An observational investigation of unemployment, underemployment, and competitive integrated employment of people with intellectual and developmental disabilities in 2021-2022

Lindsay A DuBois; Valerie Bradley; Nilüfer Isvan

doi:10.1016/j.dhjo.2024.101620

An observational investigation of unemployment, underemployment, and competitive integrated employment of people with intellectual and developmental disabilities in 2021-2022

Disabil Health J. 2024 Mar 29:101620. doi: 10.1016/j.dhjo.2024.101620. Online ahead of print.

Authors

Lindsay A DuBois¹, Valerie Bradley², Nilüfer Isvan²

Affiliations

¹ Human Services Research Institute, 2336 Massachusetts Avenue, Cambridge, MA, 02140, United States. Electronic address: ldubois@hsri.org.
² Human Services Research Institute, 2336 Massachusetts Avenue, Cambridge, MA, 02140, United States.

PMID: 38584036
DOI: 10.1016/j.dhjo.2024.101620

Abstract

Background: Employment is an important component of community living, and a precursor to economic stability and independence. Despite this, research consistently demonstrates people with intellectual and developmental disabilities (IDD) have low rates of community-based employment. However, little research has been conducted to quantify competitive integrated employment, and which individuals have better employment outcomes as it relates to competitive integrated employment.

Objective: This study aims to explore the ways in which key service-related and demographic characteristics of individuals with IDD are associated with participation in competitive integrated employment.

Methods: We used the 2021-2022 National Core Indicators Intellectual and Developmental Disabilities In-Person Survey dataset. We conducted bivariate and multivariate analyses, using chi-square and generalized linear models, to examine the cross-sectional relationship between employment and demographic and service-related characteristics for 4629 individuals with IDD.

Results: Overall, 42% of the sample was unemployed but wanted a job, while 39% were underemployed and just 21% have competitive integrated employment. Several demographic and service-related characteristics were significantly associated with employment. After controlling for demographic and service-related correlates of employment, having an employment-related goal in one's service plan was associated with 4.5 (95% CI: 3.6-5.5) times higher odds of competitive integrated employment relative to unemployment.

Conclusions: This study underscores the value of person-centered planning for improved employment outcomes. Further research is needed to fully understand potential inequities in employment and system-level factors that are associated with competitive, integrated employment, as well as solutions to improve access to customized individual employment supports for all people with IDD.

Keywords: Community living; Employment; Intellectual/developmental disabilities; Medicaid home- and community-based services; Person-centered planning.