What are the impacts of invisible disability on business and the economy?

If you manage more than a handful of employees, chances are that some of them are challenged by a chronic disease or invisible disability. In fact, we know that one in three workers have at least one chronic health condition.

 A recent study in Great Britain indicated that most employees with invisible disabilities do not properly maintain their health at work. This may be due to a number of factors, ranging from the stigma attached to illness to a lack of flexibility in their jobs.  As chronic health conditions become more prevalent in our society, it is crucial that the workplace provides a supportive atmosphere that allows employees to both maintain their health and take advantage of resources such as wellness programs and flexible work arrangements.

A flexible, understanding culture, which allows employees to perform at their best, will ultimately reduce costs such as absenteeism and presenteeism (employees who show up to work but are not fully functional). As you will soon see, these costs are a lot higher than you may think.

How widespread are invisible disabilities?

57.3 million working-aged Americans, 33 percent of the working-aged population, have at least one invisible disability.

Center for Studying Health System Change 2009

Chronic health conditions cost the U.S. economy more than $1 trillion a year, a figure that could jump to nearly $6 trillion by 2050.  

Milken Institute. An Unhealthy America: The Economic Burden of Chronic Disease

More than half of Canadians live with an invisible disability. 

Canadian Coalition for Public Health in the 21st Century

Worldwide, chronic diseases have overtaken infectious diseases as the leading cause of death and disability. In Ontario, chronic diseases account for 55% of direct and indirect health costs.

Ontario (Canada) Ministry of Health and Long-Term Care May 2007 

The economic burden of chronic diseases has been estimated at over $150 billion in direct and indirect costs annually. The cost of lost productivity due to short-term and long-term disability alone represents close to 30% of total costs. ($50 billion)

Centre for Chronic Disease Prevention and Control.  Public Health Agency of Canada 

96% of people with chronic illness show no visible symptoms. These people do not use a cane or any assistive device and may look perfectly healthy.
United States Census Bureau 2002 

Depression is 15-20% higher for the chronically ill than for the average person
Rifkin, A. “Depression in Physically Ill Patients,” 1992

In 1999, the Employers Health Coalition in Florida analyzed seventeen diseases and found that lost productivity from presenteeism was 7.5 times greater than productivity loss from absenteeism. For specific problems, like allergies, arthritis, heart disease, hypertension, migraines, and neck or back pain, the ratio was more than 15 to 1.

The Changing Face of U.S. Health Care: Employers Health Coalition Inc; 1999. 

Image of Jason Reid pointing to logos of a number of organizations who are scheduled to have him speak to their organizations. At the top, in blue, are the words Talks and Presentations on Invisible Disability in the workplace, workplace neurodiversity and workplace mental health.At the side the text reads: Some Dates and times are still remaining for Disability Employment Awareness Month, Invisible Disabilities Week, and International Day of Persons with disabilities.At the bottom it ways Book Jason now at Invisible Disability Speaker.com

Short Timeline of Workplace Resources around Invisible Disabilities

Published on Linkedin August 23rd, 2023

Image of Jason Reid pointing to logos of a number of organizations who are scheduled to have him speak to their organizations. At the top, in blue, are the words Talks and Presentations on Invisible Disability in the workplace, workplace neurodiversity and workplace mental health.At the side the text reads: Some Dates and times are still remaining for Disability Employment Awareness Month, Invisible Disabilities Week, and International Day of Persons with disabilities.At the bottom it ways Book Jason now at Invisible Disability Speaker.com

This summer I have been extremely heartend by the significant number of organizations reaching out to me to speak about invisible disability, mental health and neurodiversity in the workplace.

As someone who not only speaks about invisible disabilities, but who has also dealt with the same issues in a very unforgiving industry, I’ve seen a positive shift in the business world over the past couple of decades and even more so the past few years.

Here’s a short timeline of resources related to disability at work:

20-30 Years ago: Almost no one spoke of invisible disabilities and even fewer managers understood the nature of chronic conditions. You were either sick or you were well. If you were sick you were expected to go to a doctor to get “cured” of your ailment immediately so you could return to work. If you were well then you were expected to be 100 percent at all times. At work, there was no concept of a world with long-lasting, unpredictable and invisible medical conditions.

Twelve years ago – When I first began speaking professionally about working with chronic illness there was certainly some interest in the subject, but it was mostly “academic”. Organizations had no budget or resources in place to educate their staff about chronic conditions or invisible disabilities. Pioneers like myself were expected to speak for free, despite the fact we were essentially helping organizations with everything from recruitment, retention, and leadership communication to building more efficent workflow. There was no understanding that this topic was essentially about business and not charity.

Seven years ago: Organizations began integrating DEI into their organizations, creating leadership positions to deal with diversity, equity and inclusion and allocating budget resources to those areas.

Three years ago to present: A rapid rise in Employee Resource Groups, which now had their own budgets to bring in outside speakers and experts on various topics related to diversity. These groups not only acted as a way to bring together people with similar challenges, they also allowed to examine and suggest changes in the workplace that would reduce stigma and promote fairness.

Even today the work still isn’t done, but there has been significant progress. This Fall I’m as busy as I’ve ever been, providing insight and real life stories to organizations about working with invisible disabilities (including mental health and neurodiversity). I salue the organizations and Employee Resource Groups that are putting in time and effort to make the workplace better for people with invisible disabilities.

How to Deal with Long Covid in the Workplace

Potential increase in disability leave, presenteeism, as well as recruitment and retention issues.

For some people, COVID 19 can cause symptoms that last months or even years after the original infection, this is called LONG COVID

Studies suggest that long covid affects between 10 to 30 percent of infected people.

In the U.S. alone it will strike up to 43 million workers or more than 13 percent of the adult population.

Symptoms can include severe fatigue, brain fog, gastrointenstinal issues and problems with breathing. Additional symptoms can also arise.

The effect of these symptoms can sometimes be unpredictable. At one moment the person can seem well, at another, their symptoms can be significant and even disabling.

As a result of all of these factors, there are worries that Long Covid could cripple the workforce, forcing the early retirement of key people, an increase in disability leave, recruitment and retention issues, presenteeism and much more.

However, there are ways to deal with Long Covid in the workplace.

Long COVID is a chronic illness. By dealing with chronic illness in the workplace we can mitigate its effects.

More than 13% of American workers will get Long COVID

You see, Long Covid is essentially a chronic Illness, and its effects on work are much the same as diseases such as rheumatoid arthritis, lupus, mental health issues and many others.

In fact, before Long Covid even existed, Chronic illness already affected more than 25% of the workforce.

If we know how to deal with chronic illness, we can deal with Long Covid.

Battling chronic illness doesn’t preclude high performance. I was able to succeed in the competitive industry of national television news despite living with both Crohn’s disease and arthritis. I also effectively managed teams with many members who had similar challenges.

Now, I talk to organizations across the world, educating their managers and employees about how we can embrace chronic illness and invisible disabilities in the workplace.

Whether it’s better communication, creative accommodations or even handling those difficult conversations, I can show YOUR organization how to better manage Long Covid, invisible disabilities and even caregiver issues.

For more information contact me here. I’m easy to work with and usually respond in less than 24-hours.

Chronic Illness and The Lifestyle Myth

We are living in an age where lifestyle is finally being recognized as one of the cornerstones of health. There are good reasons to be concerned about our lifestyle these days. As our population gets older, our bodies become more difficult to maintain and the consequences of poor lifestyle choices can become more evident. 

The concept that we should be actively involved in our own health makes a lot of sense. For too long our health system has concentrated on fixing problems to the detriment of promoting wellness and I believe it is important that we address this imbalance.

The difficulty occurs when we pursue lifestyle solutions with a religious zeal, believing that lifestyle is the cause and cure of every ailment and every disease.  It is true that many chronic illnesses such as type 2 diabetes, lung cancer, heart disease and hypertension often have roots related to diet, exercise or smoking. These are significant health issues that impact a large number of people and should not be ignored.

Unfortunately, we have a tendency, as human beings, to generalize ideas and concepts. As a result, the term chronic illness has become shorthand for lifestyle illness, which is fundamentally incorrect.

To put this in context, The World Health Organization identifies more than 70 different types of chronic illnesses and most of them are not directly related to obesity, lack of exercise or smoking. In fact, many of these diseases occur in people with relatively healthy lifestyles.

Healthy Habits Alone Can’t Cure Most Chronic Illnesses

One of the most difficult things for healthy people to understand is that people with certain illnesses sometimes have little control over their disease. Many conditions (particularly autoimmune disorders) can flare up for no obvious reason. This is an uncomfortable truth that most people do not like to hear. As human beings we like to think we have total control over our health, but the sad fact is that sometimes we do not.

Regrettably, people with chronic illness often get blamed for things they have no control over. I have had more than one coaching client phone me in tears after getting a reprimand from her boss for not taking care of herself. The employee’s disease had flared up and the manager made the assumption that something the employee did or did not do was likely the cause.

The Stress of Managing Chronic Illness and Invisible Disability

This idea that every person with a chronic illness is somehow responsible for their poor health is not only incorrect, but puts additional strain on someone who is already managing a great deal of stress in their lives. The resulting level of guilt and frustration can be indescribable.       

To add to the stress, the complex and individual nature of many chronic diseases often makes it difficult to distinguish “healthy behavior” from “non-healthy” behavior.

I remember an incident involving a friend of mine who had Crohn’s disease and, like me, could no longer eat high fiber foods due scar tissue build-up on his intestines. I listened as a co-worker started criticizing my friend’s diet to another person in the office; “No wonder he’s always sick! Look at the crap he eats – meat, dairy and white bread.”

As I overheard this unjust criticism, I couldn’t help but realize that this was exactly the same diet I was limited to. I wondered how many people were thinking the same thing about me – and criticizing me behind my back. 

Please keep this in mind the next time you feel compelled to give health advice to co-workers or employees. Every illness is different and what you think may be healthy for someone could be just the opposite.

Making judgments about others is an unfortunate, but common aspect of our human nature. However, judging the lifestyle of someone with a chronic illness without knowing the facts is not only hurtful to the employee but could also cause damage to the organization in the long run.

Invisible Disability – The Trillion Dollar Problem.

More than a trillion dollars. That’s how much chronic illnesses and invisible disabilities cost organizations in the United States in 2007. These numbers are expected to quadruple by 2030. 

 A trillion dollars makes the mind boggle. That’s a million million.  With that amount of money, you could pay all of the rent cheques in the United States for three years!

You would think with so much at stake that our business and political leaders would take more of an interest in better engaging people with chronic illness. Not all of this money needs to be lost.

 A significant amount of this trillion-dollar productivity loss is due to presenteeism, where people show up for work but are not productive during their time on the job.  While many companies track absenteeism quite closely, the quality and quantity of the work and the engagement of the employee are not always measured.

To illustrate why this is a problem, let us look at a 2010 survey of workers with invisible disabilities in Canada. The study was called Patient’s Voice and it was published through Benefits Canada Magazine.  In it, 80 percent of chronically ill workers that were surveyed said they went into work even when they were not feeling well. 

This shocked a doctor on the expert panel that analyzed the data, but I don’t think this surprises anyone who has had a serious chronic illness. The fact is that many of us come into work sick because it is expected of us and taking too many days off can quickly kill a promising career. 

In our North American culture, there is often skepticism about workers who call in sick more than a few days a year. The assumption is that these workers are uncommitted or lazy. 

While there are some people who may take sick days when they are not truly sick, we know that the opposite is also true.  Many employees come into work beset by issues such as pain, fatigue and nausea that may significantly affect their productivity on the job.

Here are some of the challenges related to invisible disability:

  • The invisible nature of the problem makes it challenging to deal with.
  • Employees generally do not tell their employers about their illness because they worry about being stigmatized or losing their jobs.
  • Many of these same people do not monitor or attend to their illness (i.e. take their proper medications etc.) while at work.
  • Many organizations are still slow to offer flexible, results-oriented work arrangements that will allow employees to work more efficiently.

We know that chronic illness currently keeps many employees from being fully engaged and productive.  However, by finding ways to better engage these employees, organizations can realize significant savings going forward.


Want to better engage your employees with invisible disabilities? Click here to contact Jason today.