Academic journal article Journal of Health and Human Services Administration

How Well Are We Doing Addressing Disability in America? Examining the Status of Adults with Chronic Disabling Conditions, 1995 and 2005

Academic journal article Journal of Health and Human Services Administration

How Well Are We Doing Addressing Disability in America? Examining the Status of Adults with Chronic Disabling Conditions, 1995 and 2005

Article excerpt

ABSTRACT

Despite laws like the Americans with Disabilities Act (ADA), (1992), and The Ticket to Work Act, (TTWA), (2001), working age adults who develop chronic disabling conditions often find themselves faced with a choice of leaving the labor market in order to qualify for public health insurance or continuing to work, often on a "hit and miss" basis, disqualifying them from employee health benefits. Federal and state policy makers continue to struggle to find solutions addressing the needs of working age adults with disabling conditions and illnesses. In this study we examine the work status of working age adults using two National Health Interview Surveys conducted a decade apart (1995 & 2005) to investigate and compare adults who have chronic, disabling conditions and self-reported rates of work. Specifically, this research investigates whether reported work activity among working age adults who report chronic health conditions has improved in the decade between 1995 and 2005. The effects of racial/ethnic differences, age, and region of residence on one's work status are also examined.

BACKGROUND

It has been over 15 years since passage of the Americans with Disabilities Act (ADA) (42 [section] U.S.C. 12100 et seq.), and nearly five (5) years since passage of the Ticket to Work Act, (TTWA) ((Public Law 106-170), yet federal and state policy makers still struggle to find solutions addressing the needs of working age adults with disabling conditions and illnesses who choose to leave employment because of chronic mental and physical health conditions. Despite federal and state programs providing disability assistance, work retraining, and health care services, these programs have often been hampered by rising costs and budget cutbacks as well as poor participation levels (Ticket to Work Advisory Panel, 2003). The Social Security Administration has reported that it has been difficult to increase poor employment rates among Social Security Beneficiaries despite targeted programs such as the Ticket to Work Act (SSA, 2005)

Against this backdrop, a strong and consistent literature stream documents increasing rates of chronic, disability producing conditions such as diabetes, congestive heart failure ["CHF"], chronic obstructive pulmonary disease, ["COPD"], asthma and arthritis, particularly among African Americans and Hispanics living below the federal poverty level (Eberhart, Ingram, Makuc, et al 2001; Pope, Tarlov, 2001; Kaiser Commission on Medicaid and the Uninsured, April, 2001; Black, Ray, Markides, 2001; Fried, Prager, Mackay, Xia, 2003).

According to the 2000 U.S. Census, nearly 50 million men, women and children have a chronic condition or illness capable of affecting work and functioning (Census, 2005). While estimates of the prevalence of reported work-disability or functional limitation vary, the Social Security Administration currently estimates that nearly 18 million Americans between the ages of 25 and 64 has one or more work-related disability but that approximately 27 percent of these persons are currently employed (U.S. Census Bureau, 2005).

Title II of The Social Security Act was passed nearly five decades ago in order to address the public welfare of disabled Americans establishing the disability safety net we now know as Social Security Disability Insurance, ["SSDI"]. Through periods of recession and affluence in our Nation's history, the Social Security Disability Insurance system has served as an important financial safety net for millions of working-age Americans who become unable to work because of disabling conditions or injuries. An important public benefit, considering that approximately 12 million workers and their families receive either SSDI or SSI benefits at a cost of $54 billion for SSDI and $23 billion for SSI (Benitez-Silva, Buchinsky & Rust, 2002; Massanari, June, 2001). For the majority of working-age Americans, SSDI is their sole source of disability protection (GAO-01-35). …

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