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PubMed1977

Disabled-worker beneficiaries under OASDI: comparison with severely disabled PA recipients.

The 1972 Survey of Disabled and Nondisabled Adults found that more than 1 million severely disabled persons aged 20-64 were receiving payments under Federal-State public assistance programs. To determine the reasons why most of these individuals did not qualify for disabled-worker benefits under the social security program, their characteristics were compared with those of the approximately 1.5 million disabled-worker beneficiaries. The public assistance recipients were found to be younger and less well educated than their disabled-worker beneficiary counterparts. A greater proportion of them were women and more were members of minority races. Public assistance recipients became disabled at an earlier age and had been disabled longer. Compared with disabled-worker beneficiaries, they had held less skilled jobs, had earned less money, and had had a weaker attachment to the labor force. These characteristics greatly reduced their chances of qualifying for disabled-worker benefits. Lack of knowledge about the program was also an important contributing factor.

Adult↗
PubMed1986

[Illness status, causes for disability and social factors influencing disability in pregnancy. 3. Social factors influencing disability].

The following statistically significant dependences could be demonstrated. The average duration of unfitness for work higher was with the increasing age. Unmarried pregnant women had a shorter average duration of unfitness for work than married ones. Corresponding to the degree of the professional qualification the average duration of unfitness for work increased. Pregnant women who were working in the industrial production, in the sphere of trade and service and in the educational system had a higher average frequency of unfitness for work than other groups of occupation. In connection with the results possible engagements and behavioural patterns of pregnant women are discussed, especially the correlations between occupation and pregnancy.

Adolescent↗
PubMed1986

[Morbidity status, causes for work disability and social factors influencing work disability in pregnancy. 2. Causes for work disability].

The higher level of patients of pregnant woman in comparison with non-pregnant ones results from a higher unfitness for work which nearly corresponds to the increase of sicknesses depending on gestation. From all causes of unfitness for work more than 60% were depending on gestation. Causes for the half of the release from work depending on gestation were the three diagnoses threatening abortion, threatening premature birth and bleedings. On the total level of patients of 11.66% they had a share of 5.70% points. Infections of the ureter, the diagnosis' 'Other complications in pregnancy', hyperemesis and gestoses followed. Infections of the upper respiratory tract and influenza were the causes of all releases from work which were not depending on gestation. Their share on the level of patients amounted to 0.9% points. Releases from work because of sicknesses of circulation and of the digestive tract followed in their frequency. A number of further causes of unfitness for work had only a small share on the happenings of unfitness for work.

Abortion, Spontaneous↗
PubMed1996

[Disability, the risk of disability and changes in work capacity-- unacceptable conditions for insurance in occupational injuries and diseases].

According to Croatian legislation disability, risk of disability and altered work capacity are prerequisites for recognition of job injuries, occupational diseases, and, consequently, of the worker's special rights. That is also valid for all areas of insurance. The legislation, if applied, would make it impossible for a great number of insured workers to realize their particular rights based on work related health damage, especially in the field of health insurance and reinsurance of health care costs. Health insurance boards, along with insurance companies, manage by evading the condition of disability, risk of disability and altered work capacity. This has been proved on a sample of 63 cases of job injuries and one occupational disease registered in the Occupational safety unit of the Clinical Hospital in Split from May 1994 to May 1995. In all cases the medical doctor of choice, the authorized health insurance board and the authorized insurance company enabled the insured (workers injured at work or having occupational disease, the employer) to make use of their specific insurance rights without waiting for the fulfillment of the prescribed condition of disability, risk of disability and altered work capacity. The authors consider such behaviour to be inadmissible in a state based on the rule of law. If the condition of disability, risk of disability and altered work capacity is unsuitable, as indeed it is, a solution should be sought for in changing the regulations. The simplest way of doing it is to invert the defining and taking over decrees in the Law on Pension and Disability Insurance and the Law on Health Insurance.

Accidents, Occupational↗
PubMed1994

The impact of the Americans with Disabilities Act on employment opportunity for people with disabilities.

The impact of the American with Disabilities Act (ADA) on employers and the workplace extends well beyond the provisions of the Act. Besides demanding an end to discrimination in the workplace against persons with disabilities, both the ADA and the Rehabilitation Act articulate the goals of equal opportunity, full participation, independent living, and economic self-sufficiency. They state clearly the right of each person to a full and meaningful life regardless of disability. Promoting those goals through employment requires thinking more broadly about the interaction between the individual with the disability, the workplace, and society. The employer is not the only participant. The individual with the disability plays an important role, as do the health care providers. An opportunity to align the goals of SSI and SSDI more closely with the ADA may lie in efforts to expand health care approaches to disability, based on the IOM Model of Disability, and link such practice with disability management efforts in the workplace.

Activities of Daily Living↗
PubMed1998

The impact of ratee's disability on performance judgments and choice as partner: the role of disability-job fit stereotypes and interdependence of rewards.

An experiment assessed the impact of disability-job fit stereotypes and reward interdependence on personnel judgments about persons with disabilities. Students (N = 87) evaluated 3 confederates. The experiment varied disability of the target confederate (dyslexia vs. nondisabled), task, and dependence of rater rewards on partner performance. Two disability-task combinations represented stereotypical poor fit and good fit. Dependent variables were performance evaluations, performance expectations, and ranking of target as a partner. There was negative bias against the confederate with dyslexia in poor-fit conditions. In the interdependent reward condition, there was a negative main effect for disability, regardless of fit. No effects for disability were found on performance ratings or expectations. Results indicate the need to consider disability-job fit stereotypes and consequences to raters when assessing the impact of disability on personnel judgments.

Adult↗
PubMed2002

Late life function and disability instrument: I. Development and evaluation of the disability component.

BACKGROUND: Efforts to evaluate the effectiveness of clinical and community-based interventions designed to impact late-life disability have been hindered significantly by limitations in current instrumentation. More conceptually sound and responsive measures of disability are needed. METHODS: Applying Nagi's disablement model, we wrote questionnaire items that assessed disability in terms of frequency and limitation in performance of 25 life tasks. We evaluated their validity and test-retest reliability with 150 ethnically and racially diverse adults aged 60 and older who had a range of functional limitations, using factor analysis and Rasch analytic techniques to examine and refine the instrument. RESULTS: Our analyses resulted in a 16-item disability component with two dimensions, one focused on frequency of performance and the other addressing limitation in performance of life tasks, with two disability domains within each dimension. The frequency dimension consisted of a personal and a social role domain, and the limitation dimension consisted of an instrumental and a management role domain. Expected differences in summary scores of known-functional limitation groups support the validity of this instrument. Test-retest intraclass correlations of the reproducibility of each overall dimension summary score were moderate to high (intraclass correlation coefficients .68-.82). CONCLUSIONS: The Late-Life Function and Disability Instrument has potential to assess meaningful concepts of disability across a wide variety of life tasks with relatively few items.

Activities of Daily Living↗
PubMed1996

A comparison of measures of disability and health status in people with physical disabilities undergoing vocational rehabilitation.

BACKGROUND: The aim of the study was to test among people undergoing vocational rehabilitation six measures of disability and health status commonly used in medical rehabilitation. METHOD: A cross-sectional survey was carried out on 30 people with disabilities on an occupational programme at a non-medical rehabilitation facility in England. Measures used were the Barthel index, Extended Activity of Daily Living (EADL) scale, the Office of Population Censuses and Surveys (OPCS) disability questionnaire, the Functional Independence Measure (FIM), the Nottingham Health Profile (NHP) and the Medical Outcome Study Short Form 36 (SF36). The main outcome measures were item non-response and time for completion of each measure, profile of disability and health status described by each measure, including pertinent domains detected or missed, and floor and ceiling effects. RESULTS: Item non-response was very low with all the instruments; the Barthel index was on average the quickest to complete (mean time 2.2 minutes) and the SF36 the longest (mean time 9.1 minutes). The study group were characterized as having problems in mobility or locomotion and bladder or bowel control, but some of the instruments were insensitive, detecting no disability in many subjects (e.g. 33 per cent showed no disability on the Barthel index). The SF36 scores were the least affected by floor and ceiling effects; mean SF36 scores on all scales except physical functioning were similar to those for the general population of similar age. Some problems were detected by only one of the instruments (e.g. pain and sleep by the NHP, problems with intellectual functioning by the OPCS scale). CONCLUSION: Disability measures commonly used in medical rehabilitation, such as the Barthel score and FIM, may be less useful in vocational rehabilitation where disabilities are less severe. Other measures show more promise but further testing is needed.

Activities of Daily Living↗
PubMed1997

Incentives to disability in federal disability insurance and supplemental security income.

Between 1989 and 1994, Disability Insurance and Supplemental Security Income, the 2 federal programs that provide disability benefits, expanded rapidly. The largest growth has been among recipients with mental disorders in the Disability Insurance program and among children with learning disabilities in the Supplemental Security Income program. The expansion was partly due to changes in eligibility rules and partly to other factors including outreach efforts by the Social Security Administration and a lack of funds to review and terminate cases. Factors that keep many of the disabled from seeking work include a fear of being unable to obtain health insurance, which is provided to beneficiaries under Disability Insurance and Social Security Insurance, and the fear of being unable to obtain and keep stable employment. Although children's Supplemental Security Income benefits have reduced poverty in families with disabled children, there is some evidence that parents are encouraging their children to behave poorly so they can qualify. Replacing present welfare and disability programs with national health insurance and a guaranteed annual income would eliminate the work disincentives, but such dramatic restructuring is unlikely in the context of present political debates.

Eligibility Determination↗
PubMed1986

Disabilities, benefits, and disability benefits.

The purpose of this paper is to relate the patterns of disabilities in a sample of young adults to the amounts they received in social security benefits towards extra arising from disablement. Data on 248 young people aged 18 to 22 who lived in England were obtained by means of interviews with their parents. There was wide variation in weekly amounts received in benefits for the extra costs of disablement. The most severely disabled did not receive invariably the highest levels of support and some disabilities were not associated with amounts received in benefits. The findings indicate that the United Kingdom social security system is biased towards meeting the extra costs which arise from physical disablement; costs which arise because of mental disablement attract less recognition. It is concluded that help with extra costs should be based on a comprehensive assessment of disablement and its financial consequences.

Adolescent↗
PubMed1990

The Framingham Disability Study: relationship of various coronary heart disease manifestations to disability in older persons living in the community.

The relation between coronary heart disease and disability was examined in 2,576 community-dwelling women and men ages 55-88 years. These Framingham Study participants were originally recruited in 1948-51 for an examination of cardiovascular disease. Twenty-seven years later, remaining members of the cohort were interviewed to ascertain physical abilities, and a score on a disability scale was assigned. Multivariate logistic analyses examined disability in relation to uncomplicated angina pectoris (AP), complicated AP, and coronary heart disease other than AP, controlling for possible confounders. In younger and older women and men, uncomplicated and complicated AP were associated with disability. Coronary heart disease other than AP was associated with disability only in the younger men. Congestive heart failure predicted disability only in the women. These results suggest that onset of AP should be recognized as a critical point in the development of disability and that AP is a better predictor of disability than is myocardial infarction or coronary insufficiency.

Aged↗
PubMedDate not supplied

A global perspective on disability: a review of efforts to increase access and advance social integration for disabled persons.

Disability has emerged as a major public health problem worldwide, common to nations presenting disparate levels of socioeconomic development. Failure to integrate social welfare programmes within national development planning exacerbates difficulties arising from limited resources, with a disproportionate impact on disabled persons and other vulnerable groups. Such policy failure allows flagrant inequalities and social injustice to persist. Strategies are emerging, however, that are useful for solving common international problems. Community-based disability prevention and rehabilitation is one emerging solution that has attracted considerable attention worldwide, including in the United States. Following a review of global estimates of disability, which reveal the magnitude of the problem and provide background information for this report, I will summarize major international initiatives designed to prevent disability and ensure comprehensive rehabilitation for disabled persons. I will also analyse the relationships between health, socioeconomic development, and disability. Finally, I will describe community-based rehabilitation, an innovative approach evolving from the World Health Organization's Global Strategy for Health for All by the Year 2000, an approach with potential to eliminate barriers to equal opportunities and social integration for disabled persons.

Community Health Services↗
PubMed1996

Disablement observed, addressed, and experienced: integrating subjective experience into disablement models.

Although subjective experience is critical to full comprehension of disablement, it has yet to be integrated into models in a systematic and theoretically grounded way. This article presents a framework for modelling disablement that includes both objective and subjective features. The framework is based on a novel integration of: (1) perspectives on disablement; (2) the contexts within which disablement occurs; and (3) interaction among these perspectives and contexts. The framework is developed using nomenclature derived from the WHO's International Classification of Impairments, Disabilities, and Handicaps (ICIDH). Although ICIDH terminology is used, the article's integration of ideas can as well be applied to other disablement nomenclatures and models. The framework offers a conceptual background for innovative clinical, policy, and research responses to disablement, as well as for further development of disablement theory and models.

Activities of Daily Living↗
PubMed2001

Widespread musculoskeletal pain and the progression of disability in older disabled women.

BACKGROUND: Widespread musculoskeletal pain is a poorly understood but common problem in older adults. Little is known about the progression of disability related to this condition. OBJECTIVE: To determine whether widespread musculoskeletal pain increases the risk for worsening disability in older women with disabilities. DESIGN: Prospective cohort study. SETTING: The Women's Health and Aging Study. PARTICIPANTS: 1002 community-dwelling women 65 years of age or older with disability. MEASUREMENTS: Widespread musculoskeletal pain was defined as pain in the upper and lower extremities and axial pain with moderate or severe pain in at least one of the three regions. Worsening disability was defined as progression from no or mild difficulty to severe difficulty or inability to perform activities of daily living (ADLs), walk one-quarter mile, or lift 10 lbs. RESULTS: At baseline, 24% of participants had widespread pain and 25% had no pain or only mild pain in a single site. Women with widespread pain were 2.5 to 3.5 times more likely to have severe difficulty with ADLs, walking, or lifting at baseline compared with women who had no or mild pain. In women without severe difficulty initially, widespread pain nearly doubled the risk for progression to severe difficulty in each of the tasks, after adjustment for age, body mass index, comorbid illness, and other confounders. CONCLUSION: Widespread musculoskeletal pain is frequent among community-dwelling older women with disability and appears to predict the progression of disability. Efforts to better understand the cause of this pain and its treatment might reduce the overall burden of disability.

Activities of Daily Living↗