Overview of the socio-economic status of people with disabilities

3.4Overview of the socio-economic status of people with disabilities

Clearly, poor nutrition, lack of access to health care, unsafe living and working conditions and other conditions associated with poverty can lead to disability. However, people who are richer have been shown to live longer⁶⁸, and disability is associated with ageing. Also, people who become disabled later in life are more likely to have assets and children who can help support them. Moreover, richer people who are injured or experience the onset of an illness – or even have a congenital disability – are more likely to get the care and services they need to live longer. That is, poorer people with disabilities are more likely to die and thus disappear from prevalence rates while richer people with disabilities remain. Studies from Vietnam and Indonesia show that the link between disability and poverty weakens as the age of onset of disability increases,^69,70 helping to explain why a strong relationship between consumption measures of poverty and disability has not always been found, especially when age of onset of disability is neglected. Out of 15 developing countries, one study found that only four countries showed a significant relationship between consumption based poverty and disability. ⁶⁰ However, when multidimensional measures of poverty are used, the relationship between disability and poverty is stronger. The same study of 15 developing countries found a significant correlation between disability and various measures of exclusion, such as deficits in education, employment, life expectancy, etc. These results are mirrored in a study of disability and poverty in Afghanistan and Zambia⁷¹ which did not find significant differences between the assets of people with and without disabilities, but found that people with disabilities were associated with other forms of exclusion, when it came to domains such as education, employment, and health care.

In addition, one study in Vietnam found that the relationship between disability and poverty varied significantly by district, with some districts showing a big gap in poverty rates (as measured by consumption) between people with and without disabilities but some districts showing much smaller ones.⁷² That study found that those gaps were correlated with lower levels of infrastructure, suggesting that improved infrastructure can help weaken the link between disability and poverty. Even though improved infrastructure may remove some barriers keeping people with disabilities poor, the link between disability and poverty can also be observed in developed countries with more advanced infrastructure. In the United States, for example, people with disabilities made up 47% of those in poverty and 65% of those in long-term poverty.⁷³

Many of the studies looking at disability and poverty do not account for the extra costs of disability. People with disabilities have costs associated with health care, transportation, personal assistance or assistive devices, modified residences, etc.⁷⁴ The result is that two households with the same level of consumption (or income) – one with a member with a disability and one without – are not enjoying the same standard of living due to the extra costs associated with reasonable adjustments for persons with disabilities.

presents the estimated costs of living with a disability. While the estimated costs of living with a disability range significantly, a rough estimate would be that having a disability increases the cost of living by about a third of average income. ⁷⁵

Another way that the poverty rates for people with disabilities can be understated is that poverty rates are usually reported for households and not individuals. The assumption is that all individuals in the household receive an equal share of family resources, yet, it can be posited that persons with disabilities are de-valued or discriminated against in their own households and may receive a lesser share. Studies show that family investment in children with health conditions is significantly lower than for children without disabilities.⁷⁶

There are differences in access for persons with disabilities to fundamental services such as water and sanitation. For example, 32% and 48% of people with disabilities in Uganda and Zambia, respectively, are able to get help fetching water. In both countries, about 70% of those who did report difficulties in doing so explained that the difficulties were due to barriers such as the distance of the water source to home, the heaviness or unreachability of pump handles, time spent waiting in line (for those who have difficulty standing), and the weight of water containers.⁸³ In addition to physical barriers, attitudes undermined their ability to obtain water. In Uganda, 19% were told they should not touch the water that other people drink, presumably for fear of contagion.

People with disabilities also found barriers in using the same toilets as household members used in their home (24% in Uganda, 16% in Zambia). Toilets in public places were even more inaccessible with 39% of people in Uganda reported having trouble finding an accessible toilet in their community. Persons with disabilities also reported that when they used the toilets, they were often mocked or laughed at by non-disabled people. People with disabilities in these countries were nearly 25% less likely to bathe, and reported feeling ashamed because they were unclean or smelled.