Disability in the Inflammatory Bowel Diseases: Impact of Awareness of the Americans with Disabilities Act

Background and Goals-Morbidity from the inflammatory bowel diseases (IBD) can influence patients' ability to maintain employment. The Americans with Disabilities Act (ADA) protects workers with medical conditions to include IBD. Whether factors such as education or awareness of the ADA mediate employment has not been studied. We investigated employment outcomes for a subset of IBD patients and looked at whether this was influenced by education or ADA awareness. Methods-A database of nearly 2,000 patients diagnosed with IBD is maintained at the University of Virginia Digestive Health Center of Excellence as part of ongoing research studies. Study surveys were sent in an alphabetical fashion to potential subjects in the database. Results-One hundred seventy three subjects participated. Overall, 32.3% (46/142) of subjects who were not retired were unemployed, with a disability rate of 20.4% (20/142). Subjects with post-college education had an employment rate of 91.2% (31/34). College graduates and those with some college education were employed at rate of 72.0% (36/50). Finally subjects with high school education or less were employed at a rate of 41.9% (18/43) (p < .001). Of subjects who were employed, 66.0% (64/97) were aware of the ADA compared to 44.4% (20/45) for the unemployed (p < .025). Conclusions-Persons with IBD have high levels of unemployment. Educational level of patients may play a substantial role in employment outcomes. A significantly smaller percentage of unemployed subjects had awareness of the ADA than their employed counterparts. Interventions aimed at high risk patients may lead to better employment outcomes.