Posts Tagged "disabled"

Woman in a dark place

Opioids Make it Harder, Not Easier to Work

The twin goals of prescribing opioids to workers with a bad back or arthritis are to alleviate their pain and keep them employed.

But the use and abuse of opioids can cause poor memory, extreme drowsiness, and an inability to engage in normal social interactions – all of which limit workers’ ability to function. Opioids also have serious physical effects outside of the dependence itself.

The resulting detachment from the labor market, revealed in a new research study, calls into question any benefits the medications have.

Between 2012 and 2018, average employment declined by nearly 2 percent for every 10 additional opioid prescriptions per 100 adults in a county-sized area, the researchers found. Wages also dropped by 6 percent, indicating that the opioid users who do remain employed are less productive.

The painkillers had more permanent consequences, too, when workers, unable to cope, left the labor market for good. The rate of applications for federal disability benefits increased sharply in the areas with higher prescribing rates, according to the study funded by the U. S. Social Security Administration, which runs the disability program. …Learn More

Disability Applicants’ Opioid Use in Decline

A big drop in opioid use among people applying for federal disability benefits seems like encouraging news, even if they do still use the drugs at considerably higher rates than the general population.

A Big Drop in Use in Just 5 YearsNew research finds that opioid use fell from one in three disability applicants in 2013 to one in four 2018 applicants. And the improvements were across the board: opioid use declined regardless of age, education level, sex, or region, according to the study funded by the U.S. Social Security Administration, which administers the program.

The researchers wanted to get as accurate a picture as possible of use and abuse in the disability community, a source of one in four hospitalizations for opioid overdoses. To tease out opioid use in Social Security’s records, they combed through applicants’ own free text descriptions of their medications for every conceivable name they might’ve used, including generic and brand names. The researchers even included misspellings – for example, oxycotin for oxycontin – and excluded cough suppressants with an opioid as an ingredient. …Learn More

Adults with Disabilities Cluster in Regions

SSDI Hotspots

When workers develop disabilities on the job, it often has some connection to where they live.

Musculoskeletal conditions like arthritis and tendinitis can happen anywhere but are especially prevalent in a swath surrounding the Kentucky-West Virginia border and running south to Alabama. Intellectual disabilities and mood disorders like autism and depression are common in Vermont, New Hampshire, Massachusetts, and Rhode Island.

The hot spots, described in new research, represent areas that fall in the top 10 percent of all the areas with awards for the specific condition in many of the years studied, 2005 through 2018.

New Hampshire is a dramatic example: all 10 designated areas of the state were identified as hot spots for awards based on mental disorders in all 14 years.

In addition to mental and musculoskeletal conditions, the researchers from Mathematica found a third major hot spot for circulatory and respiratory disorders like heart disease and asthma. These disorders are prevalent in an area that starts in Indiana and Illinois and flows down the Mississippi River to Mississippi.

The explanations for the hot spots are myriad and complex. Musculoskeletal disabilities constitute the largest single type of benefit award – a third of the U.S. total – and hot spots in the Southeast, where coal mining, agriculture and manufacturing are dominant, tend to have older, less educated populations and more veterans. …Learn More

newborn baby at hospital

Newborns’ Health Issues Affect Moms’ Work

One in five babies born in U.S. cities is in poor health, with profound and lasting impacts on their own and their mother’s lives.

Researchers reached this conclusion after following nearly 3,700 infants and their mothers through Princeton’s Fragile Families Survey, which checked in on the families six times between the child’s birth and age 15. The survey was fielded in cities with a 200,000-plus population, and the babies’ most common medical conditions were low birth weight, premature birth, and genetic or other abnormalities, such as difficulty breathing.

A body of research on the long-run prospects for children with disadvantages – whether medical or socioeconomic – has established that they have far more problems as adults. Consistent with other prior research, a study by Dara Lee Luca and Purvi Sevak at Mathematica also found an immediate consequence for newborns in poor neonatal health: a greater likelihood of having a disability such as a motor or speech disorder or neurodevelopmental problems such as ADHD and autism.

Within their first year, the infants often qualified for federal cash payments to their mothers under Supplemental Security Income for Children (SSI).

The inordinate amount of time spent caring for babies in poor neonatal health takes an enormous toll on the mothers, the researchers found. While caregiving didn’t seem to impact their mental health, their ability to hold down a job was significantly compromised. The mothers of babies in poor health worked fewer hours, especially when the children were very young, and were more likely to drop out of the labor force entirely. …Learn More

Opioids

Opioids are in the Disability Community Too

Opioids fueled a record of nearly 100,000 drug overdose deaths in the United States last year.

The biggest cause of overdose deaths was dangerous synthetic opioids, such as fentanyl. But the epidemic involving illegal chemicals grew out of the abuse of highly addictive prescription opioids. A spate of new research reveals that the use and abuse of these prescription drugs have plagued people with disabilities, who often start taking them to treat painful musculoskeletal conditions such as arthritis or a bad back.

A 2017 analysis featured in this blog provided the first estimate of opioid use among people who have disabilities that limit their ability to work. The researchers found that about one in four people applying for federal disability benefits used the medications – a much higher rate than in the U.S. population overall.

Painkillers often do more harm than good because they can increase society’s dependence on disability benefits by impairing lung function, aggravating existing conditions like rheumatoid arthritis, or causing addiction. According to 2021 research by RAND that followed older workers over several years, the opioid users in the study were much more likely to wind up on disability than their counterparts who did not take them.

“Although the pain relief is an important health goal,” the researchers concluded, “the consequences to workers and social programs of powerful prescription painkillers are substantial and long-lasting.”

The isolation and stresses caused by the pandemic are believed to have fueled the dramatic rise in overdose deaths last year. But a long-running cause, prior to COVID, was the decline in U.S. manufacturing employment. Research reported in this blog directly tied the movement of robots onto factory floors to the rise in deaths of despair – from drug addiction, alcoholism, and suicide – among men between ages 30 and 54. The study found that automation accounts for nearly one in five overdose deaths in manufacturing counties, which are concentrated in the heavily industrialized Midwest. The researchers said the rate of applications for disability benefits is also higher in these counties.

Opioid abuse in the disability community is happening for the same reason it is pervasive in society: an ample supply of the addictive drugs. …Learn More

Disability Discrimination and Aging Workers

Older workerA unique situation faces older workers with a disability: apply for federal disability insurance now or try to hold on and keep working to retirement age.

Of course, people who leave the labor force and apply for disability are taking a risk: they might be denied the benefits. But another possible factor in how these situations play out are state anti-discrimination laws to protect people with disabilities, including older workers, from employment discrimination. If these laws can reduce discrimination, could they increase employment and eliminate the need for some older workers to apply for disability?

A new study suggests that state anti-discrimination laws have prevented some disability applications – if the laws are broad enough to provide better protection to workers with disabilities.

The state laws deemed to be broader set a lower burden for proving that the individual has a disability than the standard in the federal Americans with Disabilities Act (ADA). Under the ADA, individuals must prove that their condition “substantially” impacts their ability to function. Under this high burden of proof, many individuals with disabilities were not considered disabled under the ADA and did not receive the federal legal protections from discrimination.

The researchers analyzed whether the broader state laws limited the growth in disability applications between 1992 and 2013 by making it easier for workers at or near retirement age to remain employed.

Disability applications increased during that period for a range of reasons, from the Great Recession to a long-term deterioration in older workers’ health. But the basis for this new study was an increase in disability applications tied to a 1983 reform to Social Security. The reform reduced retirement benefits by raising the program’s full retirement age. Disability checks, which were not reduced, became more attractive to older workers relative to their retirement benefits.

But the researchers found that disability applications did not increase as much – and sometimes not at all – in the states with the broadest disability discrimination laws. The laws were especially effective in reducing applications by people getting close to retirement age. …Learn More

Hard for People on SSDI to Resume Work

Man sanding woodThe federal government runs numerous small-scale experiments across the country to explore ways to help people on Social Security disability ease back into work to reduce the benefits being paid.

In a recent webinar, researchers discussed the extreme challenges of designing programs that are effective, given the inherent disadvantages – from the disabling condition itself and discrimination to having less education – that people with disabilities face in the job market.

After close examination of several programs, the researchers found that the primary goals of most demonstration programs are very difficult to achieve: reducing disability benefits or increasing the earnings of people on disability who have sporadic or part-time work. But they also suggested that the programs would be deemed more successful if policymakers would broaden the goals to include the improved well-being of people with disabilities.

To increase their employment, Kilolo Kijakazi, deputy commissioner of retirement and disability policy at the U.S. Social Security Administration, said it’s critical to first address inequities in the job market.

Research shows that many people on disability express an interest in working but face multiple barriers. Employers aren’t always willing to make the workplace accommodations needed to hire them. People on disability also tend to be older than most workers and may face age discrimination. Others have been discouraged by past work experiences, and finding transportation to and from a job is often a challenge.

Although a minority of all Americans with disabilities are working, the 2020 unemployment rate among people with a disability who are either working or looking for a job was 12.6 percent. However, unemployment among Black Americans with disabilities was 16.3 percent. The rates were also very high for Asian-Americans and Latinos with disabilities –  15.7% and 16.8 percent, respectively.

“We need to develop policies and programs that address these inequities,” Kijakazi said.

Robert Moffitt at Johns Hopkins University analyzed several back-to-work programs, including the use of counselors and financial incentives. He found that the programs are extremely difficult to implement well and that participation is fairly low.

Although they do help some individuals, he concluded, “Most of the efforts to increase employment, earnings and labor force engagement of [disability] beneficiaries have been disappointing.” …Learn More