education levels may well be one route to increasing work.

Gaining work experience also increases the likelihood of future work. Not all adults with disabilities who are not working now have never worked. For some working adults a disabling incident may have ended a job. Others may just be between jobs, although only a small percentage report they are currently unemployed. More than half (54 percent) of non-workers report they have worked in the past five years (exhibit 5). This fairly recent work experience is positive news for helping people move back into work. Only 12 percent of the non-working group report having never worked. This group may require additional job placement support or participation in programs that provide on-the-job or “real-world” job training to help them find that first job (in addition to any workplace accommodations they may need). Participating in volunteer work can help substitute for work experience and in some cases lead to jobs. Of non-workers, 15 percent report they are currently participating in volunteer work.

These results suggest that, demographically, there are many similarities between non-workers and workers. However, lower education levels and less work experience are barriers to work and need to be kept in mind as context when interpreting other results. In the next three sections we discuss three specific areas where policy can make a difference for adults with disabilities trying to move into work: looking for work, workplace accommodations, and transportation to work.

II. LOOKING FOR WORK

When considering policies to support work, we often focus on those factors necessary to carry out job duties, such as worksite accommodations or personal assistance. But there are many steps along the road to employment including deciding to seek employment, preparing to undertake a job search, finding out about job openings, applying and interviewing for jobs, and being hired. All of these “pre-hiring” steps are essential to employment and potential points for policy intervention. We group them together under the category looking for work.

In the survey, non-workers were asked whether an ongoing health problem, impairment, or disability makes it difficult for them to look for work.7 More than half, 55 percent, said yes (exhibit 6). This means that before dealing with problems associated with working, many people are having difficulties even looking for a job.

Why are Non-Workers Discouraged from Looking for Work?

What kinds of problems are adults with disabilities having looking for work? What parts of the job search process pose the biggest challenge? Non-workers were asked the reasons they were discouraged from looking for work.8 Among those reporting a difficulty looking for work, the most frequently given answer, 52 percent, was that no appropriate jobs are available (exhibit 7). This could mean there were no openings for jobs with appropriate accommodations or there were no jobs in the right occupational field. It could also be interpreted that the respondent was unable to locate openings. Past studies have shown that networks of employed friends or acquaintances and personal referrals are important ways people find jobs. In addition, many employers use informal methods to find employees. Groups that are more isolated from mainstream employment, such as inner city residents of poor neighborhoods, have been found to lack these employment networks as a source of finding out about job openings. Persons with disabilities may, to some degree, be in a similar situation, lacking these same types of networks. Another possibility is that persons with disabilities may be less likely to be referred by employed friends and acquaintances than those without disabilities. If either of these are true, then more formal job information resources, such as community groups or local government job agencies, may fill the void. This is supported by the fact that 23 percent of respondents who were discouraged from looking indicate they lacked appropriate information about jobs.

The second most common reason for being discouraged from work, given by more than a third of this group, is family responsibilities. This could be reflecting difficulties in balancing care for children or other adults and work, such as need for child care. It could also reflect a reason people choose not to work at all, a voluntary decision not to look more than a barrier to work. In general labor force surveys, women are more likely to give this answer as a reason for not working. This fits with our earlier report of a higher percentage of women with disabilities among non-workers than among workers.

Almost a third of those with difficulty looking for work report lack of transportation as a problem. This could include lack of access to public or private transportation or inability to use public transportation (we discuss these later). Lack of transportation would also be a problem if public transportation is available, but does not go where the job openings are. This is a commonly cited problem for city residents when job growth is mainly suburban. If lack of transportation is a relatively large problem in looking for a job, it is likely to continue to be an issue in accepting a job or may limit the geographic scope of job opportunities.

Another important reason given for being discouraged from looking for work is inadequate training. Training can take many forms from formal education to on-the-job instruction. We have already seen that among persons with disabilities, those who are not working are far less likely to have completed high school or college than those who are working. Inadequate training could also be diminishing job search opportunities because some non-workers with low education levels are in school or training. A greater percentage of non-workers do report being in school or other job training program (8 percent) than workers (4 percent), but the percentage is still relatively low.

Fear of loss of benefits, either government or private, is another reason given for being discouraged from working. Twenty percent report fear of losing health insurance or Medicaid, 16 percent loss of SSI, SSDI, or other income, and 9 percent loss of housing.9 The extent to which loss of benefits is a deterrent to work has been well studied. Aware of these deterrent effects, policy makers, particularly at the SSA, have implemented rule changes and continue to experiment with programs to encourage work by limiting loss of benefits (or easing return to benefits), and allowing continuation of public health insurance coverage while a person is making the transition to finding a stable job with employer provided health insurance.

The final reasons given for being discouraged from looking for work are fears about access to the full complement of opportunities once on the job and being discouraged by family or friends. About a tenth of those with difficulties searching for work report they believe they would be refused training, promotion, or a transfer by employers. This fear may be based on their own past experience, highlighting how discrimination can reduce future employment. Continuing enforcement of the ADA to combat unfair lack of access to opportunities to grow on the job can not only increase employment opportunities directly, but could have the effect of encouraging those who experienced past discrimination to search for work. To the extent this belief of discrimination is unwarranted or based on outdated information, job information intermediaries, as mentioned earlier, can help.

As for the 14 percent who are discouraged from working by family or friends, education about work possibilities for those with disabilities and information on how many persons with disabilities are working may help. Family and friends may be discouraging work because of additional burdens that may fall to them if a relative or friend with a disability goes to work. To the extent that this is true, resources that can help a person with disabilities to be more independent may help to encourage work. This could include accommodations that assist people getting ready for or getting to work such as a personal assistant or appropriate transportation.

Who Reports the Most Difficulty Looking for Work?

Not surprisingly, difficulty looking for work because of an ongoing health problem is higher among those who are less “prepared” for the labor market. That is, those with lower levels of education and less recent work experience (exhibit 8). About half of those with high school or less education have difficulty looking for work, while only a quarter of those with a college education have difficulty. This could mean that information is more available to those with higher education levels or the type of jobs they seek are more formally advertised. Those who have not worked in the past 5 years are much more likely to have difficulties looking for jobs. Almost three-quarters of this group reported difficulties compared to less than half of those who had worked in the past 5 years. Clearly, recent experience having a job is valuable in finding another job.

Among non-working adults with disability there are differences in severity. Those with more severe levels of disability have greater difficulty searching for jobs. Sixty-two percent of those with severe limitations (i.e., unable to perform one or more of the considered activities) report job search difficulties compared to 32 percent of those without activity limitations. While we often discuss accommodations to make work possible, the higher level of difficulty searching for those with severe limitations indicates a need to consider ways to make accommodation available for job search as well. Some search needs are the same as work accommodation needs, such as transportation. But others may be specific to looking for work. These may include ensuring that job information or preparedness activities (e.g., resume preparation, interviewing techniques) provided by community or government agencies are accessible to persons with more severe activity limitations.

III. WORK ACCOMMODATIONS

Even after locating a job, people with disabilities may require workplace accommodations to begin working or to maintain a job after the onset of a disability. This idea was implicit in the passage of the ADA in 1990 which required that all employers with more than 25 employees provide reasonable accommodations to people with disabilities unless the accommodation would cause an unreasonable hardship on business operations (Public Law 101-336).10

In this section, we ask to what extent do non-workers with disabilities report needing accommodations to work and what specific accommodations do they need?11 We also address what accommodations current workers with disabilities have and how this compares to the needs non-workers with a high likelihood of working report. Finally, we touch on the question of whether needing an accommodation lowers the probability that a person with a disability will be working. Needing an accommodation may serve as a disincentive for employers to hire people with disabilities and decrease employment.

We focus on accommodations that employers could provide rather than accommodations that employees could make, for example by changing jobs. Both types of accommodation have been documented in previous research.12 One important shortcoming in the data is that the source for workers’ current accommodations is unknown. For example, if a worker reports having a reader, it is not clear if the employer or employee (possibly via an outside agency) is providing this service. This makes it impossible to use this information to determine the extent to which employers had responded to the ADA in this relatively early stage of implementation.

What Accommodations do Non-Workers Need?

Adults with disabilities who are not working but are categorized as having a high likelihood for work were asked whether they need an accommodation to work.13 They were also asked whether they each needed of a list of specific work accommodations. We group accommodations into four categories: worksite features, special work arrangements, equipment needs, and assistance. Worksite features include handrails or ramps, accessible parking or transportation stop, elevator or special elevator, modified workstation, special needs restroom, and automatic door. Special work arrangements are those accommodations that require changes in type of work or hours including reduced work hours for increased breaks, reduced or part-time work hours, and job redesign. Equipment needs include special office supplies, Braille, enlarged print, special lighting or audio tape, voice synthesizer, TDD, infrared system, or other technical device. The assistance category includes job coach, personal assistant, reader, and oral or sign language interpreter. Each person can indicate multiple needs.

Approximately one-third of non-workers need some type of accommodation in order to work (exhibit 9). This level of reported need for accommodations could suggest that need for work accommodations is not a major impediment for work, at least for a majority of non-working adults with disabilities. On the other hand, it is possible that those who are not working do not know what kinds of accommodations are available, making reporting of specific accommodation needs difficult. If this is the case, a key step in assisting people with disabilities to work may be providing information about the potential benefits and uses of various types of accommodations.

The most common type of accommodation that non-workers with disabilities need is a worksite feature (26 percent), followed by special work arrangements (12 percent), equipment needs (7 percent) and assistance (7 percent). Eight percent of people with disabilities in this group report needing some other (not specified) type of accommodation (number not shown in table). A high number of persons needing accommodations have multiple needs. The median person who needs any accommodation reports needing five accommodations.

Having accessible parking or an accessible transportation stop close to the building is the most commonly needed worksite feature (needed by 19 percent of non-working people with disabilities), followed closely by the need for an elevator (17 percent), need for workstation adaptations (15 percent) and handrails or ramps (10 percent). A smaller proportion of people report needing an automatic door or a restroom designed for persons with special needs (about 5 percent). Since many people have multiple accommodation needs we should not interpret these findings as meaning 19 percent of non-workers could work if only accessible parking or transportation stops were available. Presumably, all of a person’s needs would have to be met in order for them to be able to work at their maximum potential. However, a person may be able to do certain jobs if they receive some but not all of the required accommodations.

Among the worksite features, there is a wide variety of complexity associated with each accommodation. For instance, adapting a workstation may be a relatively easy task compared with installing an elevator. However, these “bigger” changes tend also to be one-time accommodations that can ultimately provide accommodation for more than one person. For example, if an employer installed an elevator in order to accommodate the needs of one employee, most likely that elevator would remain to benefit future employees with disabilities as well. As the number of firms that have employees with disabilities increases, accommodations that are fairly permanent in nature should become more prevalent. To the extent that this happens, needing one of these accommodations should become less of an impediment to employment over time.

Among non-workers needing special work arrangements, approximately 10 percent report needing a reduction in work hours to allow for more breaks. Another 10 percent report needing reduced or part-time work hours and 8 percent report needing job redesign, that is, modification of difficult job duties or slowing the pace of tasks. Because of the similarity in these accommodations, most who report needing one of these accommodations report needing more than one.

Each of the accommodations classified as equipment are needed by less than 5 percent of people with disabilities. The most common accommodation in this category is the need for special pens or pencils, chairs, or other office supplies needed by nearly 5 percent of non-working people with disabilities. These accommodations seem more straightforward to implement and perhaps even less costly than the need for accommodations classified as assistance, reported by about 7 percent of non-workers. Within the assistance category the largest need reported is for job coaches to help train or supervise people with disabilities, reported by about 6 percent of people. This is likely a more intense and ongoing form of accommodation than other accommodations.

Who Needs Accommodations?

Need for accommodation may in part be a reflection of a more severe disability. Since severity of disability itself affects employment prospects, examining the connection between severity and accommodation needs can help us try to disentangle how need for accommodation separately affects employment. Exhibit 10 shows accommodation needs in each of the broad categories across severity of disability. Recall that severe disability is defined as being unable to perform at least one activity, while moderate includes those having difficulty with at least one activity. Without activity limitations includes those with serious seeing, hearing, or mobility problems who report no difficulty with activities. About one-third of people with severe or moderate disabilities report needing an accommodation -- 39 percent and 33 percent, respectively. This is significantly larger than the 21 percent of people with disability but no activity limitations who report needing an accommodation.

This overall relationship between severity of disability and need for accommodation is driven by the need for worksite feature accommodations. As severity of disability increases, the probability of needing a worksite accommodation also increases from 16 percent of people with no limitation to 37 percent of people with severe limitations. However, in the special work arrangements accommodation category, differences are only observed between people with moderate or severe limitations as compared to those with no limitations, roughly 14 percent versus 4 percent. And there are no significant differences across severity levels in the need for special equipment or assistance accommodations. This shows that while people with more severe disabilities are more likely to need some specific types of accommodations, this is not true for all work accommodations.

What Accommodations are Workers Using?

How do the work accommodations being used by current workers with disabilities compare to the needs reported by non-workers? A smaller proportion of workers report using accommodations compared to non-workers who report needing accommodations. Exhibit 11 shows that about 18 percent of workers with disabilities report using some sort of accommodation. Again, a person may be using more than one accommodation. In addition, the intensity of use among workers is lower than need among non-workers -- the median worker who uses at least one accommodation reports using only that one accommodation compared to the five reported needs for non-workers needing at least one accommodation.

Although workers use fewer accommodations than non-workers report needing, comparison of the specific types of accommodations used and needed can provide insight into whether need of a particular accommodation seems to be a greater barrier to work. For example, if a smaller percent of workers with disabilities report having a modified workstation than non-workers who report needing this accommodation, it might be that need for this specific accommodation is a barrier to work. However, we find that the specific types of accommodations most commonly reported as used and needed are similar. By category, the proportion of workers with disabilities reporting worksite feature accommodations at work is 13 percent. For work arrangements it is 4 percent, with 2 percent each for equipment needs and assistance. These figures suggest no obvious difference between the types of accommodations used by workers versus the types of accommodations needed by non-workers.

A shortcoming of the data is that the source of this accommodation is unknown. It is possible that the accommodation was made possible by the employer, that an outside employment program provided the accommodation, or the accommodation could be privately financed by the individual with the disability. We can say that, at the very least, the accommodations that workers currently have represent a measure of availability of these particular accommodations -- and that this availability seems to fall roughly in line with the types of accommodations people are reporting needing.

What Accommodations Needed by Workers Remain Unmet?

Some accommodation needs reported by workers have not been met by their employers. In the survey, it is possible to examine which needs for accommodation reported by workers have been met and which have not. Although the questions asked are phrased in a manner that indicates needing the accommodation in order to work14, some workers report that they need an accommodation but do not have it. It is possible that people interpret the question as what accommodations they would need to do the job they think they should be doing or to work at their maximum potential. This could mean working at an entirely different job or taking on more tasks or responsibilities in their current job. Having an accommodation might open up a broader range of job possibilities, which could also have implications for higher wage rates or promotions. Essentially, not having certain accommodations could be holding working adults with disabilities back.

About one-quarter of workers with disabilities who report an accommodation need also report that they do not have that accommodation on their job. This is about 6 percent of all workers with disabilities. The only exceptions where unmet need is significantly higher is for two specific worksite features. Almost two-thirds of people who need a job coach do not have one and about 60 percent of people who need some type of job redesign (modifications of difficult job duties or slowing the pace of tasks) do not have that accommodation. Since both of these accommodations are intended to allow people to do different jobs, this suggests that adults with disability who are already working could use accommodations to help them expand their opportunities.

This information has implications for non-workers with multiple work accommodation needs. It may be possible to work with only a subset of those accommodations being met. Some accommodations may be “critical” to enabling some type of work while others are less critical -- but perhaps necessary for people to hold certain types of jobs.

How Does Need for an Accommodation Affect the Probability of Work?

A smaller proportion of people with disabilities who need an accommodation are employed than people with disabilities who don’t need an accommodation. Even after we control for demographic characteristics (education, age, sex, race, and marital status) and the severity of one’s disability, we still observe significant differences in employment rates by accommodation need. Comparing two people with identical characteristics except for needing an accommodation, the adjusted employment rate for those needing an accommodation is 66 percent compared to 75 percent for those who do not need an accommodation (exhibit 12).15

This means that while the observed difference in employment rates is in part due to differences in the characteristics of the group -- for instance the fact that non-working people with disabilities have, on average, more severe disabilities than people with disabilities who are working -- some of the difference is attributed to need for an accommodation. Even those with similar levels of education, and severity of disability will have different probabilities of working if they report needing an accommodation. This could in part reflect a lower likelihood of being hired when asking for a work accommodation.

IV. TRANSPORTATION AND WORK

Transportation can also be critical to seeking, finding, and maintaining employment. Although integral to employment for most people, transportation is of particular concern for people with disabilities who may have fewer transportation options available to them than their non-disabled peers. As we have already shown, transportation is cited as a major reason for difficulty in looking for work among adults with disabilities. Problems with transportation are also common reasons for low job retention.16 Accessible parking and transportation stops are reported as needed accommodations by 19 percent of non-workers with disabilities. Because of its prominence, this section explores the role of public transportation and special transit systems in work for adults with disabilities.

Although there are many different ways people get to work, including driving, sharing rides, buses or trains, we focus here on public transportation systems and transit systems for persons with special needs because they are generally publicly supported and a clear point for government intervention. It is appropriate to see if changes in these systems could enhance work among persons with disabilities. We examine the availability and use of public transportation and special transit systems by working and non-working people with disabilities and discuss how these transportation systems may make work possible.17 We also examine the difficulties people report in using these transportation systems to address areas for future improvement.

There are two types of transportation systems we address here: public transportation, including buses and subways, and special transit services, including special bus, cab or van service for people who have difficulty using the regular public transportation service.18 Most public transportation systems are, or attempt to be, accessible for common physical disabilities, potentially making their presence in the community an asset for adults with disabilities trying to work. Special transit systems allow people to call ahead and ask to be picked up. Unfortunately, we do not know some important factors about the special transit systems to which survey respondents have access. For example, we do not know how expansive the systems are in terms of where they go, the purpose for the system (to provide assistance in getting to hospitals, recreation activities, etc.), or the hours of operation of the system. Each of these is an important consideration for how useful a transportation system is in helping people get to and from work.

Having access to one of these transit systems is the first step if they are to be useful in helping adults with disabilities get to work. If workers with disabilities report greater access to these systems than non-workers, expansion could improve work prospects. We find that access to at least one of the two systems is widespread and similar for workers and non-workers with disabilities. Four-fifths of adults with disabilities report that either a public transportation system or a special transit system is available in their community (exhibit 13). Furthermore, there is no significant difference in the availability of transit between workers (82 percent) and non-workers (81 percent), suggesting that lack of a local transportation system is probably not a key barrier to work. These results are the same for both public transportation and special transit system separately. Each are available to approximately two-thirds of adults with disabilities who are working or not working.

How Much Are Transit Systems Used?

A transportation system that exists must also be appropriate for the needs of persons with disabilities, particularly in relation to work, to enable ease of use and truly reduce transportation problems. Therefore we examine use of these systems in addition to availability.19

Contrary to the idea that public transportation makes work possible, adults with disabilities who are not working are somewhat more likely to use either of these transit systems than workers. Of non-workers, 22 percent use public transportation and 5 percent use special transit systems compared to 16 percent and 2 percent, respectively, for workers (exhibit 14). Combining the two systems only serves to magnify this result. While 18 percent of workers with disabilities are using one of these transportation systems, 25 percent of non-workers are using them. These results suggest that policies aimed at increasing use of public transportation among non-workers may not be the key to increasing work. However, it is possible that lower usage rates could be reflecting differences in severity of disabilities across workers and non-workers. People with less severe disabilities are less likely to be dependent on public transportation or special transit systems, and workers tend to have less severe disabilities than non-workers.

In an attempt to separate out differential use rates from severity of disability, we examine usage of both public transportation and special transit systems for just the group of adults with severe activity limitations. By making this comparison, we can observe whether, among people with a similar level of disability, more workers are using transit systems suggesting that public transportation and special transit systems are key to enabling people to work.

Again, we find that workers with severe disabilities are not using public transportation to a greater degree than non-workers. Almost 14 percent of people with severe disabilities who are working use public transportation, not significantly different from the 16 percent of non-workers with severe disabilities using public transportation (exhibit 15). Use of special transit systems reflects the same pattern, with 3 percent of workers with a severe disability using special transit compared to 8 percent of non-workers with severe disabilities. Again this suggests that use of transit systems is not a key barrier to work, because few workers -- even amongst those with the most severe disabilities -- are making use of these systems.

For this reason we examine an important subgroup, those who report that they never drive a car because of an impairment or health problem, who may need to rely more on transit systems than others. Access to public transportation or special transit systems is the same or slightly higher for those who never drive compared to those who drive. Use of these systems overall is also higher for non-drivers. However, still less than 20 percent of people with disabilities are using any type of transit system, even when they never drive because of an impairment or health problem.

Does all this mean that transit systems do not have a role to play in increasing work among adults with disabilities? Not necessarily. The low rate of using public transportation and special transit systems among workers and non-workers overall could mean that barriers exist to using these systems for persons with disabilities generally or specifically for getting to work. Only 20 percent of people with disabilities report using either type of transportation, while 80 percent report them as available in the community. Even among those adults with disabilities who never drive a car because of an impairment or health problem, a group likely to have more need for public transit systems, usage is low. Public transportation is used by 21 percent of those who never drive and special transit systems are used by 17 percent of those who never drive. Low transit use by adults with disabilities who are working means they have another way of getting to work, either having their own cars or rides from friends or family. If non-workers do not have access to these other means, than making transit systems more usable and useful to non-workers with disabilities could increase employment.

Why Are People Not Using Public Transportation and Special Transit Systems?

Given the low usage rates of transit systems, the next question is why is usage low and can policy intervene to increase use, and thereby work, among persons with disabilities. Because of the differences in usage rates and the nature of these two transit systems, we examine public transportation and special transit separately.

To what extent do health and disability issues make using public transportation difficult? The majority of people with disabilities report no difficulties related to their health or impairments in using public transportation. Almost two-thirds of working adults with disabilities and 57 percent of non-working adults report that they have public transportation available and are not limited in using it by health problems or impairments (exhibit 16). As shown earlier, most of these people are not using public transportation.

A minority of people with disabilities report a health-related difficulty in using public transportation. Working people are less likely to report a health-related difficulty (about 4 percent) than people who are not working (12 percent). Some people reporting difficulties in use related to a health problem or impairment are still using public transportation, but only a small percentage. The most commonly reported reasons for difficulties include having difficulty walking, needing help from another person, wheelchair/scooter accessibility problems, or cognitive and mental problems. Few workers or non-workers (less than half of a percent) reported cost or inadequate hours as difficulties they have in using public transportation. Addressing these reported difficulties for the 12 percent of non-workers reporting health or impairment-related difficulties, might make public transportation a viable aid for getting to work.

Unfortunately, those who do not report health or impairment-related difficulties using public transportation are not asked why they are not using this form of transportation. These reasons could include inadequate hours or too high costs that were not perceived as health or disability-related difficulties, so not reported.

Why are people not using special transit systems? Although almost 60 percent of people with disabilities have a special transit system available, only 5 percent of non-workers are actually using it. The most frequently cited reason among working and non-working adults is that the service is either not needed or not wanted (exhibit 17). Forty-six percent of people who are working report this and 39 percent of non-workers. The next most common reason for people not using the service is that they do not know how, although the proportion of people giving this answer is dramatically lower (about 1 percent). A smaller proportion of people report not using special transit systems because they need help from another person, were denied use, and the system has unreliable or inconvenient pickup. As with public transportation, very few said they did not use this service because of cost or hours of service being inadequate, less than half of a percent of all adults with disabilities.

Despite fairly widespread availability, few people with disabilities are actually using public transportation or special transit systems. In addition, few report that lack of usage is due to health or disability-related reasons. Although there is a small group of non-workers reporting disability-related limitations in using transit systems -- limitations that should be addressed -- the majority of people with disabilities are not using them for some other reason. Potential other reasons for lack of use have been discussed in the context of low-wage labor markets in general and may apply here as well, including high cost and inadequate hours. Another reason suggested is that public transportation systems in urban areas do not reach centers of job growth in the suburbs.20

For special transit, we do not know enough about the available systems to know if supporting work is a goal, or whether they are set up to be used this way. Those who say special transit is not needed or wanted could mean this in relation to their currently available system, which may not be designed to provide regular transportation to work. If these systems were designed with a work purpose in mind, usage might increase. Aligning the goals of transit systems with the needs of people with disabilities could be an important step in improving access to employment.

V. CONCLUSIONS

Persistently low employment rates for adults with disabilities, relative to adults without disabilities, leave many people wondering how government policies and programs can better support work for the 11.3 million working-age adults with disabilities. This study investigates policies related to looking for work, providing accommodations and transportation -- all key elements to getting or maintaining employment.

Heterogeneity amongst non-working adults with disabilities leads us to first divide the group of people with disabilities into two groups -- those with a high likelihood of future work and those with a low likelihood of future work. These groups are based on respondents’ self-reports of work characteristics. The former group includes those for whom accommodations will enable work or who report their disabilities are not work limiting. The latter group includes those who report they are retired from working or cannot work even with accommodations. Almost a quarter of adults with disabilities who are not working fall under the high likelihood to work classification. Not surprisingly, we find that adults with high likelihood of work have more activity limitations, on average, than workers, but far fewer than those in the low likelihood to work group. However, we find that 17 percent of adults with disabilities who are working have severe activity limitations.

Overall, we identify several areas where there are barriers to work among non-working adults with disabilities that could potentially be addressed by government policies. There are several key findings and potential policy implications.

Before work can be supported, people need to find jobs. Difficulties in looking for work are widespread, encountered by more than half of non-workers with disabilities. While there are a variety of reasons people offer for being discouraged in looking for work, lack of appropriate jobs, information about appropriate jobs and transportation problems are frequently cited. Programs helping with job search or even preparation for job search may alleviate these issues. Programs can provide information about where jobs are or serve as an intermediary between employers and people with disabilities seeking jobs. This concept is not a new one. Indeed, many community programs already engage in these types of activities, though they are not always targeted at or accessible to people with disabilities. A special focus on this group might yield valuable results. Further targeting may be appropriate for those with the most difficulty looking for jobs, those who have less education or who are lacking recent work experience.

Need for accommodations limits employment prospects among adults with disabilities. While a greater proportion of non-workers need accommodations than workers, the types of accommodations most frequently needed are similar. The most common accommodation needs for both workers and non-workers are special worksite features, such as specially designed workstations and elevators, and special work arrangements including more breaks in work schedules. This congruency between accommodations that are being provided to workers and accommodations that are needed by non-workers provides a positive sign for non-workers in need of accommodations.

Not all needs of workers are met, providing support for the idea that some needs are essential to employment while others are necessary for a person to work at their maximum potential. So, while non-workers may report needing, on average, more accommodations than workers, it is possible that providing some of those needs will result in employment. Among workers, approximately three-fourths of all needs are met, although special worksite features are the most frequently unmet need.

Although the ADA is aimed at increasing employment for adults with disabilities and decreasing the negative impact that needing accommodation may have, at the time these data were collected -- five years after ADA’s passage -- need for accommodations appears to decrease the likelihood of work. This is true even after controlling for severity of disability. It may be appropriate for government policies to continue to assist in providing those accommodations in order to increase work for people with disabilities (e.g., by promoting Medicaid buy-ins).

Most people with disabilities who are not working report no need for an accommodation. Needing no accommodations could indicate that while appropriate attention should be paid to making accommodations accessible and enforcing ADA requirements, other barriers to employment may be more important than the ones cited by respondents.

Being able to reliably get to work is an issue in accepting a job and continuing work. It was also cited by 24% of persons who reported having difficulty searching for work. In addition, one in five non-workers reported the need for accessible parking or an accessible transportation stop close to the job as an accommodation to work. Clearly transportation is important. It may be one of the reasons that 14% of people with disabilities are discouraged to look for work by family and friends who may be the primary provider of transportation.

One avenue for supporting workers’ transportation needs is through public transportation systems or special transit systems that are often publicly funded. Availability of these systems appears relatively widespread (about 80 percent of adults with disabilities have either public transportation or special transit systems in their community), yet their use is low. Only about 20 percent of non-workers use public transportation and about 5 percent use special transit systems. It does not appear that use of these systems is what makes work possible for those who are working, since the rates of usage among workers with disabilities are lower than among non-workers -- even for those with severe disabilities, people we would think most likely to be in need of transportation assistance.

Though commonly thought of as problems, few people reported cost, accessibility, inconvenient hours, unreliability, or difficulties in understanding how to use public transportation as reasons for not using it. For special transit systems, those people not using them primarily said it was neither needed nor wanted. This could indicate these individuals have other modes of transportation available. However, given the high reports of transportation needs in general, further study of current transportation programs and their usefulness to persons with disabilities is warranted.

Finally, in addition to policies that might address the above barriers to work, it seems clear that the broader policies that could increase investments in human capital for persons with disabilities have a role to play. The relatively low rate of educational attainment of many adults with disabilities who are not working but say they could is an impediment for work and for progress in the labor market. Policies that address the school to work transition for young people with disabilities as well as policies that support the continuation of education for those with disability onsets during the school years can help to address these issues.

Barriers to employment appear to be widespread for persons with disabilities. Multiple aspects of government intervention may be appropriate in order to alleviate some of these barriers. This study shows room for policy intervention in the areas of looking for work, providing accommodations, and improving transportation.

NOTES

  1. McNeil, JM, “Employment, Earnings and Disability,” U.S. Bureau of the Census, July 2000. This is based on data from the Survey of Income and Program Participation using a definition of difficulty with ADLs or IADLs. These results are robust to a variety of different definitions and data sources.

  2. ADLs include bathing or showering, dressing, eating, getting in and out of bed or chairs, using the toilet including getting to the toilet, and getting around inside the home. IADLs include preparing own meals, shopping for personal items, managing money, using the telephone, doing heavy work around the house, and doing light work around the house.

  3. LaPlante, MP, Miller, S, and Miller, K. “People with work disability in the U.S.,” Disability Statistics Abstract, No. 4, May 1992.

  4. The Lewin Group, “Exploratory Study of Health Care Coverage and Employment of People with Disabilities,” Prepared for the Department of Health and Human Services, the Office of the Assistant Secretary for Planning and Evaluation, July 6, 1998. [Full Report]

  5. Employment rates are from Phase 1 for adults without disabilities and Phase 2 of the survey for those with disabilities. This means there is a difference in calendar time when these rates are measured. Using Phase 1 data for adults with disabilities does not substantially change results. Phase 2 is used to be consistent with the rest of these data used for this study.

  6. Throughout the report we only discuss differences that are statistically significant. For ease of presentation, we do not indicate statistical significance on every figure.

  7. Non-workers refers only to high likelihood to work non-workers as defined in the first section of the paper. In addition, those who have never worked, 12 percent of high-likelihood non-workers, were not asked this question and are excluded from this section.

  8. Only those high-likelihood non-workers who report a work limitation are asked this question.

  9. The percentage citing this reason would likely be higher if all adults with disabilities including low-likelihood non-workers (who have much higher receipt of disability benefits) were included.

  10. The provisions of the ADA originally took effect on July 26, 1992 and included only those employers with 25 or more employees. This threshold changed to include employers with 15 or more employees on July 26, 1994 (Facts About the Americans with Disability Act, http://www.eeoc.gov/facts/fs-ada.html).

  11. Non-workers refer to those with high likelihood to work as defined in the first section of the paper.

  12. Daly, MC and Bound, J. “Worker Adaptation and Employer Accommodation Following the Onset of a Health Impairment,” Journal of Gerontology, Vol 51B, No 2.

  13. Accommodation questions were not asked of everyone in the high likelihood to work group. If a person indicated that they were neither limited nor prevented from working due to health or disability, we assume that they would not need an accommodation to work. This may cause us to understate the total number of people in this group who would benefit from an accommodation.

  14. Two questions are asked “In order to work would you need any of these special features at your worksite…?” and “Because of an ongoing health problem, impairment, or disability, do you need any special equipment, assistance or work arrangements in order to do your job?” with listings of specific accommodations following in each case.

  15. All characteristics of the employees were held at the mean.

  16. Botuck, S, Levy, J and Rimmerman, A. “Post-Placement Outcomes in Competitive Employment: How do Urban Young Adults with Developmental Disabilities Fare Over Time?,” Journal of Rehabilitation, July/August/September 1998.

  17. Non-workers refers to only those with a high likelihood to work as defined in the first section of this paper.

  18. The survey asks about public or private special transit systems.

  19. These reported usage rates are use for any reason, not limited to work.

  20. For a discussion of transportation barriers to work in relation to welfare reform that may be relevant for persons with disability see Kaplin, A, “Transportation and Welfare Reform,” Welfare Information Network Issue Notes, Vol.1, No. 4, May 1997.

EXHIBITS

EXHIBIT 5. Characteristics of Workers and Non-Workers
  Low Likelihoodto Work High Likelihoodto Work Working
Male 47.2 29.0 46.9
Female 52.8 71.0 53.1
 
White 78.2 79.3 86.5
Non-White 21.8 20.7 13.5
 
Age:      
   18-22 1.4 6.2 4.4
   23-55 57.6 75.9 76.7
   56-64 41.0 17.8 18.9
 
Married 54.4 56.4 63.5
Not Married 45.6 43.6 36.5
 
Other Adults in Household 68.6 66.7 68.6
No Other Adults in Household 31.4 33.3 31.4
 
Education:      
   12 Years 44.4 32.4 18.1
   12 Years 35.7 40.9 40.1
   13-15 Years 13.7 18.5 21.5
   16+ Years 6.2 8.2 20.3
 
Work Experience:      
   Never Worked 25.3 12.0 0.0
   Last Worked 5+ Years Ago 26.9 18.8 0.0
   Worked in Past 5 Years 33.7 53.8 100.0
   Don't Know* 14.2 15.3 0.0
 
Currently Doing Volunteer Work 7.7 14.9 14.0
Source: Urban Institute Calculations from 1994/1995 NHIS-D.
EXHIBIT 8. Characteristics of Those Reporting Difficulty Looking for Work Among Non-Workers with Disabilities, 18 to 64
  Percent withDifficulty Looking
Years of Education:
   12 Years 50.6
   12 Years 51.6
   13-15 Years 56.5
   16+ Years 24.5
Work Experience:
   In Past 5 Years 44.9
   More than 5 Years Ago 73.0
Severity of Disability:
   With Disability, No Activity Limitations 31.9
   Moderate Activity Limitations 50.9
   Severe Activity Limitations 62.4
Source: Urban Institute Calculations from 1994/1995 NHIS-D.Notes: Only non-workers with high likelihood and some prior work experience are included. Difficulty looking is due to health, impairment, or disability.
EXHIBIT 9. Accommodations Needed for Work: Non-Workers with Disability
ANY ACCOMMODATION 32%
 
WORKSITE FEATURE 26%
   Accessible Parking or Transportation Stop 18.9%
   Elevator* 17.4%
   Modified Work Station 14.5%
   Handrails/Ramps 10.4%
   Automatic Door 5.5%
   Restroom Designed for Persons with Special Needs 5.2%
 
SPECIAL WORK ARRANGEMENTS 12%
   Reduced Work Hours for Increased Breaks 10.0%
   Reduced or Part-Time Work Hours 9.5%
   Job Redesign 8.0%
 
EQUIPMENT 7%
   Special Office Supplies 4.5%
   Braille, Enlarged Print, Special Lighting or Audio Tape 2.5%
   Voice Synthesizer, TDD, Infrared System or Other Technical Device 1.8%
 
ASSISTANCE 7%
   Job Coach 5.6%
   Personal Assistant 4.0%
   Reader, Oral or Sign Language Interpreter 1.8%
Source: Urban Institute Calculations from 1994/1995 NHIS-D.Notes: Elevator includes people who need any elevator as well as people who need an elevator designed for people with special needs. Only non-workers with high likelihood for work are included.
EXHIBIT 16. Limitations in Using Public Transportation by Adults with Disabilities
  Working Non-Working
Not Available 32.2 31.1
 
Not Limited in Use by Health Problem or Impairment 63.7 57.1
   Using 14.7 18.0
   Not Using 49.0 39.1
 
Limited in Use by Health Problem or Impairment 4.1 11.8
   Using 1.6 3.9
   Not Using 2.5 7.9
 
Difficulties in Use for People Limited in Use by Health Problem or Impairment*    
   Difficulty Walking 2.3 5.9
   Need Help from Another Person 0.7 1.8
   Wheelchair/Scooter Accessibility Problems 0.9 1.9
   Cognitive/Mental Problems 0.9 2.2
   Hours Inadequate 0.2 0.3
   Cost Too High 0.2 0.0
Source: Urban Institute Calculations from 1994/1995 NHIS-D.Notes: Multiple difficulties could be reported. Includes only non-workers with a high likelihood to work.
EXHIBIT 17. Reasons Special Transit Systems are Not Used by Adults with Disability
  Working Non-Working
Not Available 34.4 38.0
Used 1.9 5.2
Available but Not Used 63.7 56.8
   Not Needed or Wanted 45.8 38.7
   Don't Know How to Use 0.6 1.4
   Need Help from Another Person 0.1 0.3
   Denied Use 0.2 0.1
   Pick-Up Unreliable/Inconvenient 0.2 0.3
   Hours Inadequate 0.1 0.3
   Cost Too High 0.1 0.0
Source: Urban Institute Calculations from 1994/1995 NHIS-D.Notes: Multiple reasons could be given for not using available special transit systems. Includes only non-workers with a high-likelihood to work.
Topics
Disability
Populations
People with Disabilities