The quiet crisis of diabetes in the workplace
If you were spending more time lounging with family and friends on the day after Christmas than reading the paper, you might have missed an important health article in The York Times about the tangle of laws confronting diabetics in the workplace. According to the article, diabetes accounts for nearly 5 percent of the 15,000 annual complaints that the Equal Employment Opportunity Commission hears under the the Americans With Disabilities Act of 1990, trailing only back impairment, orthopedic injuries, and depression as a leading complaint. The American Diabetes Association reports about 100 calls a month about workplace problems related to diabetes.
Despite the many federal and state laws, working diabetics may have little in the way of legal protection. Courts have little consistency in interpreting federal and state discrimination laws, and while some related impairment such as blindness may be obvious and protected, other complications may be less apparent and may not be protected. Job restrictions are often framed as a public safety issue, perhaps understandable when applied to pilots or drivers, but this excuse has been used to bar mechanics and food manufacturers from work that they had been successfully engaged in until they crossed the often invisible line into diabetes. And, according to the article, "Establishing discrimination has become harder since 1999, when the Supreme Court held that if a disability can be corrected with medicine or things like prostheses, it is not necessarily protected."
Employment challenges and costs
The challenges for employers range from broad issues of safety and productivity to mundane daily matters of allocating breaks and allowing food consumption on the job. In terms of health care costs, diabetes is one of "the big three," trailing only heart disease and hypertension. Trending shows that the issue is likely to get worse, not better, and ironically, the matter may be recursive. A recent study linking work stress to the onset of diabetes shows that the work itself may be a contributing factor to the problem.
One reality that employers must face is that this is an issue that will increase in significance with the aging workplace. The most prevalent form of diabetes is Type 2, or the non-insulin dependent variety. Once referred to as "elderly onset," this terminology has largely been dropped as this condition affects more and more people at younger ages. Type 2 diabetes is frequently linked to weight and inactivity. To get the full measure of the scope of the problem, we refer you back a year to Diabetes and Its Awful Toll Quietly Emerge as a Crisis, another article in the NYT that described the worsening epidemic of diabetes in New York, where one person in every eight is now a diabetic and where the prevalence is nearly a third higher than in the nation. Nationwide, the Centers for Disease Control estimates that as many as 21 million Americans are diabetic, and 41 million more are prediabetic, meaning that without an alteration in lifestyle, sugar could elevate to diabetic levels.
It's not an issue that's going to go away. Some employers are tackling the issue head on through their wellness programs, offering employees health screenings, risk assessments, and exercise and weight control programs. The American Diabetes Association offers suggestions for workplace activities geared to prevention. For other resources, see: