Workplace discrimination allegations and outcomes involving Caucasian Americans,African Americans,and Hispanic/Latinx Americans with multiple sclerosis: A causal comparative analysis

Abstract

BACKGROUND:

Although African Americans and Hispanic/Latinx Americans with multiple sclerosis (MS) frequently cite workplace discrimination as a major concern, the specific nature of this discrimination is not yet well understood.

OBJECTIVE:

The purpose of this study was to investigate racial/ethnic differences in allegations of workplace discrimination by Caucasian, African American, and Hispanic/Latinx American individuals with MS.

METHODS:

The United States Equal Employment Opportunity Commission (EEOC) Integrated Mission System (IMS) database was used to describe and compare the frequency and characteristics of discrimination allegations filed by people with MS in the three race/ethnicity groups. Quantitative analyses, including a one-way analysis of variance and Chi-square tests, were used to examine 2009–2016 Americans with Disabilities Act Amendments Act (ADAAA) Title I complaints. These complaints were received by the EEOC from people with MS who identified themselves as Caucasian, African American, and Hispanic/Latinx American (N = 3,770).

RESULTS:

Both African Americans and Hispanic/Latinx Americans tended to encounter discrimination at a younger age than Caucasian Americans. African American and Hispanic/Latinx American charging parties were more likely to be women than were Caucasian charging parties. The size and location of employers against whom allegations were filed varied significantly among the three racial/ethnic groups. The EEOC was more likely to resolve allegations in the charging parties’ favor when the allegations were filed by Caucasians.

CONCLUSION:

The present study revealed modest but significant differences in the workplace discrimination experiences of the three groups under study. More research is needed to determine why racial/ethnic status bears on the discrimination experiences of Americans with MS.

Keywords

Multiple sclerosis workplace discrimination racial comparisons

1 Introduction

Multiple sclerosis (MS) is a chronic, often progressive, autoimmune condition of the central nervous system (CNS) characterized by intermittent and recurrent episodes of inflammation that result in the destruction of CNS myelin and subsequent damage to the underlying CNS axons (Andrew & Andrew, 2017; Rumrill & Bishop, 2019). The disease can be diagnosed at any age, but initial symptoms usually emerge during early adulthood, typically between the ages of 20 and 40 (Kalb, 2016; Koch et al., 2021). MS is about three times more common in women than men, a gender link that is not uncommon among high-frequency auto-immune disorders (Dunn & Steinman, 2013). Originally known as a disease primarily affecting Caucasian women, the incidence of MS among African Americans and Hispanic or Latinx populations has increased significantly in recent years (National Multiple Sclerosis Society [NMSS], 2018). In fact, recent research in the US reveals that the proportional risk of developing MS may be higher in African American women than in Caucasian American men or women (Langer-Gould, Brara, Beaber, & Zhang, 2013).

Although the experience of MS symptoms is heterogeneous and individual, the typical course of MS is characterized by alternating episodes of neurological symptoms and remissions, with MS symptoms such as fatigue, cognitive impairment, chronic pain, and mobility problems frequently intensifying over time, resulting in increased physical disability and declining general health (Bishop et al., 2016; Frain et al., 2015). The fact that MS is typically diagnosed at an age when people are beginning or establishing their careers, combined with the broad functional and psychosocial impact of symptoms, contributes to the high rates of unemployment and early-exit from work and career seen nationally and internationally among adults with MS. Moreover, recent data drawn from Americans with MS during the COVID-19 pandemic suggest that workers with MS were far more likely to be displaced from their jobs during the early stages of the pandemic than were non-disabled workers (Bishop & Rumrill, 2021).

Studies in developed countries have consistently found that about half of those working at the time of MS diagnosis will leave the workforce before reaching retirement age, despite research suggesting that 40–75%of unemployed people with MS would like to return to work (Moore et al., 2013; Rumrill et al., 2021). In the United States, 50–80%of people with MS who are working at the time of diagnosis are no longer in the workforce within 10 years, and approximately 40%leave employment in the first three years after diagnosis (Koch et al., 2021; McFadden et al., 2012; Strober, 2020).

There is an extensive and growing body of research exploring the reasons for, and consequences of, leaving employment among people with MS (e.g., Bishop & Rumrill, 2021; McFadden et al., 2012; Raggi et al., 2016; Rumrill et al., 2015; Strober, 2020). This research clearly demonstrates that beyond the significant causal influence of MS symptoms, a range of other factors –including environmental, economic, psychological and social factors; employer attitudes and beliefs; employer policies; and workplace environmental factors –all impact employment retention and status (e.g., Dorstyn et al., 2019; Frain et al., 2015; Johnson et al., 2004; Moore et al., 2013; Pack et al., 2007; Strober, 2020). Among the widely researched employment-based barriers to continued employment following diagnosis with MS is workplace discrimination.

Discrimination refers to unfair or prejudicial treatment based on characteristics such as race, gender, age, or sexual orientation. In the United States, discrimination is prohibited by law in specific contexts through federal legislation such as the Fair Housing Act of 1968 and the Civil Rights Act of 1964. Employment discrimination is defined as unfavorable treatment of an employee or job candidate because of age, disability, genetic information, national origin, pregnancy, race or skin color, religion, or sex (US Equal Employment Opportunity Commission [EEOC], 2021). Employment discrimination on the basis of disability is prohibited in the US by the Americans with Disabilities Act (ADA; Umucu, 2021). The ADA was the first civil rights law to create a legal framework to protect people with disabilities from discrimination, including employment discrimination, which is addressed in ADA Title 1 (McMahon & McMahon, 2017). As a result of federal court cases continuing to limit coverage of the ADA, the ADA Amendments Act (ADAAA) of 2008 clarified and expanded the previously established legal protections. Enforcement of the federal laws that make workplace discrimination illegal in the United States is the responsibility of the EEOC, which was formed through the Civil Rights Act of 1964 to enforce and interpret laws regarding workplace discrimination (EEOC, 2021). Among the responsibilities of the EEOC are to receive discrimination charges from employees, investigate these charges, make determinations, and negotiate settlements between employers and employees. Prior to the establishment of the EEOC and subsequent passage of the ADA, the capacity to form evidence-informed understandings of the extent and effects of workplace discrimination against people with disabilities was extremely limited.

The insidious problem of workplace discrimination has been repeatedly implicated in the high jobless rates reported by people with MS. Indeed, Rumrill (2016) went so far as to describe discrimination on the part of employers as the number one employment problem facing Americans with MS. In their national survey of employment concerns among people with MS, Roessler et al. (2002) found that most participants reported having been treated unfairly in the hiring process by employers (73%), having been denied reasonable accommodations (58%), and having received lower pay compared to their peers without disabilities (53%). Doogan and Playford (2014) indicated that more than half of their survey respondents with MS had experienced some form of on-the-job discrimination. More recently, Rumrill (2019) documented an extremely high rate of workplace discrimination allegations filed by workers with MS under Title I of the ADA. Specifically, people with MS filed more allegations of workplace discrimination related to unlawful termination, failure to provide reasonable accommodations, and inequitable terms and conditions of employment in comparison to people with other disabilities.

Between 1999 and 2013, the lead author of this article offered employment assistance and career counseling services to more than 2,800 adults with MS using an electronic telehealth service delivery platform. Known as the Kent State University MS Employment Assistance Service, this program was staffed by nationally Certified Rehabilitation Counselors who provided a wide range of vocational services via telephone and the Internet. More than two-thirds (70.3%) of inquiries to the program from employed people with MS sought assistance regarding workplace accommodations, disclosure of disability, and/or strategies for redressing workplace discrimination.

The National EEOC ADA Research Project (NEARP) is an exhaustive data-mining effort that relies upon the Integrated Mission System (IMS) database used by the EEOC to track investigations of workplace discrimination. Over the past two decades, EARP investigators have developed disability- and industry-specific profiles of employment discrimination, explored the contentious issues involved in workplace discrimination, documented the interface of disability with other demographics, evaluated extant theories of stigma, and predicted EEOC investigatory outcomes (McMahon et al., 2005).

As reported by McMahon and McMahon (2016), the IMS database is used as a case management tool to monitor workflow, performance, trends, and outcomes for EEOC field office investigators. The NEARP team was the first to utilize this database for research purposes under the scrutiny of multiple university IRBs and the EEOC Office of Research, Information and Planning. Since its inception, NEARP has obtained data on 823,536 closed allegations spanning from the effective date of ADA Title I on July 26, 1992 through December 31, 2016. This study sought, as part of NEARP, to use the IMS database to examine patterns in the discrimination allegations made by Caucasian American, African American, and Hispanic/Latinx American individuals with MS from the initial effectuation date of the ADAAA on January 1, 2009 through the end of Calendar Year 2016.

1.1 Rationale for and purpose of the present study

Although African Americans and Hispanic/Latinx Americans with MS frequently cite workplace discrimination as a major concern (Merchant et al., 2020; Rumrill et al., 2021), the specific nature of this discrimination is not yet well understood. Better understanding of the types of discrimination reported by people with MS from different racial and ethnic backgrounds can serve multiple purposes for rehabilitation professionals. First, it will enable professionals to help employed people with MS from traditionally underrepresented racial and ethnic groups identify, effectively prepare for, and respond to workplace discrimination events. Second, it will inform employer education efforts designed to reduce harmful instances of discrimination. Finally, in terms of both of these purposes, it is essential to understand whether racial and ethnic group-based differences exist in the enactment and experience of worker discrimination, as well as the outcomes or resolutions of the EEOC’s investigatory process in allegations filed by people with MS. Understanding the unique workplace discrimination experiences of racially or ethnically minoritized individuals with MS in comparison to those experiences of Caucasian Americans with MS will aid rehabilitation professionals in developing tailored interventions to reduce the incidence and impact of discriminatory conduct against minoritized individuals with MS, who may be doubly vulnerable to job loss given their racial/ethnic and disability status (Rumrill et al., 2021; Smart, 2020).

Therefore, the research team in this study sought to examine the workplace discrimination experiences of African Americans and Hispanic/Latinx Americans with MS by exploring their discrimination allegations under the ADAAA as part of the NEARP. The IMS database enabled the researchers to examine the types of discrimination that were alleged to have occurred, the characteristics of the individuals experiencing the discrimination (e.g., age, gender), the characteristics of employers who were named in those allegations (e.g., number of employees, geographic location, industry designation), and whether the discrimination was deemed to have legally taken place (merit resolution) or was deemed to be a case of perceived discrimination that did not meet the legal standard (non-merit resolution).

1.2 Research questions

This investigation addressed the following rese-arch questions:

What are the patterns in allegations of workplace discrimination filed by the three racial/ethnic groups (i.e., Caucasian, African American, Hispanic/Latinx American) of people with MS in terms of the types of allegations filed, characteristics of charging parties, characteristics of respondent employers, and resolutions or outcomes of the EEOC’s investigatory process?

Do patterns in workplace discrimination allegations filed by the three racial/ethnic groups of people with MS differ in terms of the types of discrimination that is alleged to have occurred?

Do patterns in workplace discrimination allegations filed by the three ethnic groups of people with MS differ in terms of charging party characteristics?

Do patterns in workplace discrimination allegations filed by the three ethnic groups of people with MS differ in terms of respondent (i.e., employer) characteristics?

Do patterns in workplace discrimination allegations filed by the three ethnic groups of people with MS differ in terms of the rate of merit case resolutions?

2 Method

2.1 Procedure

Under an Interagency Personnel Agreement (IPA) involving the EEOC, Professor Brian T. McMahon, and Virginia Commonwealth University, a nationwide project was begun in 2003 to utilize the IMS for research purposes in order to provide evidence-based answers to the questions regarding discrimination allegations under the ADA. Dr. McMahon and his colleagues proceeded to extract and refine the IMS database in order to retrieve, verify, and examine closed ADA allegations.

To conduct this investigation, the researchers, via NEARP, secured permission to access the IMS database with proper protections for the Charging Parties (CPs, applicants or employees) and Respondents (employers). Information that served as the basis for this study pertained to the types and numbers of complaints of employment discrimination under Title I of the ADA filed by individuals with MS who were in the three racial/ethnic groups, as well as the manner in which the EEOC resolved those complaints. From approximately three million records involving all allegations of employment discrimination, a study dataset was extracted to include only those variables related to the research questions regarding the comparability of three race/ethnicity groups of people with MS between 2009 and 2016. To protect the identity of CPs and Respondent employers, the extraction process strictly adhered to the following guidelines:

The unit of study was an allegation; it was not an individual CP, nor an individual respondent employer. A single CP may bring more than one allegation or may bring the same allegation on more than one occasion (e.g., in 2008 and again in 2015).

Only unique allegations that did not involve recording errors or duplications were included in the study dataset.

To maximize confidentiality, all identifying information regarding CPs and Respondents that were not involved in the present analysis were purged.

Study data were strictly limited to allegations brought under Title I of the ADAAA. Allegations brought under other federal employment statutes that are not directly related to disability status including the Civil Rights Act, Equal Pay Act, Age Discrimination in Employment Act, and the Family and Medical Leave Act were not considered.

To maintain consistency in definitions and procedures among the study variables, only allegations received, investigated, and closed by the EEOC were included.

Only allegations that had been closed by the EEOC during the study period, defined as January 1, 2009 (first effective date of ADAAA) through December 31, 2016 (the last date of available IMS data), were included in the study dataset.

2.2 Participants

To answer the research questions, researchers utilized the entire population of ADAAA Title I allegations received by the EEOC from the three race/ethnicity groups of people with MS from 2009 through 2016. After applying the six inclusion and exclusion criteria listed above, the data extraction procedure resulted in a study dataset of 3,770 allegations of employment discrimination pertaining to the three race/ethnicity groups of charging parties with MS.

2.3 Instrument and variables

2.3.1 Issue type

The prevailing unit of measure in this study was an allegation of employment discrimination filed by a person with MS with the EEOC since the effectuation of the ADAAA on January 1, 2009. Each allegation was treated as one distinct data point in the IMS system; if one individual filed more than one allegation with the EEOC under Title I of the ADAAA, each allegation was investigated and adjudicated separately. The number of allegations is greater than the number of charging parties in the IMS database because many charging parties file more than one allegation. In EEOC parlance, allegations are referred to as ‘Issues.’ An Issue describes the nature of the unlawful personnel action alleged by the CP. There are 41 unique Issues that have some level of allegation activity ranging in frequency from 10 to 260,572 in the overall EEOC ADAAA Title I database.

Because this study focused on detecting general patterns of allegations among different race/ethnicity groups, 23 Issues were carefully selected to represent six issue types or categories, which accounted for 96.1%of the allegations in the database. These six issue categories were: 1) Discharge, 2) Reasonable Accommodation, 3) Hiring, 4) Harassment and Intimidation, 5) Terms and Conditions of Employment, and 6) Discipline. Except Harassment/Intimidation and Reasonable Accommodation, the rest of the six categories are aggregations of multiple issues.

To be specific, the category of Discharge contained issues related to any involuntary termination on a permanent basis, such as discharge (firing), constructive discharge, layoff, involuntary retirement, severance pay, and early retirement incentives. The category of Hiring included issues such as hiring, promotion, assignment, reinstatement, prohibited medical inquiry, and training. The category of Terms and Conditions of Employment contained issues related to allegations regarding job terms, working conditions, wages, benefits, insurance benefits, and exclusionary/segregated unions. The category of Discipline referred to issues of discipline, demotion, and suspension.

2.3.2 Age and gender

Demographic variables such as age and gender were considered in this study. Age of the charging party, as measured in years at the time when an allegation was filed, was recorded. Gender, female vs male, was a dichotomous variable. For those charging parties who chose not to report their gender, gender was treated as missing data in the analysis.

2.3.3 Employer region

Allegations were filed against employers from 50 U.S. states and 2 other jurisdictions or territories. Based on the U.S. census designations, these states and jurisdictions were categorized into 5 regions: New England and Northeast, Mid-Atlantic and Southeast, Midwest and Great Plains, Southwest and Rocky Mountain, and Pacific and Northwest. More than a third of allegations in the study dataset were filed in the Mid-Atlantic and Southeast (i.e., 36.5%). Slightly more than a quarter of allegations were filed in the Midwest and Great Plains (i.e., 26%). The next largest proportion of allegations was filed in the Southwest and Rocky Mountain (i.e., 16.3%), which was followed by allegations in the Pacific and Northwest (i.e., 11.9%) and the New England and Northeast (i.e., 9.3%).

2.3.4 Employer size

Employer size was classified into four categorical levels according to the number of employees at the time of allegation: 15–100, 101–200, 201–500, and more than 500. Among 3,770 allegations in this study, 3,451 allegations (i.e., 91.5%) reported employer size. More than half (i.e., 54.9%) of the 3,451 allegations came from CPs whose employers had more than 500 workers at the time of allegation; 14.1%came from CPs whose employers had 201 to 500 employees; 9.3%came from those whose employers had 101 to 200 employees; and 21.7%came from those whose employers had less than 100 employees.

2.3.5 Resolution

This refers to the final EEOC determination as to whether discrimination actually occurred. For purposes of this study, Resolutions were dichotomously classified as Merit, favoring the charging party (a determination that discrimination did occur) or Non-Merit, favoring the respondent employer (a determination that discrimination did not occur).

2.4 Statistical analysis

Data were imported into the Statistical Package for the Social Sciences (SPSS) version 26 for all analyses. Descriptive statistics such as means, standard deviations, frequencies, and percentages were first presented across the three race/ethnicity groups (Caucasian, African American, and Hispanic/Latinx American) on all the variables of research interest. For the continuous dependent variable of CP age, a one-way ANOVA was used to compare means among the three race/ethnicity groups. A Bonferroni post-hoc test followed when an omnibus F-test was found significant.

For each categorical dependent variable (i.e., issue type, CP gender, employer region, employer size, resolution), a Chi-square test of independence was utilized to determine whether there was an association between the race/ethnicity designation and issue type, gender, region, employer size, and resolution outcome, respectively. The minimum sample size of each cell in the test was greater than five (Cochran, 1954). When the Chi-square test indicated the existence of a significant association, the magnitude of the effect size, measured by Cramer’s V, are reported. Cramer’s V ranges from 0 to 1, with a value of 0 indicating no association whereas a value of 1 indicates perfect association. Recommended by Cohen (1988), the values of 0.1, 0.3, and 0.5 on Cramer’s V represent small, moderate, and large effect size, respectively. In addition, the adjusted standardized residuals and their corresponding p-values are reported and examined in post hoc tests by using Bonferroni correction. A cell is determined to contribute to a significant association if the absolute value of its adjusted standardized residual exceeds 3 (Agresti, 2007).

3 Results

3.1 Descriptive statistics

Analysis of the first research question involved examining frequencies and column percentages of the categorical dependent variables (i.e., Issue Type, CP Gender, Employer Region, Employer Size, Resolution) across the three Race/Ethnicity groups of people with MS (see Table 1). Across the three race/ethnicity groups, there were some consistent trends as well as some distinct differences. In terms of issue type, Discharge was alleged with the highest frequency across the three race/ethnicity groups (34.4%in Caucasians, 32.4%in African Americans, and 32.6%in Hispanic/Latinx Americans); Reasonable Accommodation was the second most frequently filed allegation across the race/ethnicity groups (25.9%in Caucasians, 24.9%in African Americans, and 28.4%in Hispanic/Latinx Americans). Compared to the allegations in the other two race/ethnicity groups, issues related to Discipline and Hiring were filed more frequently by African Americans (12.2%and 9.4%respectively). Relatively, issues of Harassment and Intimidation were filed more frequently in the group of Caucasians (i.e., 9.4%) when compared to those in the other two race/ethnicity groups (8.9%in African Americans and 8.5%in Hispanic/Latinx Americans).

Table 1
Observed frequencies of three ethnicity groups and characteristics (N = 3,770)

Caucasian African American Hispanic/Latinx

Variable Freq. % Freq. % Freq. %

Issue type

Discharge 885 34.4 306 32.4 46 32.6

Reasonable accommodation 666 25.9 235 24.9 40 28.4

Terms and conditions 368 14.3 114 12.1 20 14.2

Harassment and intimidation 241 9.4 84 8.9 12 8.5

Discipline 228 8.9 115 12.2 12 8.5

Hiring 188 7.3 89 9.4 11 7.8

Gender

Female 1559 63.0 634 70.2 100 70.9

Male 916 37.0 269 29.8 41 29.1

Region

Mid Atlantic and Southeast 885 33.3 441 45.5 49 34.0

Midwest and Great Plains 700 26.4 246 25.4 34 23.6

Southwest and Rocky Mountain 456 17.2 140 14.4 20 13.9

Pacific and Northwest 364 13.7 69 7.1 16 11.1

New England and Northeast 251 9.5 74 7.6 25 17.4

Employer size

15–100 workers 572 23.5 143 16.2 34 26.4

101–200 workers 222 9.1 89 10.1 11 8.5

201–500 workers 340 13.9 123 13.9 24 18.6

More than 500 workers 1305 53.5 528 59.8 60 46.5

Merit

No merit 1889 71.1 740 76.3 119 82.6

Merit 767 28.9 230 23.7 25 17.4

	Caucasian	African American	Hispanic/Latinx
Issue type
Discharge	885	34.4	306	32.4	46	32.6
Reasonable accommodation	666	25.9	235	24.9	40	28.4
Terms and conditions	368	14.3	114	12.1	20	14.2
Harassment and intimidation	241	9.4	84	8.9	12	8.5
Discipline	228	8.9	115	12.2	12	8.5
Hiring	188	7.3	89	9.4	11	7.8
Gender
Female	1559	63.0	634	70.2	100	70.9
Male	916	37.0	269	29.8	41	29.1
Region
Mid Atlantic and Southeast	885	33.3	441	45.5	49	34.0
Midwest and Great Plains	700	26.4	246	25.4	34	23.6
Southwest and Rocky Mountain	456	17.2	140	14.4	20	13.9
Pacific and Northwest	364	13.7	69	7.1	16	11.1
New England and Northeast	251	9.5	74	7.6	25	17.4
Employer size
15–100 workers	572	23.5	143	16.2	34	26.4
101–200 workers	222	9.1	89	10.1	11	8.5
201–500 workers	340	13.9	123	13.9	24	18.6
More than 500 workers	1305	53.5	528	59.8	60	46.5
Merit
No merit	1889	71.1	740	76.3	119	82.6
Merit	767	28.9	230	23.7	25	17.4

Among those who identified their gender, 65.2%of the overall sample were female and 34.8%were male. Among Caucasians, 63%were female and 37%were male. The groups of African Americans and Hispanic/Latinx Americans were comparable in terms of their gender distributions with slightly more than 70%of the allegations in both of these groups being filed by females, whereas about 30%were filed by males.

In terms of employer region, the majority of the allegations came from the Mid-Atlantic, Southeast, Midwest, and Great Plains consistently across the three race/ethnicity groups (59.7%in Caucasians, 70.9%in African Americans, and 57.6%in Hispanic/Latinx Americans). A noticeably higher percentage of CPs in the Hispanic/Latinx group came from New England and the Northeast (17.4%), whereas the percentages of charging parties in the other two groups were relatively lower in the same region (i.e., 9.5%in Caucasians and 7.6%in African Americans).

The three groups showed similar patterns in terms of allegations by employer size. Larger employers were more likely to be the subjects of allegations. Specifically, the percentages of allegations against large employers with more than 500 workers were 53.5%, 59.8%, and 46.5%in the Caucasian, African American, and Hispanic/Latinx groups, respectively. Across the three race/ethnicity groups, compared to the mid-sized companies with either 101 to 200 or 201 to 500 workers, smaller companies with 15 to 100 workers were more likely to be named in allegations from their employees.

In terms of resolution outcomes, a minority of allegations was determined to have merit across the three race/ethnicity groups (all less than 30%). Across the three groups, a higher percentage of allegations in the Caucasian group (28.9%) was resolved in favor of CPs in comparison to the other two groups (23.7%in Hispanic/Latinx Americans and 17.4%in African Americans).

3.2 Inferential statistical comparisons

Among the three race/ethnicity groups, 3,481 allegations reported CP age. The ages ranged from 19 to 78, with an average age of 44 years old and a standard deviation of 10 years. The average ages of Caucasians, African Americans, and Hispanic/Latinx Americans with MS were 45 (SD = 10), 42 (SD = 10), and 43 (SD = 10), respectively. A one-way ANOVA was conducted to determine if the three race/ethnicity groups were different in age. Before the ANOVA test, the assumption of homogeneity of variances was assessed using Levene’s test; there was no evidence indicating that variances were not equal across groups (F_(2,3478) = 0.13, p > 0.05). As a result, the analysis proceeded. The differences in age among the race/ethnicity groups were statistically significant (F_(2,3478) = 24.32, p < 0.001). A follow-up Bonferroni post hoc analysis was conducted, and the results revealed that the mean age of Caucasians with MS at the time of filing allegations was significantly older than those in either the African American group (M_{(Caucasian - African)} = 2.63, 95%CI [1.69, 3.56], p < 0.001) or the Hispanic/Latinx American group (M_{(Caucasian - Hispanic)} = 2.23, 95%CI [0.14, 4.31], p < 0.05). However, there was no statistically significant age difference between African Americans and Hispanic/Latinx Americans (M_(Hispanic -_African) = 0.4, 95%CI [–1.78, 2.58], p > 0.05).

As noted in the Method section, the researchers applied primarily nonparametric statistics to answer Research Questions 2 through 5. The results of the Chi-square tests of independence for Issue Type, CP Gender, Employer Region, Employer Size, and Resolution across the three race/ethnicity groups are presented in Table 2. In these tests, the expected cell frequencies were all greater than five. The adjusted standardized residuals and corresponding p-values are presented after each of the omnibus tests.

Table 2
Chi-square test of independence results (N = 3,770)

Caucasian African American Hispanic/Latinx

Variable χ² df p Cramer’s V p Category Resid. p Resid. p Resid. P

Issue type 16.31 10 0.09 0.05 0.091 Discharge 1.1 0.271 –1.0 0.317 –0.3 0.764

Reasonable accommodation 0.3 0.764 –0.6 0.549 0.7 0.484

Hiring –2.0 0.046 2.1 0.036 0.0 1.000

Harassment and intimidation 0.5 0.617 –0.4 0.689 –0.3 0.764

Terms and conditions 1.5 0.134 –1.7 0.089 0.2 0.841

Discipline –2.7 0.007 3.0 0.003 –0.5 0.617

Gender 17.34 2 0.000 0.07 0.000 Female –4.2 0.000 3.7 0.000 1.5 0.134

Male 4.2 0.000 –3.7 0.000 –1.5 0.134

Region 72.43 8 0.000 0.10 0.000 New England and Northeast 0.5 0.617 –2.1 0.036 3.4 0.001

Mid Atlantic and Southeast –6.2 0.000 6.8 0.000 –0.6 0.549

Midwest and Great Plains 0.8 0.424 –0.5 0.617 –0.7 0.484

Southwest and Rocky Mountain 2.1 0.036 –1.9 0.057 –0.8 0.424

Pacific and Northwest 5.3 0.000 –5.4 0.000 –0.3 0.764

Size 26.12 6 0.000 0.06 0.000 15–100 workers 3.9 0.000 –4.6 0.000 1.3 0.194

101–200 workers –0.7 0.484 0.9 0.368 –0.3 0.764

201–500 workers –0.4 0.689 –0.2 0.841 1.5 0.134

More than 500 workers –2.5 0.012 3.4 0.001 –1.9 0.057

Merit 16.80 2 0.000 0.07 0.000 No merit –3.8 0.000 2.8 0.005 2.7 0.007

Merit 3.8 0.000 –2.8 0.005 –2.7 0.007

							Caucasian	African American	Hispanic/Latinx
Issue type	16.31	10	0.09	0.05	0.091	Discharge	1.1	0.271	–1.0	0.317	–0.3	0.764
						Reasonable accommodation	0.3	0.764	–0.6	0.549	0.7	0.484
						Hiring	–2.0	0.046	2.1	0.036	0.0	1.000
						Harassment and intimidation	0.5	0.617	–0.4	0.689	–0.3	0.764
						Terms and conditions	1.5	0.134	–1.7	0.089	0.2	0.841
						Discipline	–2.7	0.007	3.0	0.003	–0.5	0.617
Gender	17.34	2	0.000	0.07	0.000	Female	–4.2	0.000	3.7	0.000	1.5	0.134
						Male	4.2	0.000	–3.7	0.000	–1.5	0.134
Region	72.43	8	0.000	0.10	0.000	New England and Northeast	0.5	0.617	–2.1	0.036	3.4	0.001
						Mid Atlantic and Southeast	–6.2	0.000	6.8	0.000	–0.6	0.549
						Midwest and Great Plains	0.8	0.424	–0.5	0.617	–0.7	0.484
						Southwest and Rocky Mountain	2.1	0.036	–1.9	0.057	–0.8	0.424
						Pacific and Northwest	5.3	0.000	–5.4	0.000	–0.3	0.764
Size	26.12	6	0.000	0.06	0.000	15–100 workers	3.9	0.000	–4.6	0.000	1.3	0.194
						101–200 workers	–0.7	0.484	0.9	0.368	–0.3	0.764
						201–500 workers	–0.4	0.689	–0.2	0.841	1.5	0.134
						More than 500 workers	–2.5	0.012	3.4	0.001	–1.9	0.057
Merit	16.80	2	0.000	0.07	0.000	No merit	–3.8	0.000	2.8	0.005	2.7	0.007
						Merit	3.8	0.000	–2.8	0.005	–2.7	0.007

There was no statistically significant association between Issue Type and Race/Ethnicity ( $χ_{(10)}^{2}$ =16.31, p = 0.09, and Cramer’s V = 0.05, p = 0.09). The result of the Chi-square test of independence between Gender and Race/Ethnicity was statistically significant (χ²₍₂₎ = 17.34, p < 0.001), indicating an association between gender and race/ethnicity. However, the magnitude of association was small (Cramer’s V = 0.07, p < 0.001).

The result of the Chi-square test of independence between Employer Region and Race/Ethnicity was also statistically significant ( $χ_{(8)}^{2}$ = 72.43, p < 0.001). The magnitude of association was also small (Cramer’s V = 0.10, p < 0.001). In the Mid-Atlantic and Southeast, the groups of Caucasians with MS and African Americans with MS had cells with the adjusted standardized residual exceeding 3 in absolute value (p < 0.001, α after Bonferroni correction is 0.05/15 = 0.003). These results indicate that proportionally fewer allegations than expected were filed by Caucasians with MS and more allegations than expected were filed by African Americans with MS in the Mid-Atlantic and Southeast. In the Pacific and Northwest, the groups of Caucasians with MS and African Americans with MS had cells with the adjusted standardized residual exceeding 3 in absolute value (p < 0.001, α after Bonferroni correction is 0.05/15 = 0.003), indicating that more allegations than expected were filed by Caucasians with MS but fewer allegations than expected were filed by African Americans with MS in those regions. In New England and the Northeast, only the group of Hispanic/Latinx Americans with MS had a cell with the adjusted standardized residual exceeding 3 in absolute value (p < 0.001, α after Bonferroni correction is 0.05/15 = 0.003), indicating that more allegations than expected were filed by Hispanic/Latinx Americans with MS in those regions.

A Chi Square test of independence also showed that there was a statistically significant association between Employer Size and Race/Ethnicity ( $χ_{(6)}^{2}$ = 26.12, p < 0.001). Employers with 15–100 workers had a cell with the adjusted standardized residual exceeding 3 in absolute value in the groups of Caucasians and African Americans (p < 0.001; α after Bonferroni correction is 0.05/12 = 0.004); the employers with more than 500 workers had a cell with the adjusted standardized residual exceeding 3 in absolute value in the group of African Americans (p < 0.001; α after Bonferroni correction is 0.05/12 = 0.004). These results indicate that African Americans with MS were less likely to file allegations against employers with 15 to 100 workers, but more likely to file allegations against employers with more than 500 workers, than their peers in the other two race/ethnicity groups.

Lastly, regarding resolution outcomes, the Chi-square test indicated a statistically significant association between Merit rates and Race/Ethnicity ( $χ_{(2)}^{2}$ = 16.80, p < 0.001). The magnitude of association was small (Cramer’s V = 0.07, p < 0.001). By examining the adjusted standardized residuals that were greater than 3 in absolute value, the researchers found that more allegations than expected filed by Caucasians were closed with merit (i.e., discrimination did occur) when compared to the merit outcomes in the other two race/ethnicity groups (p < 0.001; α after Bonferroni correction is 0.5/6 = 0.008).

4 Discussion

Overall, this study yielded modest but noteworthy differences in the workplace discrimination experiences among Caucasian Americans, African Americans, and Hispanic/Latinx Americans with MS. In absolute terms, it is important to note that all three groups most frequently filed allegations that can be categorized under the Discharge classification, and that the second most frequently alleged complaints had to do with Reasonable Accommodations.

These findings support the current literature, where it has been reported that people with disabilities experience the highest rate of discrimination in termination and reasonable accommodations (Bjelland et al., 2010; Graham et al., 2019; Rumrill et al., 2005). Employers’ concern about costs related to health care and supposed mismatches between essential skills and work readiness of employees have been reported as potential explanations for termination of people with disabilities (Bjelland et al., 2010). Additionally, key barriers that people with disabilities face in relation to employment and advancement include supervisors’ lack of knowledge regarding accommodations, lack of disability awareness, concerns about costs, fear of legal liability, and supervisors’ and coworkers’ attitudes toward people with disabilities (Bruyere, 2000; Kaye et al., 2011; Umucu, 2021).

Strategies to reduce the frequency or occurrence of discharge and accommodation related discrimination include the following: (1) disability and accommodation related training for employers, (2) practitioners addressing potential work discrimination and accommodations with employees with disabilities, (3) offering incentives to both employers and employees with disabilities to engage in non-adversarial problem-solving in lieu of formal discrimination complaints, (4) development of pro-active inclusion policies, and (5) problem solving training for both employers and employees with disabilities (Sheppard-Jones et al., 2021). Disability awareness and accommodation related training for employers should be tailored to address the common misconceptions about employees with disabilities and information involving accommodations such as addressing employers cost concerns and knowledge of legislation (e.g., ADA), which may help in reducing employers’ fear of legal liability (Kaye et al., 2011; Sung et al., 2020). Practitioners should also discuss with employees’ potential or anticipated discrimination issues, particularly those relating to people with MS from minoritized racial and ethnic groups, to better prepare them regarding how to manage such situations (Adams et al., 2021; Bjelland et al., 2010; Graham et al., 2019). Informing employees about their employment rights, such as the right to reasonable accommodations, can enhance their self-advocacy and awareness skills. Additionally, interventions for employers centered on behavioral manifestations of negative attitudes (e.g., discrimination) may result in improvements in workplace inclusion policies and practices (Sheppard-Jones et al., 2021). Another strategy entails the government offering incentives to both employees who improve their job skills and employers who provide job opportunities to employees with disabilities (Schultz et al., 2007, as cited in Bjelland et al., 2010). These incentives could give employees the opportunity to boost their skills with retraining, thereby resulting in an improvement in their job performance which could ultimately lead to job retention and potential advancement. Never has the prospect of ensuring worker job retention been more important than it is as of this writing, when the U.S. economy is burgeoning amid the re-opening of society as the end of the COVID-19 pandemic draws nearer; workers with MS, and all workers for that matter, are likely to remain in very high demand as the full-employment American economy continues to emerge from the devastating effects of the pandemic (Umucu, 2021).

Development of universal design practices (Shep-pard-Jones et al., 2021) has also been indicated by researchers as a critical strategy to improve employment outcomes for minoritized individuals with MS (Rumrill et al., 2021). More specifically, policies related to the following are vital: (1) permit flexibility and customized support to meet employees’ unique needs (Denny-Brown et al., 2015); (2) emphasize the provision of on-the-job accommodations and prevention of turnover in all job retention efforts (Koch et al., 2021; Rumrill et al., 2005); and (3) consider telecommuting and virtual communication platforms for workers who wish to do their jobs remotely (Adams et al., 2021).

The fact that there was no statistically significant association in this study between race/ethnicity and issue type suggests that the types of discrimination encountered by people with MS generalize across racial/ethnic identities. It is also worth pointing out, albeit not surprising, that the three racial/ethnic groups roughly mirrored the ratio of women to men in the overall global population of people with MS; approximately one-third of the overall sample was male and two-thirds were female (Murray, 2016). That said, African American and Hispanic/Latinx women with MS were proportionally more likely than their female Caucasian counterparts to file ADA title allegations, and Caucasian males in the sample conversely filed proportionally more allegations than male African Americans or Hispanic/Latinx Americans. It may be the case that being female, having MS, and being a person of color render one particularly vulnerable to workplace discrimination, hence the greater proportion of allegations filed by women with those characteristics. With regard to male Caucasians being more likely to file allegations than males of color, it may be the case that the double-advantaged status of Caucasian males makes them more likely to assert their rights in a formal proceeding than would be expected of males from minoritized racial or ethnic backgrounds.

In terms of the age of CPs across the three groups, findings of this study indicated an average age of 44 years old for the entire sample, with all three groups reporting mean ages in the early to mid-40s. According to the U.S. Bureau of Labor Statistics (BLS), the average age of workers in 1999 was 39 years, in 2019 41.9 years, and in 2029 it is expected to be 42.6 years old. Thus, the findings of this study align with U.S. BLS predictions, further indicating how the average age of American workers is expected to continue to increase due to individuals delaying retirement until later in life than ever before. Moreover, a potential reason as to why older individuals are more prone to file allegations than younger individuals may be due to them having more experience with employment and with the ADA and thus more agency in ensuring that their rights are protected (Roessler et al., 2016).

Regarding the Employer Region variable, there was some cross-group variability, although the greatest frequencies of allegations across all three race/ethnicity groups came from Mid-Atlantic, Southeast, Midwest, and Great Plains regions. A potential explanation for these overall cross-regional differences in allegation frequencies lies in well-known regional differences in fair labor statutes, employee rights, and the presence of labor unions (McMahon & McMahon, 2017; Roessler et al., 2016). Rumrill & Fitzgerald (2010) noted that northeastern and New England states have lower levels of allegations than other regions across disability types and other CP characteristics, mostly because states in those regions tend to be union security states and have more protections in place for vulnerable workers. This finding was observed in the present study.

In terms of employer size, this study’s findings align with other research where it has been identified that larger employer size (i.e., over 500 employees) is associated with the highest frequency of allegations when compared to medium or small size employers (McMahon, 2012; Roessler et al., 2016). A possible explanation for this could be that larger employers hire more workers in general and more workers with disabilities in particular than do smaller employers (Strauser, 2021). As a result, these employers may have more formal policies and inclusion practices whereby workers know their rights and the procedures to use when their rights have been violated, hence the greater proportion of discrimination allegations.

Although the proportions of merit resolutions were under 30 percent for all three racial/ethnic groups considered in this study, African American and Hispanic/Latinx American CPs were significantly less likely to have the EEOC resolve allegations in their favor than were Caucasian American CPs. The low merit rate in the overall sample requires some comment before preceding to a more finely grained discussion of the intersectionality of race/ethnicity vis a vis allegation outcomes. Other research studies have reported that the rolling average for merit resolutions in NEARP studies with people with disabilities in general has been 22–26 percent for the past 25 years (McMahon, 2012), and people with MS have tended to report merit rates of around 25 percent (Rumrill et al., 2005; Rumrill et al., 2019). These low merit rates among people with disabilities and people with MS in particular underscore the need to educate workers about their rights to non-discriminatory treatment in the workplace under the ADA, remedies and recourses that are available to those who have experienced workplace discrimination, and procedures for redressing discriminatory conduct on the part of employers (Smart, 2020). Indeed, this information is especially important for African American and Hispanic/Latinx American people with MS given the merit findings in the present study.

The fact that the already low rate of merit resolutions in allegations involving people with MS falls off precipitously if the CP with MS is a person of color requires rehabilitation professionals, researchers, employers, and people with MS to take notice of the double-disadvantage that may inhere to a collective disability and minoritized racial/ethnic status –a status that may make it especially difficult to invoke the anti-discrimination protections of the ADA in a way that results in favorable outcomes. Research has demonstrated that Hispanics/Latinx and African Americans with disabilities tend to report higher levels of discrimination and unfair treatment in the workplace than do Caucasian Americans with disabilities (Rubin et al., 2016; Smart, 2020). Merchant et al. (2020) and Rumrill et al. (2021) documented that people of color who have MS report different types and degrees of employment concerns than do Caucasians with MS, and that issues of ADA implementation and workplace discrimination are more frequently cited among those concerns. African American and Hispanic/Latinx Americans with MS need technical assistance from culturally competent rehabilitation professionals in order to most effectively advocate for themselves in critically important job acquisition and retention matters such as redressing discrimination that may be directed to their disability status, to their race/ethnicity, or to both.

4.1 Limitations

An over-arching limitation of the present study is evident in the restricted range of study variables that is attendant to the nominal coding of most fields in the EEOC’s IMS database. Also, there are many demographic worker characteristics that have been shown to be relevant to both employment and long-term health outcomes that were not available in the database, including marital status, sexual orientation, overall health status, motivation, resilience, locus of control, socioeconomic status, and urban-rural-suburban residency (Kalb, 2016; Murray, 2016). Available data on the nature of CPs’ MS were similarly limited. Specific data regarding the courses of MS with which CPs were diagnosed, severity and prognosis, duration of illness, and treatment received were unavailable, yet they may have had important implications for CPs’ employment and workplace discrimination experiences. Readers should additionally take note of the fact that CPs who identified themselves as being of mixed race or ethnicity were not included in this study. It is also worth pointing out that the manner in which the database codes ADA Title I allegations is based upon primary disability, and it does not take into account co-occurring conditions. This means that a person who has MS but who also has diabetes might file his or her allegation using diabetes as the primary disability; this person’s allegation would not be part of the present study even though he or she has MS. Finally, this study was strictly limited to allegations brought under Title I of the ADAAA, thus it is certain that the study population does not fully represent the entirety of Caucasian Americans, African Americans, and Hispanic/Latinx Americans with MS who experience workplace discrimination. People with MS who experience unfair treatment in the workplace often choose not to report their experiences to anyone (Nissen & Rumrill, 2016), and those who do choose to file complaints may do so under other employment-related legislation such as the Rehabilitation Act of 1973, Civil Rights Act, Equal Pay Act, or Age Discrimination in Employment Act. Allegations of workplace discrimination by people with MS could also have been filed on the basis of race or gender with the EEOC, as the alleged discrimination may not have occurred exclusively as a result of MS (McMahon & McMahon, 2017).

5 Conclusion

Discrimination and unfair treatment in the workplace endure as frequently cited barriers to the career maintenance prospects that await racially and ethnically minoritized people following MS diagnoses. Racial and ethnic identifications on the part of CPs with MS turned out to be differential indicators of workplace discrimination experiences in terms of the age of CPs, gender, the location and size of respondent employers, and case resolution patterns. Understanding the recent discrimination experiences of Caucasian American, African American, and Hispanic/Latinx American people with MS in both absolute and comparative terms will enable vocational rehabilitation professionals to tailor culturally grounded interventions that assist people with MS in identifying and redressing unfair treatment in the workplace, which in turn has the potential to increase labor force participation among this experienced and well-educated community of workers.

Footnotes

Acknowledgment

The data examined in this study were analyzed with permission of the Equal Employment Opportunity Commission (EEOC) through an Interagency Personnel Agreement (IPA) and Confidentiality Agreement involving the EEOC, Dr. Brian T. McMahon, and his employer (a state university).

Conflict of interest

None to report.

Ethical declarations

Ethical approval was not necessary, as the study used extant data that were collected for another purpose.

Funding

Funding for this study was provided by a research grant from the National Multiple Sclerosis Society, New York, NY (grant # SI-2012-37169).

Informed consent

The researchers utilized archival data provided by the US Equal Employment Opportunity Commission. No personally identifying information was used. Informed consent was not required for this investigation.

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