Topics covered include changes in the nature of work, rising health care expenditures, changing disability population, the American with Disabilities Act, social security disability insurance.

A major debate has begun over reports of an unprecedented decline in the employment rate of working-age people with disabilities by those using currently available data sources to track the health employment and economic well-being of the United States population. Many question whether the decline is real, and some have even called on the Federal government to end its financial support for the dissemination of employment estimates for people with disabilities using currently available data. In this policy brief we summarize the arguments and evidence on the issue, and reflect on the importance of the issue for the ongoing debate on disability policy. We conclude that the decline is real and it has important implications for public policy.

A major debate has begun over reports of an unprecedented decline in the employment of working age people with disabilities over the 1990s business cycle. Here we review the literature on what can and cannot be said with current data on this subject and conclude that this decline is not an artifact of the data. We then review the various explanations and evidence for this decline and conclude that it was caused by changes in social policy rather than increases in the severity of the underlying health conditions and impairments of this population. The implication is that significant changes in public policy are needed to more effectively integrate working age people with disabilities into employment. We identify and discuss the most promising directions for public policy in this area.

For over two decades, the employment rate of individuals with disabilities has declined nationally. This period of decline, which occurred between 1980 and 2002, includes within its boundaries two landmark federal statutes, the Americans with Disabilities Act and the Family and Medical Leave Act. This research addressed five research questions that sought to find the interactions of those selected labor market factors that were likely to have had an impact on the employment rate of individuals with disabilities at a state level. The relationship between state and federal minimum wages and the employment rates of individuals with and without disabilities was analyzed using a time series procedure. The relationship between wages and the application rates to the benefits programs of the Social Security Administration were analyzed in a second time series model. The third analysis added the state and federal ADA and FMLA legislation to the time series model to determine how these factors affected the employment rates of individuals with disabilities over and above the effects of minimum wages. The results indicated that while minimum wages affect both individuals with and without disabilities, the relationship was stronger for the non-disabled. No significant relationship was found between minimum wages and benefit application rates. The state and federal ADA and FMLA were significantly related to the decline in employment rates in the time period. The effects of the FMLA appear to have been more significant than the effects of the ADA. Using a sample of 20 states, selected based on high and low employment rate variability, the groups were compared based on industry composition, population profiles, tax revenues, and spending on rehabilitation programs. The most significant predictors of employment rate stability were the percentage of the states' population with a disability, percentage of jobs in the government sector, per capita taxes, per capita spending, and the number of disability related state statutes. The outcomes of these investigations provide insight into not only how these labor market factors have affected the employment rates of individuals with disabilities, but also how that relationship has changed over time.

The overarching objective of this book is to support and facilitate efforts to improve statistics and data on working-age people with disabilities.

This paper replicates the recent findings that the employment rate among all disabled persons has declined since the ADA. A closer look at this decline, however, indicates that the source of this measured decline in employment is the result of a tremendous drop in the labor force participation rate among the disabled. While also of potential concern, further analysis indicates that this drop in the labor force participation rate was not the result of the disabled fleeing the labor market, but, rather, more likely the result of re-classification of non-disabled, non-participants, as disabled. The unconditional employment probability among the disabled (taking selection into the labor market into account) has actually not declined, and may have in fact improved slightly for certain disability classifications. The results are consistent across two different data sets and mirrored by a state-level analysis. While the relative employment position of the disabled has not deteriorated, the lack of significant impact of the ADA does raise the issue of the merit of its labor market provisions.

The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.