Supplement to Healthcare Executive, November/December 2006
by Wayne M. Lerner, DPH, FACHE; Peter A. Weil, PhD, FACHE; and Kristi L. Kirschner, MD
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According to a sample survey of more than 829,000 households conducted by the U.S. Census Bureau in 2003, 6.3 percent of noninstitutionalized workers had a disability. What is the extent of disability among ACHE affiliates? To answer this question, ACHE, in collaboration with the Rehabilitation Institute of Chicago, sent a four-page fax questionnaire in fall 2005 to a random sample of ACHE affiliates.
We identified two criteria to establish whether an affiliate had a disability:
- Does the respondent have a condition that limits full participation in work?
- Does he or she have a learning, emotional or mental disability or disease; a sensory impairment; a physical handicap; pain; or chronic fatigue syndrome?
These criteria are similar to those the U.S. Census Bureau uses to define a disability.
The following appendixes are supplements to “The Prevalence and Impact of Disability Among Healthcare Executives,” published in the November/December 2006 issue of Healthcare Executive.
Appendix A: About the Survey
To determine the approximate proportion of healthcare executives with a disability, a random sample of ACHE’s active affiliates was selected. Initially, 2,000 affiliates were chosen; faxes sent to 270 individuals were unsuccessfully transmitted, leaving 1,730 affiliates in the final sample. It had been previously determined that the most cost-effective and expeditious method of administration would be via fax.
Of the 1,730 affiliates who were sent faxes in mid-September 2005 and again in early October to nonrespondents, 832 responded, yielding a 48 percent response rate. A nonresponse analysis was conducted to determine if nonrespondents were demographically different from respondents to the survey. The analysis showed that respondents were no different from nonrespondents in the level of position they held or in gender. However, a higher proportion of Fellows (60 percent) than Members (43 percent) responded.
Appendix B: Data Tables
| Number sampled: | 1,730 |
| Number received: | 832 |
| Response rate: | 48% |
| Date faxed: | September 15, 2005 |
| Second fax: | October 3, 2005 |
1. Does a disability currently keep you from participating fully in work, that is, to the same extent as your peers?
| Percent | Number | |
|---|---|---|
| Yes | 21 | 12 |
| No | 78 | 45 |
| No comment | 1 | 1 |
| 100% | 58 |
2. Please indicate whether or not you have any of the following:
| Row percentage | Number | |||
|---|---|---|---|---|
| Yes | No | Yes | No | |
| A learning disability (e.g., dyslexia) | 10 | 90 | 6 | 57 |
| An emotional or a mental disability or condition (e.g., depression, anxiety disorder, bipolar disease) | 16 | 84 | 10 | 53 |
| A speech impairment | 2 | 98 | 1 | 62 |
| A hearing impairment | 32 | 68 | 20 | 43 |
| Any vision impairment except for ordinary eyeglasses | 11 | 89 | 7 | 56 |
| Any physical handicap or disability that limits use of your hands, arms or legs | 10 | 90 | 6 | 57 |
| Chronic pain | 29 | 71 | 18 | 44 |
| Chronic fatigue syndrome | 6 | 94 | 4 | 58 |
| Any physical disability other than those stated above (please specify) | 15 | 85 | 9 | 53 |
| Other disabilities mentioned | Total cited |
|---|---|
| Pain in joints/back or joint replacement | 2 |
| Asthma | 1 |
| Cancer | 1 |
| Physical injury | 1 |
| Bell’s palsy | 1 |
| Fibromyalgia | 1 |
3. Please enter the name or nature of your disabilities:
| Name/nature of disability | Total cited |
|---|---|
| Hearing loss | 12 |
| Discomfort in joints | 5 |
| Depression (includes one manic depressive) | 5 |
| Physical injury | 4 |
| Eye disorder | 4 |
| Reading disorder | 3 |
| Cancer | 2 |
| Brain disorder | 2 |
| Joint replacement | 2 |
| Organ problem | 2 |
| Heart problem | 2 |
| Chronic fatigue | 2 |
| Anxiety | 2 |
| ADHD | 2 |
| Diabetes | 1 |
| Intestinal problem | 1 |
| Hormone problem | 1 |
| Sleep disorder | 1 |
| Respiratory problem | 1 |
| Blood disorder | 1 |
| Missing a limb | 1 |
| Nerve disorder | 1 |
| HIV/AIDS | 1 |
| Orthopedic disability | 1 |
| Infection | 1 |
| Verbal disorder | 1 |
4. Would you say your disability is:
| Percent | Number | |
|---|---|---|
| Slight | 36 | 22 |
| Moderate | 47 | 29 |
| Somewhat severe | 15 | 9 |
| Very severe | 2 | 1 |
| 100% | 61 |
5. Does your disability affect you:
| Percent | Number | |
|---|---|---|
| Daily | 70 | 42 |
| Weekly | 12 | 7 |
| Monthly | 8 | 5 |
| Less often than monthly | 10 | 6 |
| 100% | 60 |
6. At what age did your disability begin?
- Median 34
- Mean 32
- [25th percentile = 20; 75th percentile = 45]
7. In column 1 please circle which of the following best describes your current employment situation. In column 2 please circle which best describes your current preferred employment situation.
| Percent | Number | |||
|---|---|---|---|---|
| Current | Preferred | Current | Preferred | |
| Working full time for an employer | 92 | 86 | 54 | 50 |
| Working part time for an employer | 2 | 4 | 1 | 2 |
| Self-employed | 5 | 3 | 3 | 2 |
| Unemployed | — | — | — | — |
| Retired | — | 3 | — | 2 |
| Other current (please specify) | 2 | — | 1 | — |
| Other preferred (please specify) | — | 3 | — | 2 |
| 100% | 100% | 59 | 58 | |
8. If you are not currently in your most preferred employment situation, please indicate the main reason(s) by circling the response codes below.
| Total cited | |
|---|---|
| Unable to conduct a job search due to a health problem or disability |
0 |
| Cannot find a job that accommodates my disability | 1 |
| Difficulty traveling to work | 0 |
| Might lose income assistance or health benefits if I obtain a job | 1 |
| My age | 1 |
| Perceived performance inadequacy | 2 |
| Lack of funding | 3 |
| Other reason (please specify) | 1 |
| Don’t know | 1 |
| (n = 9) |
9. Do you feel that you have ever encountered job discrimination because of your disability?
| Percent | Number | ||
|---|---|---|---|
| Yes | 12 | 7 | |
| No | 86 | 51 | |
| Don’t know | 2 | 1 | |
| 100% | 59 |
10. What kind of job discrimination did you encounter as a result of your disability?
| Total cited | ||||
| I was denied a job interview | 1 | |||
| I was denied a job | 1 | |||
| I was denied a job promotion | 3 | |||
| I was given lesser responsibilities than my co-workers | 1 | |||
| I was denied a workplace accommodation (e.g., more accessible shelves) | 3 | |||
| I was paid less than other workers in similar jobs with similar skills | 1 | |||
| I was denied health insurance | 0 | |||
| I was denied other work-related benefit(s) | 0 | |||
| I encountered other discrimination (please specify) | 3 | |||
11. In general, how would you characterize your health?
| Percent | Number | |
|---|---|---|
| Excellent | 27 | 16 |
| Good | 59 | 35 |
| Fair | 14 | 8 |
| Poor | 0 | 0 |
| 100% | 59 |
12. Number who ever use:
| Equipment such as a walker, wheelchair, scooter, lift designed for wheelchairs or scooters, or any other devices that help with mobility | 1 |
| Voice-recognition technology, a special keyboard or mouse, or any other devices that help with limited dexterity or use of your hands or arms | 0 |
| Prostheses or orthoses of any kind | 2 |
| Modifications to furniture such as desks, tables or toilets | 4 |
| Any devices, electronic or otherwise, designed to assist with speech communication | 3 |
| Hearing aids or other devices to assist with limited hearing or deafness | 17 |
| Braille notetakers, screen readers, special computer software or any other devices to assist with vision or blindness | 1 |
| Flexible work schedule | 9 |
| Work from home | 9 |
| Extra time to complete projects | 8 |
| A personal assistant | 3 |
| My work place is acceptably configured to meet my needs | 28 |
13. To what extent do you feel that you have a sense of common identity with other people with disabilities?
| Percent | Number | |
|---|---|---|
| No sense of common identity | 29 | 17 |
| Some sense | 48 | 28 |
| Somewhat strong sense | 9 | 5 |
| Very strong sense | 10 | 6 |
| Don’t know | 3 | 2 |
| 100% | 58 |
14. Do you feel that your disability has prevented you from reaching what you feel is your full potential as a person?
| Percent | Number | |
|---|---|---|
| Yes, to a great extent | 8 | 5 |
| Yes, to a limited extent | 30 | 18 |
| No | 60 | 36 |
| Don’t know | 2 | 1 |
15. Finally, on the lines below, please tell us what the healthcare management profession needs to do to ensure equitable treatment of its members with disabilities.
| Total cited | |
|---|---|
| Greater understanding of the handicapped | 18 |
| Disability-ready facilities | 13 |
| Diversity training | 8 |
| Increased publications/reports on the topic | 6 |
| Flexible time schedule | 5 |
| Nonresponse/already doing a good job | 3 |
| Need ACHE support | 2 |
| Insurance compliance | 1 |
| Hiding the disability to get/keep a job | 1 |
| Need support outside of work | 1 |
Appendix C: List of Disabilities That Prevent Full Participation at Work
Following is a list of the specific disability that was associated with those who indicated that a disability currently keeps them from participating fully in work, that is, to the same extent as their peers.
- Corneas are dying
- Coronary artery disease (two myocardial infarctions, three coronary stents); clinical depression; cancer
- Manic depression
- HIV/AIDS
- Attention deficit hyperactivity disorder
- Severe hearing loss due to military combat service
- Degenerated hip/joint replacement
- Bell’s palsy
- Complete loss of hearing in one ear; partial in the other
- Chronic low back issues
- Degenerative disc causing severe back pain, sometimes leg pain
- Chronic pain due to Lyme disease
Appendix D: Age Distribution of Respondents by Type of Disability
| Number | |||||
|---|---|---|---|---|---|
| Type of Disability | <35 (n = 6) |
35–44 (n = 12) |
45–54 (n = 21) |
55–59 (n=13) |
60+ (n = 9) |
| Learning | 2 | — | 2 | 1 | — |
| Emotional/mental | 2 | 3 | 2 | 2 | 1 |
| Speech | 0 | 0 | 1 | 0 | 0 |
| Hearing | 0 | 3 | 5 | 7 | 5 |
| Vision | 1 | 0 | 2 | 1 | 3 |
| Hands, arms or legs | 0 | 3 | 1 | 1 | 1 |
| Chronic pain | 1 | 6 | 7 | 3 | 1 |
| Chronic fatigue | 1 | 1 | 0 | 2 | 0 |
| Other | 0 | 0 | 6 | 1 | 1 |