Improvement In Employment Outcomes Research Articles

Older workers’ employment and Social Security spillovers through the second year of the COVID-19 pandemic

AbstractThe COVID-19 pandemic triggered a large and immediate drop in employment among U.S. workers, along with major expansions of unemployment insurance (UI) and work from home. We use Current Population Survey and Social Security application data to study employment among older adults and their participation in disability and retirement insurance programs through the second year of the pandemic. We find ongoing improvements in employment outcomes among older workers in the labor force, along with sustained higher levels in the share no longer in the labor force during this period. Applications for Social Security disability benefits remain depressed, particularly for Supplemental Security Income. In models accounting for the expiration of expanded UI, we find some evidence that the loss of these additional financial supports resulted in an increase in disability claiming. Social Security retirement benefit claiming is approximately 3% higher during the second year of the pandemic.

Employment Equity for People With IDD Across the Lifespan: The Effects of State Funding.

In the last decade, major strides have been made to elevate the importance of employment for people with intellectual and developmental disabilities (IDD). Despite progress, improvement in employment outcomes remain modest. Using extant data, a sample of 9,871 adults with IDD accessing Medicaid Home and Community-Based Services waiver services across 33 states were studied using hierarchical modeling to understand the effects of age on employment as well as assess how state fiscal effort toward integrated employment services affects employment equity across the lifespan. Key findings showed young and older adults experienced the lowest employment outcomes. The effects of age, however, were moderated in states with higher fiscal effort to integrated employment services. Implications for research, policy, and practice are discussed.

Fidelity and IPS: does quality of implementation predict vocational outcomes over time for organizations treating persons with severe mental illness in the Netherlands?

Individual placement and support (IPS) is an evidence-based supported employment intervention. Quality of IPS implementation is assessed using a validated fidelity scale. Previous studies found a positive association between fidelity and employment outcomes at a single time-point. This study examines the longitudinal associations between IPS fidelity scores and employment outcomes. We examined fidelity and employment outcome data for 27 IPS programs in the Netherlands providing IPS. These programs received at least one fidelity assessment and reported quarterly employment outcomes for at least one year to a central registry between 2014 and 2019. We first examined changes over time for fidelity and employment outcome. Then we analyzed the longitudinal associations between the quarterly employment outcomes and the IPS fidelity assessments on multiple time-points using a mixed-model analysis for the 17 programs with at least two fidelity assessments. Both IPS fidelity and employment outcomes improved over time, with the largest improvement in employment outcomes achieved after 18 months of implementation. We found a significant positive longitudinal association between IPS-fidelity and employment. Improvement of fidelity is associated with improvement of employment outcomes over time. Future research should be focused on the improvement of specific elements of IPS implementation and their influence on employment outcomes.

Estimation of indirect costs based on employment and earnings changes after spinal cord injury: an observational study.

Cross-sectional. (1) Identify changes in employment status and earnings after spinal cord injury (SCI). (2) Estimate annual indirect costs and lifetime indirect costs due to lost earnings for various age and neurologic categories of those with SCI. (3) Compare our estimates with previous research. Medical university in southeastern United States. A population-based cohort of 307 participants met eligibility criteria of: (1) residual impairment resulting from traumatic SCI, (2) at least 1 year post injury, (3) between 23 and 64 years old at time of injury, (4) <65 years old at time of measurement, and (5) complete information on injury level, injury completeness, employment status, and earnings before and after injury. Main outcomes were employment status and earnings at the time of injury and post injury. Earnings were adjusted for inflation and the value of fringe benefits. Employment rate decreased from 87% at the time of injury to 35% after injury. Average annual indirect costs were $29,354 in 2019 dollars. Lifetime indirect costs for persons injured at age 25 varied by severity of injury, ranging from 0.5 to 2.3 million dollars. Lifetime indirect costs for persons injured at age 50 ranged from 0.3 to 0.6 million dollars. Our estimate of indirect costs is lower than the previously estimated number. However, the higher unemployment rate and decreased earnings after SCI still make a heavy economic burden. With improvements in employment outcomes after SCI, the indirect costs affecting individuals, their families, and society can be further reduced.

Integrating Refugee Healthcare Professionals In The UK National Health Service: Experience From A Multi-Agency Collaboration.

PurposeRefugee healthcare professionals (RHPs) may encounter several barriers to employment upon moving to the UK, such as conversion of professional qualifications and a lack of familiarity with the recruitment process. The Building Bridges Programme (BBP) is a London-based multi-agency collaboration which helps refugee healthcare professionals seek employment in the UK National Health Service (NHS).MethodsWe have kept an electronic database of all RHPs who have participated in the BBP from October 2009 to March 2018. Data collected include gender, language spoken, country of initial medical qualification, immigration status, religion, ethnicity and professional work experience. In this paper, we focus on employment outcomes and determine the proportion (%) of RHPs joining the BBP who enter employment in the NHS.ResultsBetween October 2009 and March 2018, the BBP supported 372 refugee doctors, 42 refugee pharmacists, 69 refugee dentists, 25 refugee biomedical scientists, 4 refugee physiotherapists and 83 refugee nurses. The following are the results for the RHPs who settled into a registered NHS position appropriate to their (home country) professional qualifications: 98/372 (26%) doctors, 4/42 (10%), pharmacists, 17/69 (25%) dentists, 1/25 (9%) biomedical scientists, 1/4 (25%) physiotherapists and 2/83 (2%) nurses. The following are the results for the RHPs who settled in associated healthcare profession positions: 109/372 (29%) doctors, 16/42 (38%) pharmacists, 12/69 (17%) dentists, 10/25 (40%) biomedical scientists, 3/4 (75%) physiotherapists and 34/83 (41%) nurses.ConclusionThe BBP provides a useful model that is transferable to other countries. Future studies assessing the utility of such programmes should ensure that the long-term employment outcomes of RHPs are more closely tracked. A key limitation of this paper is the absence of a control group of participants who did not join the BPP, which would help to conclusively demonstrate whether participants who joined our programme had a statistically significant improvement in employment outcomes.

Psychological Changes and Employment Outcomes After Kyphosis Correction in Patients With Ankylosing Spondylitis.

A retrospective study. To evaluate the psychological changes and employment outcomes following corrective osteotomy in patients with ankylosing spondylitis (AS). To date, no study has investigated the changes in psychological status and subsequent improvement in employment outcome after correction of kyphotic deformities in patients with AS. This study included 48 patients with AS who underwent corrective osteotomy for severe kyphotic deformity. Sagittal alignment was assessed radiographically. Clinical status was evaluated using the Short Form-36 Health Survey, psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS), and employment outcomes were assessed using the Lam Employment Absence and Productivity Scale (LEAPS). The degree of postoperative sagittal alignment correction was measured, and changes in clinical and employment outcomes and psychological status were evaluated. The relationship between the degree of sagittal alignment correction and each evaluation item was analyzed. Following postoperative sagittal alignment correction, all patients could stand erect and look straight. Significant improvements were observed in the clinical and employment outcomes, as well as in patients' psychological status. The degree of sagittal vertical axis correction was significantly correlated with the HADS depression and the LEAPS total scores. The degree of correction of the chin-brow vertical angle was significantly correlated with the Short Form-36 mental health score, the HADS depression and anxiety scores, and the LEAPS total and productivity subscores. Notably, the improvement in the HADS depression score was significantly correlated with the LEAPS total score. This study demonstrated the psychological changes and subsequent improvement in employment outcomes after corrective osteotomy in patients with AS. The degree of sagittal alignment correction was correlated with improvements in psychological status and employment outcomes. 4.

Employment Outcomes 2Years After Bariatric Surgery: Relationship to Quality of Life and Psychosocial Predictors.

Bariatric surgery is the most effective long-term treatment for severe obesity. In addition to sustained weight loss, bariatric surgery can result in improvements in mental and physical health-related quality of life (HRQOL) and, consequently, work capacity. The purpose of our study was to evaluate changes to employment impairment (EI) and related HRQOL in patients 2years post-bariatric surgery. Prospective data was collected on a cohort of 211 patients who underwent bariatric surgery. The Lam Employment Absence and Productivity Scale (LEAPS) and the 36-Item Short Form Survey (SF-36) were used to assess pre- and post-operative EI and physical and mental HRQOL, respectively. Predictors of work impairment changes were analyzed via multiple regression analysis and included demographic variables, history of psychiatric illness, and depression and anxiety self-report measures. Significant improvements in employment outcomes 2years following surgery were noted with 68% of participants reporting an overall decrease in EI (total LEAPS score change = - 2.43 ± 5.76, p < 0.001), and 44% participants reporting an increase in work productivity (LEAPS productivity score change = - 0.67 ± 2.38, p < 0.001). Bariatric surgery was also associated with significant improvements in physical (change = 17.41±10.72, p< 0.001) and mental (change = 2.67 ± 12.89, p= 0.001). Improvements in HRQOL predicted improvements in work-related impairment and productivity, while history of psychiatric illness predicted was associated with reduced improvement in work productivity. Our results provide further evidence of improvement in work productivity and reduction in EI post-bariatric surgery. This study also provides insights into potential predictors of work-related impairment and productivity.

Raising Expectations for U.S. Youth with Disabilities: Federal Disability Policy Advances Integrated Employment

While conversations around the inclusion of individuals with disabilities often focus on the educational rights and needs of children with disabilities during their school years, there is a growing recognition that the period of transition from secondary school to adult roles is a critical time in the lives of individuals with disabilities. For young people, gaining meaningfulemployment in a typical community job is an important step towards realising full community membership. The present article examines how contemporary U.S. federal disability policy has heightened expectations that youth with disabilities – including those with significant disabilities – can and should be prepared to work in integrated workplaces. The article begins with a consideration of how evolving assumptions about the nature of disability and the employment potential of individuals with significant disabilities have influenced the development of federal disability policy in the U.S. This is followed by an overview of key legislative and policy developments in the areas of civil rights and workforce development that havethe potential to dramatically impact the employment outlook for young people with disabilities. The article concludes with a discussion of challenges in translating the legislative intent of federal disability policy into noticeable improvements in employment outcomes, along with recommendations for aligning legislation, funding priorities and service delivery systems to achieve policy goals.

Organizational and cultural factors that promote creative best practices in the public rehabilitation program: Findings from a four-state multiple case study

The state-federal vocational rehabilitation system is tasked to demonstrate accountability for employment outcomes of persons with disabilities. State VR agencies have sought to evaluate existing practices, and in areas that existing practices leave room for improvement, create the conditions for innovation to occur. The purpose of this article is to identify promising organizational and cultural factors that appear to promote best practices in the public vocational rehabilitation program. A multi-stage study utilizing the Consensual Qualitative Research (CQR) was conducted involving four high performing state VR agencies to discover emerging and promising organizational practices leading to improvements in employment outcomes of people with disabilities. The comprehensive examination revealed specific organizational practices, culture and structural elements that encourage and support the development of innovative, effective service delivery practices. Given the complexity of service provision and the increasing demand for successful outcomes, VR agencies must develop organizational cultures that facilitate transformational learning by employing evidence-based practices that lead to successful outcomes for agency consumers.

An Integrated Drug Counseling and Employment Intervention for Methadone Clients

After drug use stabilization, employment has long been considered an important goal for clients enrolled in Methadone Maintenance Treatment Programs (MMTPs). The integrated counseling and employment intervention described here is a manualized treatment based on interpersonal cognitive problem solving (ICPS) theory. The six-month intervention utilized a problem-solving framework to help methadone clients obtain a job and manage employment within the context of drug treatment. In this pilot study, 23 subjects were randomly assigned to either integrated ICPS drug and employment counseling (n = 12) or to an ICPS drug counseling control condition (n = 11). While there were no differences between the integrated and control conditions, both groups showed a significant improvement in employment outcomes and reduction in HIV risk behaviors at the six-month follow-up. Although there may be concerns regarding the generalizability of the findings, overall, the problem solving framework may be an improvement over standard methadone counseling. The intervention may be beneficial when implemented with a larger group of motivated ex-offenders who are mandated to drug treatment as a condition of their parole.

Employment Outcomes of Persons With a Mental Disorder and Comorbid Chronic Pain

Employment Outcomes of Persons With a Mental Disorder and Comorbid Chronic Pain

Integration of Mental Health Care and Supported Employment

Back to table of contents Previous article Next article Letters to the EditorFull AccessIntegration of Mental Health Care and Supported EmploymentROBERT ROSENHECK M.D.,ROBERT ROSENHECK M.D.Search for more papers by this author,Published Online:1 May 2006AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To The Editor: Judith A. Cook, Ph.D., et al. (1) presented an illuminating reanalysis of data from the Employment Implementation Demonstration Program, perhaps the largest study of supportive employment ever conducted. In their article, the authors shifted the analytic focus from a comparison of supported employment and control interventions (2) to a comparison of programs with greater integration of psychiatric and employment services and those with less integration. This is evidently a crucial shift because the difference in employment rates in the original analysis (55% for those with supported employment and 34% for comparison subjects—a 1.6-fold difference) was almost double in the newer analysis (58% employed in the high-integration programs versus 21% in the low-integration programs—a 2.8-fold difference). Unfortunately, the explanation of the measure of integration was somewhat ambiguous. On p. 1950, a clearly defined four-level measure of integration was presented. It was subsequently explained that the measure was dichotomized at 50% or more, with integrated sites defined as those that met two or more of the four criteria. Given the hierarchical nature of the four-level measure (the higher levels seem to encompass the lower levels), the threshold for integration would seem to have been met if 1) common charts were used and 2) both types of service were provided by the same agency. This modest level of structural integration seems to have had a substantial impact on employment outcomes, and if replicable in other studies, it could be implemented widely. However, in footnote c to Table 2 and in the first paragraph of the discussion, all four integration criteria are listed, suggesting that perhaps all four had to be met for a program to be considered highly integrated. I inferred from the fact that two-thirds of the programs met the threshold for high integration that the looser criteria had been applied. Could the authors clarify what is the correct definition of the integration variable used in their analysis and whether they believe that such modest structural characteristics can, indeed, improve employment outcomes? If so, what is the role of the quality of supported employment itself? The importance of integration would have received stronger support if the authors had demonstrated a monotonal progressive improvement in employment outcomes as one moves up the five levels of integration on this measure. Was this observed?West Haven, Conn.

Integration of Mental Health Care and Supported Employment

Back to table of contents Previous article Next article Letters to the EditorFull AccessIntegration of Mental Health Care and Supported EmploymentROBERT ROSENHECK M.D.,ROBERT ROSENHECK M.D.Search for more papers by this author,Published Online:1 May 2006AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To The Editor: Judith A. Cook, Ph.D., et al. (1) presented an illuminating reanalysis of data from the Employment Implementation Demonstration Program, perhaps the largest study of supportive employment ever conducted. In their article, the authors shifted the analytic focus from a comparison of supported employment and control interventions (2) to a comparison of programs with greater integration of psychiatric and employment services and those with less integration. This is evidently a crucial shift because the difference in employment rates in the original analysis (55% for those with supported employment and 34% for comparison subjects—a 1.6-fold difference) was almost double in the newer analysis (58% employed in the high-integration programs versus 21% in the low-integration programs—a 2.8-fold difference). Unfortunately, the explanation of the measure of integration was somewhat ambiguous. On p. 1950, a clearly defined four-level measure of integration was presented. It was subsequently explained that the measure was dichotomized at 50% or more, with integrated sites defined as those that met two or more of the four criteria. Given the hierarchical nature of the four-level measure (the higher levels seem to encompass the lower levels), the threshold for integration would seem to have been met if 1) common charts were used and 2) both types of service were provided by the same agency. This modest level of structural integration seems to have had a substantial impact on employment outcomes, and if replicable in other studies, it could be implemented widely. However, in footnote c to Table 2 and in the first paragraph of the discussion, all four integration criteria are listed, suggesting that perhaps all four had to be met for a program to be considered highly integrated. I inferred from the fact that two-thirds of the programs met the threshold for high integration that the looser criteria had been applied. Could the authors clarify what is the correct definition of the integration variable used in their analysis and whether they believe that such modest structural characteristics can, indeed, improve employment outcomes? If so, what is the role of the quality of supported employment itself? The importance of integration would have received stronger support if the authors had demonstrated a monotonal progressive improvement in employment outcomes as one moves up the five levels of integration on this measure. Was this observed?West Haven, Conn.

Gender differences in income after substance abuse treatment.

This study asked whether men and women who enrolled in substance use treatment reported similar changes in income from work, public assistance, and crime over time. Income data were analyzed for 261 substance users (77 women, 184 men) who entered day or residential treatment, and completed Addiction Severity Index measures at treatment entry and up to 18 months later. Over time, respondents reported increases in employment income. People whose main source of income at baseline had been crime or public assistance showed significant decreases respectively in income from crime or public assistance. Men made greater gains in work income than women did. Across time, men were more likely to be employed than women were. Findings show the economic value of substance use treatment, but less improvement in employment outcomes for women than men.

Converting Day Treatment Centers to Supported Employment Programs in Rhode Island

The purpose of the study was to compare vocational and nonvocational outcomes of clients of two community mental health centers that underwent conversion from day treatment programs to supported employment programs with outcomes of clients of a center that delayed conversion until after the study was completed. As part of a statewide effort in Rhode Island to convert day treatment programs to supported employment programs, the authors assessed 127 day treatment clients with severe mental illness in three community mental health centers. Two of the centers converted to supported employment, and one continued its rehabilitative day program. Participants were assessed prospectively for 30 to 36 months, with special attention to vocational and social outcomes. Former day treatment clients in the converted centers attained higher rates of competitive employment than those in the comparison group (44.2 percent and 56.7 percent versus 19.5 percent). Other employment outcomes also improved, and hospitalization rates and overall social functioning were unchanged. This study supports findings of previous studies suggesting that replacing rehabilitative day treatment programs with supported employment programs yields improvements in employment outcomes without adverse effects.

Union loyalty among white‐collar workers in Japan

AbstractPrevious research on Japanese union members has documented occupational differences in employees' attitudes toward union organizations (Japan Productivity Center, 1990; Morishima, 1993). Yet, little has been done to examine why these differences occur. This study examines, using a data set obtained in 1987 from about 4000 employees, the correlates of union loyalty across white‐collar and blue‐collar occupations, and among white‐collar occupations. A model is developed from previous research on employees' attitudes toward union organizations and on Japanese industrial relations. The results obtained by OLS analyses of union loyalty correlates—members' judgements of union contributions to improvements in employment outcomes and of employers' human resource policies—indicate that Japanese unions have benefited mainly blue‐collar workers and traditional white‐collar workers, such as those in administrative positions, relative to those in technical positions.