Substance use disorders impose a tremendous burden on the U.S. economy in terms of lost productivity and income. Persons with substance use disorders are more stigmatized than persons with other health conditions, suggesting that part of the losses may be attributed to employer discrimination. Our preliminary research finds evidence that a history of substance abuse/dependence has a significant negative impact on employment rates, but it is unclear what part of the employment differential is attributed to differences in the productivity-related characteristics of those with and without a history of substance use disorders, and what part can potentially be attributed to stigma. No studies have applied state-of-the-art econometric techniques to measure specifically the relative importance of stigma vs. productivity-related factors in determining employment outcomes for this group. The proposed research uses data from the 1991-92 National Longitudinal Alcohol Epidemiologic Survey and the 2001-02 National Epidemiologic Survey on Alcohol and Related Conditions to conduct a rigorous economic analysis of the potential impact of discrimination on employment outcomes for persons with substance use disorders. The overall objective is to analyze these two large, nationally representative surveys of working-age persons, using state-of-the-art econometric tools, to identify specific determinants of employment for persons with former substance use disorders in periods before and after implementation of the Americans with Disabilities Act (ADA). Study samples are restricted to persons with former, but not current, substance use disorders to be consistent with coverage of the ADA. We exploit inter-state variations in employment protections for persons with substance use disorders prior to the ADA to estimate the likely impact of the law on employment outcomes for this group. The research fills an important gap in the literature because, ten years after implementation, objective empirical information on how effective the ADA has been in improving employment opportunities for persons with substance use disorders is still lacking. The proposed project is relevant to public health because the results will inform policy interventions designed to improve employment opportunities for persons with former substance use disorders. Productive employment has been shown to be an essential component to the rehabilitation, self-worth and general well being of persons with mental disorders, and to their integration into the community. The project uses state- of-the-art econometric models to estimate the potential impact of discrimination on employment outcomes for persons with former substance use disorders, and to analyze how effective the Americans with Disabilities Act of 1990 has been in improving employment opportunities for this population. If, for example, discrimination is found to be potentially important, an appropriate intervention is targeted education to reduce the stigma associated with a history of substance use. If the results suggest that the ADA has not had its intended effects, then further investigation is needed to identify why the policy change has been ineffective for this group. ? ? ?
|Baldwin, Marjorie L; Marcus, Steven C (2014) The impact of mental and substance-use disorders on employment transitions. Health Econ 23:332-44|
|Baldwin, Marjorie L; Marcus, Steven C; De Simone, Jeffrey (2010) Job loss discrimination and former substance use disorders. Drug Alcohol Depend 110:1-7|