The Nexus of Employment, Health and Disability

Unemployment rates for low-income people with disabilities are much higher than for the general population, at least in part because increased employment can jeopardize individuals’ federal disability cash benefits and health care coverage through Medicare and/or Medicaid. Medicaid Buy-In programs allow people with disabilities to work, accumulate assets, and get or maintain Medicaid coverage. Little is known about how or if program participation affects health outcomes of enrollees, with little research focused on poverty in combination with disability and how employment affects health and quality of life outcomes.

We are conducting an in-depth longitudinal study of participants in the Kansas Medicaid Buy-In, Working Healthy, to document long-term outcomes associated with increased work efforts and earnings, as compared to a similar group of individuals not enrolled. This project aims to understand health and quality of life changes related to work and, in particular, participation in a Medicaid Buy-In work incentive program, as well as foster innovative data management techniques necessary to identify health disparities.  Our approach involves studying disparities in health among enrollees and non-enrollees in Working Healthy. Specific research questions include:

1. What disparities exist among selected social determinants of health for Working Healthy participants (enrollees) and a comparable sample of low-income Kansas Medicaid beneficiaries with disabilities (non-enrollees)? 

2. What is the relative health status of enrollees and non-enrollees, based on health care utilization patterns and costs over time; inpatient, outpatient and emergency department use; co-morbidities; and overall costs? 

3. What differences exist between adjusted gross incomes and earnings of enrollees and non-enrollees? 

4. What is the relative effect of Working Healthy on health and quality of life outcomes for low-income, working age people with disabilities compared to people who may be eligible for but not enrolled in Working Healthy? 

5. Which of the selected social determinants best predict health outcomes and overall quality of life for low-income, working age people with disabilities?

Findings are important to more fully understand the nexus of health, disability, and work interaction, so that these particular social determinants of health disparity can be addressed at the federal, state, and local levels. Specific policy implications and policy recommendations will be forthcoming at this website.


Project Details

February 28, 2013 Webinar: Employment as a Health Determinant in a Medicaid Population with Disabilities

Watch the presentation about employment as a health determinant (CC Video) 

Download the slides for the presentation about employment as health determinant (PDF) 

Principal Investigator: Jean Hall, Ph.D.

Project Coordinator: Noelle Kurth, M.S.