Outcomes of employment discrimination charges filed under the Americans With Disabilities Act

Legal Remedies to Address Stigma-Based Health Inequalities in the United States: Challenges and Opportunities

Policy Points Stigma is an established driver of population-level health outcomes. Antidiscrimination laws can generate or alleviate stigma and, thus, are a critical component in the study of improving population health. Currently, antidiscrimination laws are often underenforced and are sometimes conceptualized by courts and lawmakers in ways that are too narrow to fully reach all forms of stigma and all individuals who are stigmatized. To remedy these limitations, we propose the creation of a new population-level surveillance system of antidiscrimination law and its enforcement, a central body to enforce antidiscrimination laws, as well as a collaborative research initiative to enhance the study of the linkages between health and antidiscrimination law in the future.

CONTEXT

Stigma is conceptualized as a fundamental cause of population health inequalities. Antidiscrimination law is one important lever that can influence stigma-based health inequities, and yet several challenges currently limit the law's potential to address them.

METHODS

To determine whether antidiscrimination law adequately addresses stigma, we compared antidiscrimination law for its applicability to the domains and statuses where stigma is experienced according to the social science literature. To further examine whether law is a sufficient remedy for stigma, we reviewed law literature and government sources for the adequacy of antidiscrimination law enforcement. We also reviewed the law literature for critiques of antidiscrimination law, which revealed conceptual limits of antidiscrimination law that we applied to the context of stigma.

FINDINGS

In this article, we explored the importance of antidiscrimination law in addressing the population-level health consequences of stigma and found two key challenges-conceptualization and enforcement-that currently limit its potential. We identified several practical solutions to make antidiscrimination law a more available tool to tackle the health inequities caused by stigma, including (1) the development of a new surveillance system for antidiscrimination laws and their enforcement, (2) an interdisciplinary working group to study the impact of antidiscrimination laws on health, and (3) a central agency tasked with monitoring enforcement of antidiscrimination laws.

CONCLUSIONS

Antidiscrimination law requires better tailoring based on the evidence of who is affected by stigma, as well as where and how stigma occurs, or it will be a poor tool for remedying stigma, regardless of its level of enforcement. Further interdisciplinary research is needed to identify the ways in which law can be crafted into a better tool for redressing the health harms of stigma and to delimit clearer boundaries for when law is and is not the appropriate remedy for these stigma-induced inequities.

The Legal Context of the Management of Human Resources

Laws designed to reduce employment discrimination and to regulate labor standards have a strong impact on the management of human resources in organizations. This article examines in detail the development and enforcement of antidiscrimination laws in the United States; it also considers comparable laws and policies in the European Union (EU). A significant body of research focuses on the standards that are used to determine whether particular policies or practices are discriminatory, and if so, whether they are sufficiently job-related to be legally permissible; here, I examine key themes in this research. This article also examines emerging issues, such as determining who is an applicant and who is an employee, and it explores the role of the legal environment in impeding the application of scientific knowledge to advance the practice of human resource management (HRM).

Job Discrimination in the Post-ADA Era

The Americans with Disabilities Act (ADA) of 1990 was intended to facilitate employment, job retention, and workplace promotion of individuals with disabilities by protecting them from job discrimination. However, ongoing questions have been raised about the efficacy of the legislation. This study uses population data from the Disability Supplement to the 1994 and 1995 National Health Interview Surveys to assess rates of work discrimination among adults with disabilities ages 18 and older. The analysis suggests that nearly a 10th of all adults with disabilities who were in the workforce during the 5-year period immediately following passage of the ADA experienced some form of job discrimination. People who reported job discrimination were more likely to be younger and poorer and to have more severe disabilities than those who did not report any discrimination. About a third of the respondents who experienced discrimination left the workforce permanently. The implications of these findings for rehabilitation practice are discussed.

Workplace Discrimination and Americans With Psychiatric Disabilities

This study reports findings from an analysis of employment allegations and resolutions maintained in the U.S. Equal Employment Opportunity Commission (EEOC) database. Spanning the years 1992 to 2005, the data were aggregated for individuals with psychiatric disabilities and individuals with a variety of physical, sensory, and neurological disabilities. Compared to the general disabilities group, allegations from the psychiatric disabilities group were more frequently filed by people who were younger, female, and White. The psychiatric disabilities group was significantly more likely than the general disabilities group to file against Transportation and Utilities, Finance and related fields, Services, and Public Administration industries; larger employers; or employers from the Northeast and West regions. Allegations from the psychiatric disabilities group were significantly less likely to be deemed meritorious by the EEOC at the conclusion of the investigation process. Implications for psychiatric rehabilitation are discussed.

Public policy and employment of people with disabilities: exploring new paradigms

A "sea change" in public attitudes, legislation, and political power at the end of the 20th century in the United States has helped set the stage in the early 21st century for the entry of people with disabilities into the labor force. Major pieces of federal legislation have altered national policy with the intention of maximizing the work force participation of people with disabilities. At the same time, a new theoretical paradigm of disability has emerged, which emphasizes community inclusion, accommodation, and protection of civil rights. This "New Paradigm" of disability can be applied in concert with rigorous behavioral science methodologies to shed light on the outcomes of recent federal policy changes regarding the labor force participation of people with disabilities. In so doing, social science can be used in more meaningful ways to understand both the intended and unintended consequences of federal policy.