Topics covered include changes in the nature of work, rising health care expenditures, changing disability population, the American with Disabilities Act, social security disability insurance.

A major debate has begun over reports of an unprecedented decline in the employment rate of working-age people with disabilities by those using currently available data sources to track the health employment and economic well-being of the United States population. Many question whether the decline is real, and some have even called on the Federal government to end its financial support for the dissemination of employment estimates for people with disabilities using currently available data. In this policy brief we summarize the arguments and evidence on the issue, and reflect on the importance of the issue for the ongoing debate on disability policy. We conclude that the decline is real and it has important implications for public policy.

The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.

This paper replicates the recent findings that the employment rate among all disabled persons has declined since the ADA. A closer look at this decline, however, indicates that the source of this measured decline in employment is the result of a tremendous drop in the labor force participation rate among the disabled. While also of potential concern, further analysis indicates that this drop in the labor force participation rate was not the result of the disabled fleeing the labor market, but, rather, more likely the result of re-classification of non-disabled, non-participants, as disabled. The unconditional employment probability among the disabled (taking selection into the labor market into account) has actually not declined, and may have in fact improved slightly for certain disability classifications. The results are consistent across two different data sets and mirrored by a state-level analysis. While the relative employment position of the disabled has not deteriorated, the lack of significant impact of the ADA does raise the issue of the merit of its labor market provisions.

A major debate has begun over reports of an unprecedented decline in the employment of working age people with disabilities over the 1990s business cycle. Here we review the literature on what can and cannot be said with current data on this subject and conclude that this decline is not an artifact of the data. We then review the various explanations and evidence for this decline and conclude that it was caused by changes in social policy rather than increases in the severity of the underlying health conditions and impairments of this population. The implication is that significant changes in public policy are needed to more effectively integrate working age people with disabilities into employment. We identify and discuss the most promising directions for public policy in this area.

The overarching objective of this book is to support and facilitate efforts to improve statistics and data on working-age people with disabilities.

With the passage of the Americans with Disabilities Act of 1990 (ADA), the employment of persons with disabilities has taken center stage in policy debates. The passage of the ADA could not have come at a more propitious time: the employment situation of persons with disabilities, particularly older workers, has been worsening dramatically for over two decades. In the traditional view, this worsening employment necessarily follows the aging of the population, which puts more of us at risk for chronic disease and impairment. Yelin does not agree with that view, nor with the alternative view that disability compensation programs entice persons with minimal disabilities to leave the work force by providing them with a secure income. In this controversial new book, Yelin dispels both these views and argues that the welfare state is not to be blamed for the growth in work disability. Rather, Yelin maintains that the growing work disability problem is due to the decline of manufacturing employment, which drove older workers with disabilities out of the labor force as part of a "first-fired" phenomenon. He links disability to changes in all forms of work that made secure full-time employment with a wide range of benefits a thing of the past. Yelin argues that work disability policy and industrial policy must be joined to create a heightened demand for older workers generally and older workers with disabilities in particular. When employers create work environments flexible enough to accommodate people with disabilities, they enjoy the benefits of an exceptionally skilled, able work force - and the economies of a smaller welfare system. Paradoxically, the products of flexible manufacturing have been very successful in the marketplace, demonstrating that what is good for workers with disabilities is also good for all workers and for the economy as a whole.