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


U.S. Department of Health and Human Services

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

Executive Summary

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 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:

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.

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.


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.


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.

The Full Report is also available from the DALTCP website ( or directly at