Document Type

Research Report


University of Montana Rural Institute

Publication Date



Economics | Labor Economics | Social and Behavioral Sciences


Secondary conditions are health problems that exacerbate or intensify limitation caused by a primary impairment. They affect an individual’s physical, medical, emotional, and psychological well-being. Untreated secondary conditions may cause acute medical episodes or severe health conditions that limit normal activities of daily living (DeVivo, 1998; Ipsen, 2006). Several research studies report that the probability of employment is lower for people who experience secondary conditions such as depression, pain, anxiety, sleep problems, fatigue, and feelings of isolation (Crisp, 2005; Ipsen & Seekins, 2008). Fortunately, many secondary conditions are manageable through health promotion behavioral interventions that improve healthy lifestyle behaviors. Although health promotion programs are effective in a variety of settings, people with disabilities have limited access due to employment, financial, insurance, and environmental barriers. Vocational Rehabilitation (VR) is a possible delivery point to overcome these barriers and improve access. Although health promotion services seem to fit within the Rehabilitation Act’s definition of allowable VR services, there is little evidence that health promotion programs for VR clients are effective. This report describes research that addresses this gap.


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


©2009 RTC:Rural.

Granting Agency

Centers for Disease Control


This research is supported by grant #RO1DD000135-01 from the Centers for Disease Control.

Project Number