Workshop on Health and Disability among Working-Age Adults: Trends, Disparities, and Implications for Employment and Federal Programs

10:00 a.m. | Welcome; NIA Goals for the Discussion

After introductions, the workshop chair previewed the workshop session topics: (1) defining, conceptualizing, and measuring disability; (2) Period and cohort trends in disabling morbidity—health and medical drivers; (3) Population disparities; (4) Contextual factors and policy influences on morbidity and disability; (5) Workforce/workplace trends in disability and disability policy; and (6) synthesis and takeaways.

• Malay Majmundar, Committee on Population
• Kriti Jain, National Institute on Aging
• Emily Agree, Johns Hopkins University, Workshop Chair

10:15 a.m. | Session 1: Defining, conceptualizing, and measuring disability; data needs

Guiding questions:

• What are the conceptual and technical challenges in measuring disability and estimating disability prevalence for the working age population?
• How do alternative definitions and measurement approaches affect estimates for specific populations?
• What measures are most appropriate for different purposes—e.g., population monitoring, establishing eligibility for programs, informing policies, international comparability in reporting, etc.?
• What are the key data and infrastructure needs for improving measures/statistics. How can existing data investments, particularly in longitudinal sources, be enhanced to better study disability in working age populations and how it tracks with work experiences/trajectories?
• For understanding disparities between disabled and non-disabled people, what frameworks are available for measuring health disparities that are specific to the disability context?

Presenters, each given 15 minutes:

• Scott Landes, Syracuse University, Moderator
• Bonnielin Swenor, Johns Hopkins University
• Kathleen J. Mullen, University of Oregon
• Sarah Rose, University of Texas
• Anjali Forber-Pratt, AAHD

Q&A – Open Discussion

12:00 p.m. | Lunch

1:00 p.m. | Session 2: Period and cohort trends in disabling morbidity—health and medical drivers

Guiding questions:

• Among the working-age population, what are the health-related factors driving trends and disparities in disability and disabling morbidity (e.g., obesity, cardiovascular disease, diabetes, physical and psychological pain)?
• What impacts have COVID-19 and long COVID had on projected trends in disability?
• What countervailing trends have emerged for different age/demographic groups? What do the various longitudinal data sources reveal?
• How are disability trends interacting with those for other health and risk factors?

Presenters, each given 15 minutes:

• Emily Agree Moderator
• Hiram Beltrán-Sánchez, University of California-Los Angeles
• Neil Mehta, University of Texas Medical Branch
• Anna Zajacova, Western University, Ontario

2:30 p.m. | Break

3:00 p.m. | Session 3: Population Disparities

Guiding questions:

• How does the timing, types, and severity of disability and disabling morbidity differ across minoritized populations? How prevalent are early onset disabilities for different groups?
• By what pathways do structural racism/sexism and disadvantage contribute to these differences in disability, and in ableism?
• How are inequalities in disability and mortality changing across education levels? How do these inequalities contribute to differential employment opportunities/outcomes and to occurrence of other types of disability?
• What are the unique challenges to immigrant populations? To what extent are immigrant workers likely to be working in vulnerable occupations (such as care work) and at risk of injury? What access to immigrants of different statuses have to disability programs?
• Maternal morbidity as a source of midlife health disadvantage—how are earlier life events linked to midlife?

Presenters, each given 15 minutes:

• Jennifer Karas Montez, Syracuse University, Moderator
• Marc Garcia, Syracuse University
• Taylor Hargrove, Univsersity of North Carolina
• Rupa Valdez, University of Virginia

4:45 p.m. | Day 1 Closing Remarks by Emily Agree and Committee Members

5:00 p.m. | Adjourn for Day

9:00 a.m. | Welcome Back

• Kriti Jain, National Institute on Aging
• Emily Agree, Johns Hopkins University, Workshop Chair

9:15 a.m. | Session 4. Contextual factors: Policy influences on morbidity and disability

Guiding questions:

• How does disability prevalence vary across regions and states within the United States?
• How might differences in minimum wage laws, worker protections, and other state level employment policies affect disability prevalence?
• How can natural experiments, such as those created by state-by-state variation in policies or environment, contribute to our understanding of the causal relationship between contextual and structural factors on disability severity and benefit program enrollment?
• How do changes in the supply of and type of housing and other aspects of the built environment affect disability prevalence?
• What is the role of environmental factors—e.g., climate change, exposure to toxic elements—in incidence or severity of midlife disability?

Presenters and discussants, each given 15 minutes:

• Jennifer Karas Montez, Syracuse University, Moderator
• Philippa J. Clarke, University of Michigan
• Ellen Meara, Harvard University
• Hwa Jung Choi, University of Michigan

10:45 a.m. | Break

11:00 a.m. | Session 5. Workforce and workplace trends in disability and disability policy

Guiding questions:

• How have functional needs required for work changed over time? How have these changes affected the occupational distribution of workers with disabilities and disability-related unemployment?
• What are the key facilitators to inclusion of individuals with disabilities in the workforce, including workplace accommodations and employment/benefit policies.
• To what extent have COVID and post-COVID era changes to the nature of the workplace affected disability prevalence overall and by occupation?
• What policies and practices—both positive and exploitive (e.g., subminimum wages)—affect employment of individuals with intellectual or other severe disabilities?
• What have been the effects of programs and disability policies on workers’ participation and well-being (e.g., the effectiveness of the ADA in ensuring employer accommodations and assessing effectiveness). How do the outcomes of U.S. policies compare with those enacted in other countries?

Presenters and discussants, each given 15 minutes:

• Emily Agree, Moderator
• Nicole Maestas, Harvard Medical School
• Ari Ne’eman, Harvard University
• Douglas Kruse, Rutgers University
• Luigi Pistaferri, Stanford University

Q&A – Open Discussion

12:45 p.m. | Lunch

1:45 p.m. | Session 6: Synthesis and takeaways—research gaps, data and measurement needs, policy directions

3:00 p.m. | Adjourn