Research Paper
The risk of developing a work disability across the adulthood years

An earlier version of the manuscript was presented at a conference sponsored by the Panel Study of Income Dynamics, “Health Across the Life Course,” Ann Arbor, Michigan, September 23 and 24, 2010.
https://doi.org/10.1016/j.dhjo.2013.12.001Get rights and content

Abstract

Background

Work disability has implications for individual health, national health care expenditures, economic productivity, and the social safety net. Knowledge about population dynamics and risk factors associated with work disability are not delineated by cross-sectional research.

Objective

In this paper the authors estimate, for the first time, the prospective lifetime risk that a head of household will report a work disability.

Methods

Using forty years of longitudinal data from the Panel Study of Income Dynamics (PSID), we estimate the lifetime risk of developing a work disability and conduct a logistic regression analysis to examine personal characteristics that increase the likelihood of a self-reported work disability. Life table methods are used to calculate lifetime prevalence, and to compute covariate effects.

Results

Between the ages of 25 and 60, over half (54.6%) of U.S. household heads will self-report a work disability, and approximately one quarter (24.1%) will self-report a severe work disability. Persons with income below 150% of the federal poverty level, or lower educational attainment, have an increased likelihood of reporting a work disability.

Conclusions

This study finds that more than half of U.S. household heads will self-report a work disability, which is a higher prevalence than in existing cross-sectional estimates. The social context for this finding is that work disability is a major driver of spending on health care services and the social safety net.

Section snippets

Data set

This study is based on longitudinal analysis of the Panel Study of Income Dynamics (PSID), a nationally representative data set. The statistical methodology is the life table. An extended discussion of the PSID and life table methods can be found under Ancillary Material.

The life table method eliminates omission bias confounding Meyer and Mok's12 longitudinal analysis of work disability using the PSID. These authors identify end of study age groups within the PSID, and then retrospectively

Life course probabilities of developing a work disability

The first column (1 or more years) in Table 1 represents the proportion of household heads who at some point during their prime working age years will develop a work disability. For reasons of space we only include the cumulative proportions at five year intervals, although our analysis contains these proportions for each year between 25 and 60. In addition, although life table results are generally reported as proportions (as they are in Table 1, Table 2), for our discussion of the results we

Discussion

This study has provided a first time look at the overall likelihood of American heads of household developing a work disability at some point between the ages of 25 and 60. Our results indicate that over half (54.6%) of household heads will report some type of a work disability during these years, while nearly one quarter (24.1%) will report having a severe work disability. This is in sharp contrast with the cross-sectional U.S. Census Bureau annual rates of 12.7% of the population 16 to 64

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    • Work disability in the United States, 1968–2015: Prevalence, duration, recovery, and trends

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      African American and Hispanic women reported less moderate and severe work disability than whites. Studying individuals’ risks of a first occurrence of either any work disability or severe work disability, Rank and Hirschl (2014) found that nonwhites were less likely to report any work disability than whites, with no significant difference for severe work disability. That the latter finding differs from our result may be due to their focus on household heads, which limited the representation of women, or to differences in methods.

    • Identifying adults aging with disability using existing data: The case of the Health and Retirement Study

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      Diagnosis of at least one chronic illness in adulthood used as a measure of physical health in adulthood. Work limitation is a lesser studied disability construct9; but an important one to understand as it relates to life course experiences of living with disability. To assess the impact of disability in adulthood on work, HRS asks, “Do you have any impairment or health problem that limits the kind or amount of paid work you can do?”

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    Sources of financial support: Funding for the analysis in this study was provided by a Ford Foundation Grant administered through the Center for Social Development, Washington University, as well as funding from the Panel Study of Income Dynamics, University of Michigan. The authors have no conflicts of interest.

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