Work 52 (2015) 749–756
DOI:10.3233/WOR-152202
IOS Press
749
Employment as a health promotion
intervention for persons with multiple
sclerosis
Chung-Yi Chiu
a,*
, Fong Chan
b
, Seneca Edward Sharp
c
, Alo Dutta
c
, Ellie Hartman
d
and Jill Bezyak
e
a
University of Illinois at Urbana-Champaign, Champaign, IL, USA
b
University of Wisconsin-Madison, Madison, WI, USA
c
Southern University, Baton Rouge, LA, USA
d
University of Wisconsin, Stout, WI, USA
e
University of Northern Colorado, Greeley, CO, USA
Received 1 January 2015
Accepted 19 May 2015
Abstract.
OBJECTIVE: To examine the relationship between employment status (no employment, part-time employment, and full-time
employment) and functional disability, health-related quality of life, and life satisfaction of people with MS.
METHODS: 157 individuals with MS completed a survey packet, including employment status, self-report disability severity,
and health-related scales. A series of multivariate analysis of variance was performed to determine the differences between
employment groups in health-related outcomes.
RESULTS: The unemployed group had the highest levels of incapacity and social impairments among the three groups. They
also had the lowest physical health-related quality of life and life satisfaction. The part-time employed group had the lowest levels
of depression and higher levels of physical activity participation among the three groups of individuals with MS.
CONCLUSIONS: Employment is significantly related to health-related quality of life, and as a result, it should be considered
an important public health intervention for people with MS.
Keywords: Employment, poverty, functional disability, health-related quality of life, and multiple sclerosis
1. Introduction
According to the World Health Organization [1], the
greatest cause of ill-health, suffering, and mortality
in the world is poverty. Poverty and income inequal-
ity have dire consequences to the social, mental, and
physical well-being of individuals with and without
disabilities [2, 3]. It is well documented that unem-
*
Address for correspondence: Chung-Yi Chiu, Department of
Kinesiology and Community Health. University of Illinois at
Urbana-Champaign, 127 Huff Hall, M/C 588, Champaign, IL
61820, USA. Tel.: +217 244 6435; Fax: +217 333 2766; E-mail:
chiucy@illinois.edu.
ployed people are vulnerable to a higher prevalence
of depression and anxiety disorders, use alcohol more
frequently, and report lower levels of self-esteem than
those who are employed [2]. Income inequality, sec-
ondary to unemployment, also produces high levels of
psychosocial stress, which in turn leads to deteriorat-
ing health and high mortality among people living in
poverty [2–4]. Conversely, higher income and educa-
tion levels have considerable social benefits resulting
in a healthier population and better functioning society
[5–8].
For people with chronic illness and disability, lack
of employment opportunities excludes them from full
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