There is insufficient research in the vocational rehabilitation literature that examines employment issues among older adults with diabetes.
OBJECTIVE:
The present study analyzed the Rehabilitation Services Administration case service report (RSA-911) for fiscal year 2009 to explore demographic characteristics, public supports, and vocational rehabilitation (VR) service variables impacting employment outcomes of persons age 55 and older who have diabetes as their primary cause of disability. The sample consisted of 1,489 people with diabetes who were closed either a) rehabilitated or b) not rehabilitated by state/federal vocational rehabilitation agencies. Exhaustive chi-squared automatic interaction detector (CHAID) analysis was used to extract predictive information for employment outcomes of older individuals with diabetes.
RESULTS:
The CHAID analysis indicated that receiving rehabilitation technology services increased the probability of competitive employment for the target population. Public supports were significant factors in reducing the likelihood of successful employment among older individuals with diabetes.
CONCLUSIONS:
These findings suggest certain VR services and work disincentives interact to predict the likelihood of employment outcomes among the target population. Vocational counseling implications and suggested research directions are provided to improve employment services and increase employment rates among older adults with diabetes.
AnG. J., KimM. J. (2012). Powerlessness, social support, and glycemic control in Korean adults with type diabetes. Contemporary Nurse: A Journal for the Australian Nursing Profession, 42(2), 272–279. doi:10.5172/conu.2012.42.2.272
3.
BarkerC. L. L., FordE. S., ZhangX., StrineT. W., & MokdadA. H. (2008). Diabetes and anxiety in U.S. adults: Findings from the Behavioral Risk Surveillance System. Diabetic Medicine, 25(7), 878–881. doi:10.1111/j.1464-5491
4.
BrownH. S., PerezA., YarnellL. M., PaganJ. A., HanisC. L., Fisher-HochS. P., & McCormickJ. B. (2011). Diabetes and employment productivity: Does diabetes management matter?American Journal of Managed Care, 17(8), 569–576.
ChanF., CheingG., ChanJ. Y. C., RosenthalD. A., & ChronisterJ. (2006). Predicting employment outcomes of rehabilitation clients with orthopedic disabilities: A CHAID analysis. Disability & Rehabilitation, 28, 257–270. doi:10.1080/09638280500158307
11.
DuttaA., GerveyR., ChanF., ChouC. -C., & DitchmanN. (2008). Vocational rehabilitation services and employment outcomes for people with disabilities: A United States survey. Journal of Occupational Rehabilitation, 18(4), 326–334. doi:10.1007/s10926-008-9154-z
12.
DowdyC. A. (1996). Vocational rehabilitation and special education: Partners in transition for individuals with learning disabilities. Journal of Learning Disabilities, 29, 137–147.
13.
Freak-PoliR., & PeetersA. (2012). The contribution of workplace characteristics to the risk of type diabetes. Diabetes, 29(3), 65–76.
14.
GarridoM. M., KaneR. L., KaasM., & KaneR. A. (2011). Use of mental health care by community-dwelling older adults. Journal of the American Geriatrics Society, 59(1), 50–56. doi:10.1111/j.1532-5415.2010.03220
15.
GonzalezR., RosenthalD. A., & KimJ. H. (2011). Predicting vocational rehabilitation outcomes of young adults with specific learning disabilities: Transitioning from school to work. Journal of Vocational Rehabilitation, 34, 163–172. doi:10.3233/JVR-2011-0544
16.
JamesS. A., & ButtleH. (2008). Attitudinal differences towards mental health services between younger and older New Zealand adults. New Zealand Journal of Psychology, 37(3), 33–43.
17.
KivimakiM., BattyG. D., & HublinC. (2011). Shift work as a risk factor for future type diabetes: Evidence, mechanisms, implications, and future research directions. Plos Medicine, 8(2), 1–3.
18.
LavigneJ. E., PhelpsC. E., MushlinA., & LednarW. M. (2003). Reductions in individual work productivity associated with type diabetes mellitus. Pharmacoeconomics, 21(15), 1123–1134.
19.
LippensT., & MackenzieC. S. (2011). Treatment satisfaction, perceived treatment effectiveness, and dropout among older users of mental health services. Journal of Clinical Psychology, 67(12), 1197–1209. doi:10.1002/jcl20842
20.
MariniI., LeeG. K., ChanF., ChapinM. H., & RomeroM. G. (2008). Vocational rehabilitation service patterns related to successful competitive employment outcomes of persons with spinal cord injury. Journal of Vocational Rehabilitation, 28, 1–13.
21.
MillerE., GonzalezR., FeistA. M., & KimJ. H. (2013). Predicting vocational rehabilitation outcomes among older stroke survivors. Korean Journal of Rehabilitation Psychology, 20(2), 289–315.
22.
MitchellJ. M., AdkinsR. H., & KempB. J. (2006). The effects of aging on employment of people with and without disabilities. Rehabilitation Counseling Bulletin, 49(3), 157–165.
23.
Moody-AyersS. Y., StewartA. L., CovinskyK. E., & InouyeS. K. (2005). Prevalence and correlates of perceived societal racism in older African-American adults with type diabetes mellitus. Journal of the American Geriatrics Society, 53(12), 2202–2208. doi:10.1111/j.1532-5415.2005.00501
24.
MwachofiA. K. (2009). Gender differences in access and intervention outcomes: The case for women with disabilities. Disability and Rehabilitation, 31(9), 693–700. doi:10.1080/09638280802305929
25.
OgundipeO. O., BlanfordR. L., & OgundipeO. A. (2006). A survey of the impact of insulin-treated diabetes on employment. Journal of Endocrinology, 2(2), 1–8.
26.
PoulsenK., & PachanaN. A. (2011). Depression and anxiety in older and middle-aged adults with diabetes. Australian Psychologist, 47, 90–97. doi:10.1111/j.1742-9544.2010.00020
27.
QuinnJ. F. (2110). Work, retirement, and the encore career: Elders and the future of the American workforce. Generations, 34(3), 45–55.
28.
RosenthalD. A., DaltonJ. A., & GerveyR. (2007). Analyzing vocational outcomes of individuals with psychiatric disabilities who received state vocational rehabilitation services: A data mining approach. International Journal of Social Psychiatry, 53, 357–368.
29.
RustonA., SmithA., & FernandoB. F. (2013). Diabetes in the workplace-diabetic’s perceptions and experiences of managing their disease at work: A qualitative study. BMC Public Health, 13(1), 1–10. 10.1186/1471-2458-13-386
30.
SchneiderJ. I., HashizumeJ., HeakS., MaetaniL., OzakiR. R., & WatanabeD. L. (2011). Identifying challenges, goals, and strategies for success for people with diabetes through life coaching. Journal of Vocational Rehabilitation, 34, 129–139. doi:10.3233/JVR-2010-0541
31.
SmithD. L. (2007). The Relationship of type of disability and employment status in the United States from the Behavioral Risk Factor Surveillance System. Journal of Rehabilitation, 73(2), 32–40.
32.
ToossiM. (2012). Employment outlook:. Labor force projections to: Labor force a more slowly growing workforce. Monthly Labor Review, 135(1), 43–64. Retrieved from http://www.bls.gov/opub/mlr/2012/01/mlr201201.pdf.
VijanS., HaywardR. A., & LangaK. M. (2004). The impact of diabetes on workforce participation: Results from a national household sample. Health Services Research, 39(6), 1653–1670.
37.
WadsworthJ. S., Estrada-HernandezN., KampfeC. M., & SmithS. M. (2008). Economic outcome of employment for older participants in rehabilitation services funded by the Rehabilitation Services Administration. Rehabilitation Counseling Bulletin, 51(2), 107–117. doi:10.1177/0034355207311348
38.
WallsR. T., MistraS., & MajumderR. K. (2002). Trends in vocational rehabilitation. Journal of Rehabilitation, 68(3), 4–10.
