Disability-related Policies Research Articles

Implemented disability-related policies and practices and sustained employment of partially disabled employees: evidence from linked survey and register data.

This study examined the associations between implemented disability-related policies and practices (DPP) and sustained employment among partially disabled employees in The Netherlands. Employer survey data on implemented DPP were linked to register data on employment outcomes of partially disabled employees (N=6103 employees from N=366 employers). DPP included six domains based on 48 elements: sick leave policy, occupational health and safety services (OHS), prevention policy, reintegration policy, reintegration practices within the current employer and reintegration practices towards another employer. DPP domains were standardized on a 0-1 scale. Separate logistic regression models were estimated for DDP domains on one-year sustained employment adjusted for employee characteristics, firm size, and sector. Almost all organizations implemented at least one element of DPP on prevention policy, OHS, sick leave policy, and reintegration practices within the current employer, and two-thirds on reintegration policy and reintegration practices towards another employer. Implemented DPP on prevention policy [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.3-4.0], OHS (OR 1.9, 95% CI 1.1-3.2), and sick leave policy (OR 1.8, 95% CI 1.0-3.3) were positively associated with sustained employment. No significant results were found for reintegration policy and both reintegration practices domains. Stratified analysis showed that DDP domains were particularly associated with sustained employment in larger organizations and in the private sector. Implemented DPP related to sick leave policy, OHS and prevention policy are associated with sustained employment among partially disabled employees, in particular in larger organizations and in the private sector.

Disability-related policies and practices and sustained employment: A survey and register data study

Abstract Background Many OECD countries implemented reforms to promote sustained employment of employees on long-term sick leave. Still, sustained employment remains low, which is worrying as it may affect the health and well-being of this vulnerable group of workers. This study aimed to examine the extent to which a firm's disability policies and practices increase the likelihood of sustained employment of long-term sick-listed employees with remaining work capacity. Methods Survey data on firms’ disability policies and practices was obtained from the Dutch Employee Insurance Agency (UWV) and linked to register data covering the employment outcomes of all employees that applied for disability benefits between 2006 and 2010 (N = 6103 employees from N = 366 employers). The dependent variable was sustained employment one year after the disability assessment. Implemented disability policies and practices were measured across seven domains: sick leave prevention, absenteeism management, reintegration management, occupational health and safety services (OHS), reintegration activities with the current/another employer, and positive workplace culture. Multilevel multiple logistic regression analyses were performed. Results Sick leave prevention policies (OR = 2.3, 95% CI 1.3-4.0), absenteeism management policies (OR = 1.8, 95% CI 1.0-3.3) and OHS (OR = 1.8, 95 CI 1.1-3.2) were positively associated with sustained employed one year after the disability assessment. No significant results were found for the other domains. Conclusions Employees with remaining work capacity in firms with the most comprehensive absence management policies, prevention policies, and OHS are about twice as likely to continue working one year after the disability assessment than firms with the least comprehensive policies. Legislation that encourages firms to invest more in absence management and prevention policies may result in better employment opportunities for this vulnerable group of employees. Key messages • Firm's prevention and absence management policies could be highly effective in fostering sustained employment of employees on long-term sick leave. • Legislation that encourages firms to invest more in disability policies and practices may result in better employment opportunities, health, and well-being of people with partial work disabilities.

“Crawling Takes Away My Dignity”: Effects of Inaccessible Environments on Persons with Mobility Disabilities in Ghana

Individuals with disabilities in Ghana continue to face barriers in the built environment, transportation, information and social spheres, despite local and international laws that promote their human rights and freedoms. These barriers have a negative impact on the education, employment, healthcare, safety, security and social life of persons with disabilities. Little attention is given to the way in which these barriers affect the dignity and self-determination of persons with mobility disabilities. Guided by the social relational model of disability and photovoice methodology, in this study, I sought to fill the gap. I used purposive and snowball sampling to recruit 10 persons with mobility disabilities who engaged in the data collection and analysis. The study outcome indicates that the dignity of persons with mobility disabilities was compromised while managing inaccessible environments requiring them to crawl, be carried, and rely on others for help. The findings indicate that self-determination was an issue for the participants because they either did not have opportunities or had limited opportunities to choose independently because of the restrictions posed by the environment. Education, religious and economic institutions and all other service providers should ensure that their environments are accessible and safer for persons with mobility disabilities. The government should ensure the enforcement of disability-related policies to promote accessibility for persons with disabilities. An accessible environment could promote the dignity, self-determination, health and overall well-being of persons with mobility disabilities.

Understanding Disability Policy Development: Integrating Social Policy Research with the Disability Studies Perspective

Studies on the development of social policies have provided us with a rich body of knowledge. However, being based mostly on class, gender or racial analysis, this body of work has seldom used disability as an analytical framework. This article proposes a systematic research agenda for addressing this lacuna. Drawing on the political and institutional approaches, this article illustrates how mainstream theories on social policy development cannot be assumed applicable to disability policies ‘as is’. To apply them effectively, we argue, students of social policy need to rework them in light of the insights of disability studies. Such conceptual work would involve closer attention to the uniqueness of disability as a socio-political category. Integrating these social policy theories with disability studies will allow us to better identify the unique political and institutional factors behind the trajectories of disability related policy. We conclude this discussion with suggestions for future research.

Policies as barriers for disabled medical learners: exploratory study of learners’ perspectives

Disabled medical learners have unique accommodation needs, given their diverse and changing learning environments and direct contact with patient-care. However, there are very limited policies and resources available in Canada to inform medical learners and educators about what accommodations are available to them, and little is known about the usefulness of existing policies. This study explored the perspectives of disabled medical learners on existing policies in medical schools. We conducted interviews with eight disabled medical learners, focusing on their experiences with their institutions’ disability-related policies. Interviews were thematically analyzed. The analysis demonstrated that there are gaps in services for medical learners. Participants did not feel that pre-existing policies were helpful in addressing the existing barriers. In addition, participants felt that the responsibility for navigating the system falls primarily on them. This study addresses some needed changes to create more inclusive environments in medical education. Points of interest Disabled medical learners have unique accommodation needs. In Canada there are limited policies and resources available to inform medical learners and educators about what accommodations are available. This study focuses on what disabled medical learners think about existing policies in medical schools. Services and procedures for supporting disabled learners are complex and inconsistent. The support system and attitudinal barriers are challenging to navigate. Negative perceptions of disability in medicine are persistent. Attitudinal changes, simplified services and procedures, and an inclusive learning environment can improve the experiences of disabled medical learners.

The contribution of employer characteristics to continued employment of employees with residual work capacity: evidence from register data in The Netherlands.

Objectives:This study aimed to examine the contribution of employer characteristics to continued employment of employees with residual work capacity. Moreover, we examined whether the contribution of employer characteristics differs across types of employers and employees’ types of diseases.Methods:Register data on disability assessments and employment status of N=84 394 long-term sick-listed employees with residual work capacity were obtained from the Dutch Employee Insurance Agency between 2010 and 2017. The dependent variable was continued employment four months after the assessment. We linked employees to their (former) employer to measure sector, firm size, and workforce composition. The average employment outcome of all employees assessed in the same firm and year served as a proxy measure for the extent of implemented disability-related policies and practices. Using multilevel multiple regression analysis, we compared the relative contribution of employer characteristics with employees’ characteristics.Results:Employer characteristics accounted for 10% of the variability in employment outcomes. In comparison, employees’ socio-demographic and disease characteristics accounted for 13% of the variability. The prevalence of continued employment was lowest in smaller firms and construction and low-wage service-orientated sectors. Furthermore, there were sizeable differences in employment outcomes between similar employers in terms of size, sector and workforce-composition, particularly between larger firms and among employees with mental or musculoskeletal disorders compared to other diseases.Conclusions:This study shows substantial differences between employers in facilitating continued employment of employees with residual work capacity. Encouraging firms to invest more in disability-related policies and practices may result in better employment opportunities for these employees.

Twenty-Five Years of the Partners in Policymaking<sup>®</sup> Leadership Institute: A Longitudinal Survey of Tennessee Alumni

Partners in Policymaking^® is a leadership and advocacy training program for adults with disabilities and family members of persons with disabilities. The Tennessee Council on Developmental Disabilities began implementing this intensive seven-weekend program in 1993. <i>Objectives</i>: The lasting influence of such a training program on the advocacy practices and leadership activities of graduates once they have completed the program has not been examined; this was the aim of the study. <i>Methods</i>: A follow-up survey seeking to quantify graduates’ current levels of advocacy, community involvement, accomplishments, and overall satisfaction with the training experience was created and sent to 361 graduates across a variety of formats; one hundred and thirty-five individuals completed the measure. <i>Results</i>: The findings suggest that program completion had a lasting impact on participants’ disability-related knowledge, advocacy, and self-assessed ability to create change in disability-related policy. Specifically, a majority of the graduates affirmed increases in leadership skills, leadership ability, and sense of empowerment. In addition, graduates reported increased feelings of connectedness to others with similar life experiences, with a majority even reporting increased quality of life due to participation. <i>Conclusions</i>: Use of a structured training program in leadership and advocacy to increase perceived self-efficacy in disability policy advocacy and leadership is supported. Graduates’ qualitative comments reveal enduring community activism and engagement in systems change, including statewide and national disability-related policy advocacy, years after completing the program.

Disability Focal Point Persons and Policy Implementation Across Sectors: A Qualitative Examination of Stakeholder Perspectives in Zambia.

Background: Zambia has created new disability policies and updated existing policies to be consistent with the United Nations Convention on the Rights of Persons with Disabilities. These initiatives require the widespread engagement of ministries and departments to achieve effective policy development and implementation. To pursue widespread engagement, the Government of Zambia developed a structure of disability focal point persons (FPPs). The Zambian disability FPP structure has not yet been explored systematically.Objective: To explore disability policy stakeholder perspectives about FPPs as a feature of disability policy development and implementation.Methods: We conducted semi-structured interviews with 24 disability policy stakeholders (10 policymakers, 2 researchers, and 12 disability advocates) as part of a larger study about the development and implementation of disability-related policies in Zambia. Interviews were audio recorded and transcribed. Data were analyzed using content analysis.Results: Participants presented FPPs as a promising way to mainstream disability within the government. According to participants, the initial launch of the FPP structure was ineffective, with a lack of clarity about the structure and an initial cohort of FPPs that wielded minimal influence. The FPP structure has since been revised. Participants express promise that the improved second launch will achieve mainstreaming.Discussion: Zambian disability policy stakeholders describe a disability FPP structure that is different from the models suggested for treaty implementation. Pre-established commitments to mainstreaming among stakeholders might have stimulated interest in following the cyclical development of the disability FPP structure, encouraging a whole-of-government approach to disability policy implementation.

A SYSTEMATIC APPROACH TO ENHANCING THE PERSONAL WELL-BEING OF CHILDREN AND ADOLESCENTS

This article describes a systematic approach to enhancing the personal well-being of children and adolescents with intellectual or closely related developmental disabilities. The article incorporates international trends in disability-related policies and practices and proposes a quality of life framework for implementing the approach, which consists of input, throughput, output, and outcome components. Guidelines for implementing the approach are presented, along with an example of its use.

Evaluating the role of trade unions and civil society organisations in supporting graduate educated disabled workers

This study explores the perceptions of disabled graduates regarding the effectiveness of employment-related advice and support provided by trade unions and civil society organisations (CSOs). The article reveals distinct areas of expertise, with union impact largely based in the workplace, as disabled graduates indicate limited knowledge of collectivism or broader union national disability campaigns. CSOs engage with disabled graduates across a broader range of themes, including access to the labour market and disability-related policy, with some indirect influence on workplace issues, and meet all four of Bellemare’s criteria for an industrial relations actor. In the face of concerns about the effectiveness of these representative institutions, the study identifies some conditions that may favour coalitions to support disabled workers, drawing on unions’ and CSOs’ distinct and overlapping areas of expertise.

Canadian Disability Policies in a World of Inequalities

Canadian disability-related policies are shaped within a global system of inequalities, including colonialism and neoliberalism. Using a critical theory framework, this article examines the complicated material inequalities experienced by people with disabilities and evident in the intersections of disability, gender, Indigenousness, race, and age. The collectively held ideas that give context to disability policies are at odds. Human rights protections are found in the foundational documents of Canadian society and part of its international commitments, yet these commitments often become window-dressing for a pervasive logic that it is better to be dead than disabled, and medical assistance in dying legislation supports this choice. While human rights protections are essential, they are not sufficient for decolonizing inclusion. Constructive actions between Indigenous peoples and settlers may help to find new ways of addressing disability and inclusion in Canada.

Return-to-Work Within a Complex and Dynamic Organizational Work Disability System.

Background Return-to-work (RTW) within a complex organizational system can be associated with suboptimal outcomes. Purpose To apply a sociotechnical systems perspective to investigate complexity in RTW; to utilize system dynamics modeling (SDM) to examine how feedback relationships between individual, psychosocial, and organizational factors make up the work disability system and influence RTW. Methods SDMs were developed within two companies. Thirty stakeholders including senior managers, and frontline supervisors and workers participated in model building sessions. Participants were asked questions that elicited information about the structure of the work disability system and were translated into feedback loops. To parameterize the model, participants were asked to estimate the shape and magnitude of the relationship between key model components. Data from published literature were also accessed to supplement participant estimates. Data were entered into a model created in the software program Vensim. Simulations were conducted to examine how financial incentives and light duty work disability-related policies, utilized by the participating companies, influenced RTW likelihood and preparedness. Results The SDMs were multidimensional, including individual attitudinal characteristics, health factors, and organizational components. Among the causal pathways uncovered, psychosocial components including workplace social support, supervisor and co-worker pressure, and supervisor-frontline worker communication impacted RTW likelihood and preparedness. Interestingly, SDM simulations showed that work disability-related policies in both companies resulted in a diminishing or opposing impact on RTW preparedness and likelihood. Conclusion SDM provides a novel systems view of RTW. Policy and psychosocial component relationships within the system have important implications for RTW, and may contribute to unanticipated outcomes.

The World Report on Disability and Recent Developments in South Korea

The latest National Survey on Persons with Disabilities estimated 2,683,400 persons with disabilities in South Korea, of whom 58% were men and 42% were women. People with physical disability represent approximately 50% of the entire population with disability. Disability-related policies and services to improve the participation of persons with disabilities have been expanded in the last decades, guided by 5-yr plans. The number of physiatrists has increased, although it still varies significantly by location. As part of the comprehensive measures to expand rehabilitation services, several regional rehabilitation centers have been established. In addition, a community-based rehabilitation program has been implemented that comprises Strong Point Public Health Centers, which provide local health promotion programs for persons with disabilities, family support programs, and community participation programs. As the aged population increases, it is predicted that the population of persons with disabilities in South Korea will also increase. A long-term and innovative financial model will be required to meet the corresponding needs. A recent milestone of evidence-based practice is the publication of Clinical Practice Guideline for Stroke Rehabilitation in Korea.

지속적·포괄적 재활서비스 제공을 위한 장애인 통합 데이터베이스 및 활용체계 연구

Background : Demands have increased for a variety of welfare services and customized services for persons with disabilities(PWD). A management System focused on PWD was needed to provide for comprehensive services. The purpose of this study was to design a disability database and an application system in order to provide continuous and comprehensive rehabilitation service for PWD. Methods : We analyzed local and abroad disability-related policies and systems and derived the contents that should be included in the integrated database for PWD through a survey among rehabilitation specialists. Result : The integrated database for PWD was composed of 7 categories including General Characteristics, Health & Medicine, Assistance, Education, Employment, Economics and Daily & Social Life. The applicable system of integrated database for PWD was proposed to help conducting policies in such areas as follows ; 'welfare', 'education and culture', 'economic activity', 'social participation' and 'Health'. Conclusion : The main goal of disability policy and strategy should be established by systematically analyzing disability-related data integrating database of PWD. Accordingly, specific objectives and directions for disability policies should be set and efficiently managed and operated. The integrated database for PWD may be utilized for disability-related policies and service monitering, sustainable and integrated management and community participation and integration based on the rights of the disabled.

Critical Legal and Policy Issues for People with Disabilities

A fifth of all Americans have some sort of and one in ten has a severe disability. Almost every American will face a at some point in their lifetime. The equivalent of 8% of the federal budget (approximately $175 billion) is spent on government programs and services for people with disabilities annually, yet their problems and needs have only begun to be addressed. Since the passage of the Americans with Disabilities Act (1990), increasing attention has been given to this group in terms of legal and public policy development. Among the most critical current issues in policy are: employment status and incentives for people with disabilities; education availability and appropriateness; housing availability and access; insurance for health care and related services; and access to technology and other assistance devices. In addition, over the past two years, the legal definition of disability for the purpose of eligibility for government programs and services has been hotly debated in the public policy arena. Indeed, there have been eight Supreme Court cases since 1998 that deal with this controversial area. It is these issues and their attendant body of legislation and legal decisions that we seek to examine in this article. The article is organized into five sections. First, we provide background on the prevalence of in America describing this large minority group and outlining the major current disability-related policy issues. The next section details the foundation of policy in the United States, including the major programs and services that are available to people with disabilities and the major laws and statutes that are designed to offer protections for them in the major areas of employment, education, housing, health care, and technology accessibility. Third, we analyze current Supreme Court decisions that have been precedent setting. Fourth, we describe some of the continuing issues for people with disabilities in terms of what progress has been made and what remains to be done. In the fifth and final part of this article, we draw conclusions about where we stand as a society in ending discrimination on the basis of disability. We also discuss some important implications that our current direction suggests for the future of policy in the United States.

Claiming in the name of fairness: Organizational justice and the decision to file for workplace injury compensation.

This article explored the relationship among injured workers' perceptions of workplace justice (i.e., distributive, interactional, and procedural), perceptions of employers' disability-related policies, and the decision to file a workers' compensation claim. Using a 2-wave sample of 1,077 workers with repetitive motion injuries, the authors tested a structural equation model. Results revealed that Time 1 interactional justice was negatively related to filing a claim, whereas Time 1 distributive justice was positively related to perceptions of employer disability-related practices measured a year after the date of injury report. At Time 2, the claim decision was unrelated to perceptions of justice, yet perceptions of disability-related practices were significantly related to all 3 types of justice.