a Institute on Disability, University of New Hampshire , Durham , NH , USA.
Disabil Rehabil. 2019 Sep;41(19):2299-2307. doi: 10.1080/09638288.2018.1465131. Epub 2018 May 20.
To better understand the relationship between employment and health and health care for people with disabilities in the United States (US). We pooled US Medical Expenditure Panel Survey (2004-2010) data to examine health status, and access to health care among working-age adults, comparing people with physical disabilities or multiple disabilities to people without disabilities, based on their employment status. Logistic regression and least squares regression were conducted, controlling for sociodemographics, health insurance (when not the outcome), multiple chronic conditions, and need for assistance. Employment was inversely related to access to care, insurance, and obesity. Yet, people with disabilities employed in the past year reported better general and mental health than their peers with the same disabilities who were not employed. Those who were employed were more likely to have delayed/forgone necessary care, across disability groups. Part-time employment, especially for people with multiple limitations, was associated with better health and health care outcomes than full-time employment. Findings highlight the importance of addressing employment-related causes of delayed or foregone receipt of necessary care (e.g., flex-time for attending appointments) that exist for all workers, especially those with physical or multiple disabilities. Implications for rehabilitation These findings demonstrate that rehabilitation professionals who are seeking to support employment for persons with physical limitations need to ensure that overall health concerns are adequately addressed, both for those seeking employment and for those who are currently employed. Assisting clients in prioritizing health equally with employment can ensure that both areas receive sufficient attention. Engaging with employers to develop innovative practices to improve health, health behaviors and access to care for employees with disabilities can decrease turnover, increase productivity, and ensure longer job tenure.
为了更好地理解美国（美国）就业与残疾人健康和医疗保健之间的关系。我们汇集了美国医疗支出面板调查（2004-2010 年）的数据，以检查工作年龄成年人的健康状况和获得医疗保健的机会，将身体残疾或多重残疾的人与没有残疾的人进行比较，根据他们的就业状况。进行了逻辑回归和最小二乘法回归，控制了社会人口统计学，健康保险（当不是结果时），多种慢性疾病和需要援助。就业与获得护理，保险和肥胖呈负相关。然而，过去一年就业的残疾人报告的一般和心理健康状况要好于具有相同残疾但未就业的同龄人。那些就业的人更有可能延迟/放弃必要的护理，跨残疾群体。兼职就业，特别是对于多重限制的人，与全职就业相比，与更好的健康和医疗保健结果相关。研究结果强调了解决与就业相关的延迟或放弃接受必要护理的原因的重要性（例如，为参加约会而灵活的时间），这些原因适用于所有工人，特别是那些身体或多重残疾的工人。康复的影响这些研究结果表明，寻求支持身体残疾者就业的康复专业人员需要确保充分解决整体健康问题，无论是为那些寻求就业的人还是为那些目前就业的人。帮助客户平等地将健康与就业放在同等重要的位置，可以确保这两个领域都得到足够的关注。与雇主合作，制定创新实践，以改善残疾员工的健康，健康行为和获得护理的机会，可以降低员工离职率，提高生产力，并确保更长的工作任期。
