Success and failure in narrowing the disability employment gap: comparing levels and trends across Europe 2002-2014

No evidence that social-democratic welfare states equalize valued outcomes for individuals with disabilities

It is acknowledged that generous welfare states can provide better outcomes to their populations in terms of objective and subjective indicators of well-being, yet there is little comparative evidence of the role that the welfare state regime plays in lessening disability-based inequalities. Using a large comparative data set of most European societies, Tukey's honestly significant difference and generalized Hausman tests for six welfare state regimes, we examine the assumption that social-democratic countries perform better in mitigating disability-based inequalities than conservative, liberal, Southern, Eastern European, and the former Soviet Union welfare state regimes. We compare the valued outcomes for individuals with and without disabilities regarding their education, labour market participation, material well-being, and life satisfaction. The main finding of this study is that the most generous welfare states in Europe do not perform better, and in some cases, perform worse, than other less comprehensive welfare state regimes in closing the gap in valued outcomes between individuals with disabilities and the rest of the population. We discuss potential explanations of these inequalities such as the nature of expectations and changing characteristics of welfare state regimes, and difficulties related to measuring disabilities across European societies.

Promoting labour market inclusion of the chronically ill: a scoping review of Scandinavian countries' efforts

OBJECTIVES

This article is a scoping review of efforts in labour market inclusion of the chronically ill in the Scandinavian countries, a research area that has received much political as well as research attention in recent years. The aim of the review was to identify promising strategies and the need for further research.

METHODS

Six electronic databases were searched for literature published between 2015 and 2020. We included peer-reviewed articles that studied the effect of measures, aimed at the workplace or at the individual, that are intended to increase participation. Our search resulted in 2718 articles; our screening procedures resulted in 47 included articles.

RESULTS

Among the included studies, musculoskeletal problems (17 articles) and mental health problems (29 articles) were the most frequent chronic conditions. Multimodal occupational rehabilitation programmes directed towards the individual employee were the most frequent interventions (30 articles). Return to work (24 articles) and sickness absence (12 articles) were the most common outcomes. About half (25 articles) of the included studies reported a positive impact of the intervention on work inclusion of the chronically ill.

CONCLUSIONS

Our review found little evidence of how government programmes directed towards the supply side of the labour market succeed in including the chronically ill. Our review further indicated that multidisciplinary workplace interventions have a substantial effect. We also identified a significant lack of research on the effect of various governmental policies and programmes, including local health, work and welfare services, and limited coordination and cooperation between health and work services professions.

The impact of disability-related deprivation on employment opportunity at the neighborhood level: does family socioeconomic status matter?

Introduction

Difficulties in attaining employment significantly contribute to socioeconomic poverty among individuals with disabilities. However, our understanding of how socioeconomic deprivation experienced by individuals and families with disabilities influences employment opportunities remains incomplete. This study aims to explore the relationship between index of disability-related multiple deprivation (IDMD) and employment opportunities (EMPO), while also investigating the role of family socioeconomic status (FSES) in shaping this relation.

Methods

This study explores the heterogeneous effects of IDMD, FSES, and the interaction between IDMD*FSES on EMPO among four disabled population groups categorized by IDMD and FSES.

Results

Results reveal that IDMD has a significant negative impact on EMPO, suggesting that persons with disabilities are confronted with a poverty trap resulting from the relationship between IDMD and EMPO. Furthermore, FSES demonstrates an effective moderating role in the IDMD-EMPO relationship, with the greatest impact observed among disabled population groups characterized by high IDMD and low FSES.

Discussion

The findings suggest that family-level support is crucial for vulnerable groups of disabled individuals to overcome the poverty trap, surpassing the reliance on individual-level assistance alone. This study supports a paradigm shift in comprehending disability-related deprivation by acknowledging its association with families, thereby presenting opportunities to enhance the welfare of people with disabilities.

Multidimensional poverty of persons with disabilities in China: An analysis of poverty reduction effect of employment services

Introduction

Disability is a global public health problem, and poverty due to illness and disability has always been a major problem and challenge for global poverty governance. In order to eradicate poverty, China has carried out a series of welfare reforms and employment interventions for people with disabilities. The purpose of this study is to examine the levels of multidimensional poverty of persons with disabilities aged 16-59 in China and the poverty reduction effect of employment services.

Methods

The Alkire-Foster (AF) method is applied to measure and decompose the multidimensional poverty index (MPI) of people with disabilities in this study. In order to make the results more robust, ordinary least squares (OLS) regression and the combination of propensity score matching and difference-in-differences (PSM-DID) are used to study the effect of employment services on multidimensional poverty of the disabled.

Results

The results show that among persons with disabilities aged 16-59, about 90% are deprived in at least one dimension, and about 30% are in a state of severe multidimensional poverty until 2019. The contributions of deprivation in the dimensions of education and social participation are remarkably higher than dimensions of economy, health and insurance. In addition, employment services have a significant improvement effect on multidimensional poverty, which is reflected not only in the economic dimension, but also in the dimensions of education, insurance and social participation.

Conclusion

People with disabilities are generally in multidimensional poverty in China, and their abilities in learning and social integration are seriously inadequate. Employment services have played a great role in improving poverty, but the improvement has been different in different dimensions and different disability categories. These findings provide important evidence for recognizing multidimensional poverty of persons with disabilities and the poverty reduction effect of employment services, which will help to formulate more reasonable public policies to eradicate poverty.

The importance of disability representation to address implicit bias in the workplace

Introduction

People are disabled by barriers in society, not by their impairment. Barriers can be physical or be caused by people's implicit and explicit attitudes towards people with disabilities.

Methods

We utilise the Implicit Association Test to investigate implicit attitudes towards people with disabilities among Human Resource professionals and people involved in making hiring decisions.

Results

We find no significant differences between people who work for large companies or Small- to Medium-sized Enterprises. Similarly, working in Human Resources (or making recruitment decisions) has no effect on implicit bias. We supply the first evidence linking a person's own health status (measured using EQ-5D-5L) to their implicit bias. We find that a worse health status is associated with lower implicit bias towards people with disabilities. In addition, we find women have lower implicit bias than men.

Discussion

The discussion reflects on the need for greater disability representation within the workplace - especially in making hiring decisions.

Does Work Disability Contribute to Trajectories of Work Participation before and after Vocational Labour Market Training for Job Seekers?

The contribution of ill-health to labour market participation in relation to vocational training is unclear. Using nationally representative Finnish register data on 42,691 vocational labour market trainees in 2008-2010, we constructed latent trajectory groups of work participation in the open labour market three years before and after training, identifying groups called "High-High", "High-Low", "Low-High", and "Low-Low". We plotted further patterns of labour market participation within these trajectory groups and, using multinomial logistic regression, examined assignment to these groups focusing on previous work disability status. Those with compared to those without previous work disability had previous employment more often and spent less time in economic inactivity within the two trajectory groups with low pre-training levels of work participation. Having a previous work disability was associated with assignment to the "High-Low" trajectory group of work participation instead of the "High-High" comparison group. The associations of other background factors with the assignment to the different trajectory groups were relatively similar amongst those with and without previous work disability. However, some of these associations were weaker amongst the former. Along with other key background factors, previous work disability should be accounted for when assessing the effects of vocational training.

What is the effect of changing eligibility criteria for disability benefits on employment? A systematic review and meta-analysis of evidence from OECD countries

BACKGROUND

Restrictions in the eligibility requirements for disability benefits have been introduced in many countries, on the assumption that this will increase work incentives for people with chronic illness and disabilities. Evidence to support this assumption is unclear, but there is a danger that removal of social protection without increased employment would increase the risk of poverty among disabled people. This paper presents a systematic review of the evidence on the employment effects of changes to eligibility criteria across OECD countries.

METHODS

Systematic review of all empirical studies from OECD countries from 1990 to June 2018 investigating the effect of changes in eligibility requirements and income replacement level of disability benefits on the employment of disabled people. Studies were narratively synthesised, and meta-analysis was performed using meta-regression on all separate results. The systematic review protocol was registered with the Prospective Register for Systematic Reviews (Registration code: PROSPERO 2018 CRD42018103930).

RESULTS

Seventeen studies met inclusion criteria from seven countries. Eight investigated an expansion of eligibility criteria and nine a restriction. There were 36 separate results included from the 17 studies. Fourteen examined an expansion of eligibility; six found significantly reduced employment, eight no significant effect and one increased employment. Twenty-two results examined a restriction in eligibility for benefits; three found significantly increased employment, 18 no significant effect and one reduced employment. Meta-regression of all studies produced a relative risk of employment of 1.06 (95% CI 0.999 to 1.014; I2 77%).

CONCLUSIONS

There was no firm evidence that changes in eligibility affected employment of disabled people. Restricting eligibility therefore has the potential to lead to a growing number of people out of employment with health problems who are not eligible for adequate social protection, increasing their risk of poverty. Policymakers and researchers need to address the lack of robust evidence for assessing the employment impact of these types of welfare reforms as well as the potential wider poverty impacts.

The growing American health penalty: International trends in the employment of older workers with poor health

Many countries have reduced the generosity of sickness and disability programs while making them more activating - yet few studies have examined how employment rates have subsequently changed. We present estimates of how employment rates of older workers with poor health in 13 high-income countries changed 2004-7 to 2012-15 using HRS/SHARE/ELSA data. We find that those in poor health in the USA have experienced a unique deterioration: they have not only seen a widening gap to the employment rates of those with good health, but their employment rates fell per se. We find only for Sweden (and possibly England) signs that the health employment gap shrank, with rising employment but stable gaps elsewhere. We then examine possible explanations for the development in the USA: we find no evidence it links to labor market trends, but possible links to the USA's lack of disability benefit reform and wider economic trends.