Abstract and Introduction
In 2020, approximately 21.5 million employed U.S. adults aged 18–64 years had some form of disability. Although 75.8% of noninstitutionalized persons without disability aged 18–64 were employed, only 38.4% of their counterparts with disability were employed. Persons with disability have job preferences similar to persons without disability but might encounter barriers (e.g., lower average training or education levels, discrimination, or limited transportation options) that affect the types of jobs they hold.[2,3] CDC analyzed 2016–2020 Behavioral Risk Factor Surveillance System (BRFSS) data from 35 states and Guam to estimate disability prevalences, by type and occupation group, among currently employed U.S. adults aged 18–64 years. The highest adjusted disability prevalences were among workers in three of the 22 major occupation groups: food preparation and serving-related (19.9%); personal care and service (19.4%); and arts, design, entertainment, sports, and media (17.7%). Occupation groups with the lowest adjusted disability prevalences were business and financial operations (11.3%), health care practitioners and technicians (11.1%), and architecture and engineering (11.0%). The distributions of persons with and without disability differ across occupations. Workplace programs that address the training, education, and workplace needs of employees with disability might improve workers' ability to enter, thrive in, and advance in a wider range of occupations.
BRFSS is an annual, random-digit–dialed telephone survey of noninstitutionalized, U.S. civilian residents aged ≥18 years. Conducted by states and territories, BRFSS gathers data on health-related risk behaviors, chronic illnesses and conditions, and use of health-related services.* The BRFSS questionnaire comprises standard and rotating core questions asked by all states and territories, as well as optionally administered topical modules and state-added questions. Thirty-five states and Guam† administered the optional industry and occupation module at least 1 year during 2016–2020. The median, combined mobile phone and landline response rate during the 2016–2020 survey years for all states, territories, and the District of Columbia ranged from 45.9% to 49.9%.§
To determine occupation, employed respondents were asked, "What kind of work do you do, for example, registered nurse, janitor, cashier, auto mechanic?"¶ Participants' responses were recorded as free text and later coded by an auto-coding system or computer-assisted human coders** to one of 22 two-digit standard occupational classification major groups promulgated by the U.S. Department of Labor Bureau of Labor Statistics.†† To assess disability, respondents were asked the six-item question set on hearing, vision, cognition, mobility, self-care, and independent living§§ in the BRFSS core questionnaire. Respondents replying "Yes" to at least one of these questions are considered to have a disability.
Among the 2016–2020 BRFSS participants who completed the industry and occupation optional module (1,053,331), 50.1% were currently employed and considered for analyses. Among respondents, those on active military duty (0.3%); those who were employed but reported "unpaid," "retired," or "disabled" as their occupation (0.1%); those who provided insufficient information to code occupation (6.9%); those who were missing information for occupation (7.4%); and adults ≥aged 65 years (11.5%) were excluded. The final analytic sample contained 395,141 respondents. Respondents with missing information for a specific disability type (2.2% missing for hearing, 2.4% for vision, 2.7% for cognitive, 2.7% for mobility, 2.7% for self-care, 2.9% for independent living, and 3.2% for any disability) were removed from the respective analyses. Prevalence of disability status and types were calculated for the 22 major occupation groups with and without adjustment for these sociodemographic variables: age group (18–24, 25–34, 35–44, 45–54, or 55–64 years), sex, race and ethnicity (non-Hispanic Black or African American, non-Hispanic White, Hispanic or Latino [Hispanic], or non-Hispanic other race or multiracial), and education level (less than high school diploma, high school diploma, some college, or college graduate or above). Adjusted prevalence estimates were obtained using log-linear regression analyses with a robust variance estimator while adjusting for sociodemographic variables. Analyses were conducted with SAS-callable SUDAAN (version 11.0.3; RTI International) to account for the complex survey design. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.¶¶
Overall, 14.8% of currently employed U.S. adults aged 18–64 years reported having a disability (Table 1). Cognitive disability (7.0%) was the most frequently reported disability type; self-care disability (1.0%) was least frequently reported. Prevalences of all disability types were elevated among workers who had <a high school education, were Hispanic, were veterans, lacked access to health care coverage, or had a household income <$25,000 per year. Prevalence of the following types of disability were highest among workers aged 18–24 years: vision (3.6%), cognitive (13.9%), and independent living (4.4%). Prevalences were slightly higher among women than among men for any disability (15.5% versus 14.1%), vision (2.8% versus 2.5%), cognitive (7.8% versus 6.3%), mobility (5.4% versus 3.9%), and independent living (2.8% versus 1.7%) disability.
Prevalence of disability was highest in food preparation and serving-related (24.7%) and personal care and service (22.8%) occupation groups and lowest in the architecture and engineering group (8%) (Table 2). After adjustment for demographic characteristics (Table 3), occupation groups with the highest disability prevalences were food preparation and serving-related (19.9%); personal care and service (19.4%); and arts, design, entertainment, sports, and media (17.7%). Disability prevalences were lowest for business and financial operations (11.3%), health care practitioners and technicians (11.1%), and architecture and engineering (11.0%) (Table 3). The highest prevalences of specific disability types were in food preparation and serving-related for vision (4.2%), personal care and service for mobility (6.0%), and arts, design, entertainment, sports, and media for cognitive (10.8%). The prevalence of hearing disability was highest for the following occupational groups: installation, maintenance, and repair (4.2%); construction and extraction (3.8%); production (3.5%); protective services (3.5%); and farming, fishing, and forestry (3.5%).
Morbidity and Mortality Weekly Report. 2023;72(20):540-546. © 2023 Centers for Disease Control and Prevention (CDC)