Debra L. Brucker

Outcomes of a Family-Centered Transition Process for Students with Autism Spectrum Disorders.

A three-component intervention was implemented with 47 youth with autism spectrum disorders (ASD) as they transitioned from high school to adult life. The youth, ages 16 to 19 years, were randomly assigned to a Year 1 group or a Year 2 group. Participants in the Year 1 group received a transition planning intervention consisting of (a) group training sessions for families in the transition process, (b) person-centered planning meetings facilitated by project staff, and (c) follow-up assistance with career exploration and plan implementation. Data were collected pre- and post implementation to measure student and family expectations, self-determination, and career decision-making ability. The Year 2 group began receiving services following the second data collection point. Participants in the Year 1 group reported statistically significant increases in all four measured variables, whereas the Year 2 group showed no significant changes. Implications for redesigning transition services for this population are discussed.

Participation in Safety-Net Programs and the Utilization of Employment Services Among Working-Age Persons With Disabilities

A comprehensive analysis of the 2009 Current Population Survey–Annual Social and Economic Supplement (CPS-ASEC) provides the first snapshot of the involvement of people with disabilities in a broad array of government programs. Focusing on the working-age population, this analysis reveals that people with disabilities represent one third of the persons who participate in safety-net programs. Among persons with disabilities, 65% participate in a safety-net program, compared with 17% of persons without disabilities. Among Social Security Disability Insurance (DI) beneficiaries, 38% participate in safety-net programs other than DI, Supplemental Security Income (SSI), Medicaid, and Medicare. Furthermore, results suggest that only 3% and 8% of low-income nonworking safety-net participants with and without disabilities, respectively, utilize employment services. Improved data collection on the use of employment services is needed to further evaluate the interaction of safety-net and employment services programs.

People with Disabilities in the United States.

A recent compilation of published disability statistics available for the United States showcases the pervasive and persistent disparities that exist between people with and without disabilities across multiple fronts, including employment, earnings, poverty, and participation in safety net programs. Understanding the relevance of these statistics within the current policy environment can help guide further innovations to improve the lives of persons with disabilities in the United States.

Individual Characteristics and the Disability Employment Gap

Although people with disabilities have poorer employment outcomes, on average, than do people without disabilities, some of them fare relatively well in the labor market. To learn more about the individual characteristics associated with positive employment outcomes among people with disabilities, we use data from the 2009–2011 American Community Survey to examine differences in employment outcomes by demographic and other individual characteristics in a multivariable framework. Controlling for all other individual characteristics, we find the employment gap between individuals with and without disabilities is smaller among those in their 20s and 60s relative to the middle aged, Asians relative to Whites, Hispanics relative to non-Hispanics, married individuals, individuals with higher levels of educational attainment, and women. Overall, results suggest that policies and practices designed to improve employment outcomes among people with disabilities should consider how individual characteristics interact with disability as challenges to or facilitators of employment success.

Social capital, employment and labor force participation among persons with disabilities

BACKGROUND: Social capital, an attribute that reflects connectedness or engagement with other individuals, organizations or communities, may be associated with participation in the labor force and with employment. OBJECTIVE: To examine variations in social capital among persons with disabilities. METHODS: Data from the 2010 Civic Engagement Supplement to the Current Population Survey is used to describe levels of social capital among persons with disabilities by employment and labor force participation status, controlling for demographic characteristics. Adults with disabilities who are in the labor force have higher levels of social capital than adults with disabilities who are not in the labor force. Among those persons with disabilities who are in the labor force, however, little difference in social capital exists between those who are and who are not employed. CONCLUSION: Advocates, policymakers and service providers seeking to maximize the successful inclusion of persons with disabilities within society must not lose sight of social capital as a construct as equally important as built, human, and economic capital. Innovative programs and services that are offered throughout the lifespan should incorporate strategies to address each of these types of resources.

Estimating the Prevalence of Substance Use, Abuse, and Dependence Among Social Security Disability Benefit Recipients

With the passage of Public Law 104-121, the Contract with America Advancement Act of 1996, the federal Social Security Administration was no longer allowed to grant disability benefits to persons whose primary diagnosis was one of substance abuse or dependence. The National Survey on Drug Use and Health (NSDUH; Substance Abuse and Mental Health Services Administration, 2004a), a nationally representative household survey, uses validated scales to measure rates of substance abuse and dependence among the U.S. population. In 2002, for the first time, the NSDUH also included questions about disability. Data from the 2002 survey is examined to determine whether issues of substance abuse and dependence are still relevant for the 2 Social Security programs that serve persons with disabilities: Social Security Disability Insurance (DI) and Supplemental Security Income (SSI). Results indicate that a substantial portion of DI and SSI beneficiaries continue to struggle with issues of substance abuse.

Trips to medical care among persons with disabilities: Evidence from the 2009 National Household Travel Survey

BACKGROUND Persons with disabilities experience multiple barriers to obtaining necessary medical care. Problems with access to transportation and provider choice could lead to longer travel distances and longer travel times to medical appointments. OBJECTIVE/HYPOTHESIS 1) Persons with disabilities travel further distances to receive necessary care, holding other variables constant. 2) Travel to medical appointments takes a longer amount of time for persons with disabilities, controlling for distance, mode of transportation and other factors. 3) Disability is the key factor influencing access to transportation options, holding other variables constant. METHODS The 2009 National Household Travel Survey (NHTS) is used to examine travel patterns of persons with disabilities as they access medical care. Logistic regressions are run on distance to medical appointments, time taken for travel to medical appointments, and access to private vehicle. RESULTS There is no difference in the distance traveled, but trips to medical care by persons with disabilities take longer amounts of time than trips taken by persons without disabilities, holding other variables constant. Access to private transportation is similar for both persons with and without disabilities. CONCLUSIONS Persons with disabilities experience longer travel times to receive medical care, despite traveling similar distances and having similar access to private vehicles.

Social construction of disability and substance abuse within public disability benefit systems

Federal legislation passed in 1996 in the United States changed the eligibility criteria for public disability benefit programmes. After 1996, persons with a primary diagnosis of substance abuse no longer qualified to receive disability benefits. Using a framework of social construction, a qualitative comparative analysis examines how the national disability systems of eight countries - Australia, Canada, Germany, Japan, the Netherlands, South Africa, Sweden, the United Kingdom, and the US - address issues of substance abuse. The US is the only country among the focal countries that does not currently allow disability benefits to be awarded to those with primary conditions of substance use disorders. International experience in providing disability benefits to persons with substance use disorders can inform US policy makers as to how the current US federal disability benefit system might be expanded to be more inclusive of persons with substance abuse disorders.

Using Sensory, Functional, and Activity Limitation Data to Estimate Employment Outcomes for Working-Age Persons With Disabilities in the United States

Using data from the 2010–2012 American Community Survey (ACS), we estimate employment outcomes among persons with different combinations of sensory, functional, and activity limitations while controlling for individual characteristics. We consider activity limitations as indicators of barriers to independent living and of a need for support services. We find that the presence of an activity limitation is strongly associated with decreased odds of employment for persons with sensory or functional limitations. Results provide support for the targeted allocation of resources to increase independent living among persons with disabilities as a means to improve employment outcomes among persons with disabilities.

The association of food insecurity with health outcomes for adults with disabilities

BACKGROUND Adults with disabilities are more likely to live in households that are food insecure and are more likely to experience health disparities than adults without disabilities. Research examining the intersection of food insecurity and health outcomes for adults with disabilities has so far been lacking, however. OBJECTIVE/HYPOTHESIS The research presented here tests whether living in a food insecure household is associated with poorer self-reported health and mental health and different health care utilization, controlling for disability status and other sociodemographic characteristics. METHODS Multivariate regression analyses are conducted using linked data from the 2011 National Health Interview Survey and the 2012 Medical Expenditures Panel Survey. RESULTS Adults with and without disabilities who live in food insecure households have higher odds of reporting fair or poor health or mental health in either the current year or the subsequent year. Health care utilization patterns differ for adults who are food insecure as well, both within and across years. CONCLUSIONS Efforts to address health disparities among adults with disabilities should consider the possible additional impact of food insecurity on health outcomes.