Document Type

Research Progress Report


University of Montana Rural Institute

Publication Date



Economics | Labor Economics | Social and Behavioral Sciences


A new line of research for the Research and Training Center on Disability in Rural Communities (RTC: Rural) focuses on the role of secondary conditions and health promoting lifestyle behaviors in obtaining and maintaining employment for adults with physical disabilities. This line of research started with Ipsen (2006) conducting an analysis of Behavioral Risk Factor Surveillance System data. She found that individuals who reported lower rates of secondary conditions and/or who practiced better lifestyle behaviors had a higher probability of being employed after controlling for demographic characteristics including age, gender, race, education, and disability severity. Past research has shown that secondary conditions can be reduced through participation in health promotion programs (Ravesloot, Seekins, & White, 2005; Lorig, et al., 1999). It follows that participation in such programs may be a strategy to increase employment outcomes for people with disabilities. Unfortunately, access to health promotion programs is a significant problem for people with disabilities. For example, since many people with disabilities are not employed (61.9%), they cannot access employer sponsored wellness programs (StatsRRTC, 2005). Many individuals receive Medicaid and/or Medicare health insurance benefits, which typically do not cover preventative health measures. Paying out-of-pocket costs for health promotion is difficult for those with high medical expenses and low incomes. Additionally, there are few healthpromotion programs in the rural US. These factors limit the opportunities available to people with disabilities to best manage their health. One avenue for improving access to health promotion programming is for state Vocational Rehabilitation Agencies (VR) to include it in the menu of available services. VR is charged with assisting people with disabilities to become employed, and health promotion appears to fit within this broad mission. Because VR dollars must be allocated to services that positively impact work outcomes, however, establishing the linkage between secondary conditions and subsequent employment outcomes is the first step in creating a role for health promotion. To explore this relationship, RTC: Rural conducted a longitudinal study of VR consumers to determine whether baseline secondary conditions could help predict future employment outcomes.


employment and vocational rehabilitation, working well with a disability, health promotion, health and wellness, health self-management, rural, disability


© RTC: Rural, 2007.

Granting Agency

National Institute on Disability and Rehabilitation Research


National Institute on Disability and Rehabilitation Research, U.S. Department of Education Grant #H133B030501 supports this research.

Project Number