Inequalities In Disability Research Articles

Health sciences training for disability inclusion: the need to engage with emotion

Material aspects of disability inequality, such as access to quality services, housing and employment, are an urgent, worldwide concern. Less recognised though, are psychological layers of prejudice and discrimination, which...

Inequalities in disability

Abstract Prevalence of disability and receipt of disability benefits have steadily increased among the UK’s working-age population in recent years. We examine inequalities in disability and its prevalence between educational groups, year of birth cohorts, regions and genders in the UK. Our analysis reveals significant disparities in disability rates across groups. In particular, disability is strongly related to education: those with lower levels of education have similar disability rates to those with degrees who are decades older than them. These gaps in disability rates open up early on in the life cycle, and while the prevalence of poor physical health increases steadily with age, we see the prevalence of poor mental health rising particularly fast among younger cohorts. These patterns in early life may have profound future implications for physical health and longevity. These results suggest that disability may be a key driver of inequalities across the life cycle.

Raising awareness isn’t enough: The role of the psychology of education in disability-related justice and inclusion in primary classrooms

What:Regarding education, disability inequality is arguably a structural and systemic issue. The social model of disability, enshrined in teacher education programs in the UK, espouses the ways in which school environments, rather than disabled children themselves, need to adapt and change. However, the role of psychology in addressing disability-related systemic injustice is less clear. The aim of this paper is to consider the potential role of the psychology of education in working towards disability justice in schools.Why?Many inclusive teacher-education programmes set out the ways in which environments may be created to include disabled children. Psychologists have focused on disabled children’s needs to access and participate in the classroom, but often do not consider their exclusion in social model terms, from curriculum materials, classroom displays, or material culture more generally. Favazza and colleagues (e.g. 2017) now offer a sizeable body of research showing that disability representation in school classrooms is negligible. This lack of representation is reflected among the staff in the teaching profession, where the 2016 census suggests that 0.5% of English teaching staff declared a disability (DfE, 2017), and more recent census data show that disability data were not collected (DfE, 2023a). It is this lack of representation of disabled people and its possible psychological underpinnings that this paper addresses.How?This paper uses social and affirmative model lenses to (a) explore the ways in which disability may be seen as a structural inequality in contemporary UK education and (b) suggest ways in which researchers and practitioners in the Psychology of Education may work towards disability justice. This may be achieved by considering extant research practice and through research focusing on the perceptions of and attitudes towards disability, alongside existing psychological work that focuses on disabled children’s individual needs.

Factors Explaining the Change in Socioeconomic Inequality of Disability in Iran: A Repeated Cross-sectional Study.

More than 15% of the world's population live with some form of disability. Assessing socioeconomic inequalities in disability and monitoring its change over time can help policymakers to design and implement targeted interventions to reduce these inequalities. This study aimed to assess the change in socioeconomic inequality in disability in Iran from 2000 to 2010. Data for this cross-sectional study were obtained from 2 waves of Iran's demographic and health surveys (2000 and 2010). The Wagstaff normalized concentration index was used to measure the socioeconomic inequality of disability. Contributing factors to the inequality in 2000 and 2010 were investigated by concentration index decomposition. The Blinder-Oaxaca decomposition method was used to determine contributing factors of change in disability inequality. All analyses were conducted in Stata14. The negative and statistically significant concentration indices (-0.132 in 2000 and -0.165 in 2010, P < 0.001) suggested more concentration of disability among poor people. The absolute value of inequality was increased by 0.034 between the 2 points of time (P = 0.025). Level of education (123.5%), household size (12.9%), age (-35.1%), and residency (in terms of Iran's provinces) (-19.3%) were the contributing factors to the measured disability inequality in 2000. In 2010, level of education (105.8%), household size (30.5%), and urban residency (-46.3%) explained the measured inequality. Change in disability inequality was explained by household size (99.4%), province of residence (54.8%), education (36.9%), socioeconomic status (20%), urban residency (-90.3%), and age (-47.7%). Iran suffers from significant socioeconomic inequality in disability, and it significantly increased over time. Interventions such as increasing health literacy and providing suitable job opportunities for people with low education level, improving the socioeconomic status of extended households, and paying more attention to the balanced development in the provinces and urban and rural areas, and attending to prevention, treatment, and mitigation of disability adversities among poor young and elderly people could be recommended to tackle increased socioeconomic inequality in disability and its unfavorable consequences in Iran.

Unequal burdens of COVID-19 infection: a nationwide cohort study of COVID-19-related health inequalities in Korea.

While the Korean government's response to the coronavirus disease 2019 (COVID-19) pandemic is considered effective given the relatively low mortality rate, issues of inequality have been insufficiently addressed. This study explored COVID-19-related health inequalities in Korea. Age standardization for various health inequality indices was derived using data from the Korean National Health Insurance Service, the Korea Disease Control and Prevention Agency, and the Microdata Integrated Service of Statistics Korea. The slope index of inequality (SII) and relative index of inequality (RII) were calculated for socioeconomic variables, while absolute difference (AD) and relative difference (RD) were used for gender and disability inequalities. We observed a number of COVID-19-related health outcome inequalities. Gender inequality was particularly noticeable in infection rates, with the rate of women 1.16 times higher than that of men. In contrast, socioeconomic inequality was evident in vaccination rates, with a 4.5-fold (SII, -4.519; 95% confidence interval, -7.403 to -1.634) difference between the highest and lowest household income groups. Regarding clinical progression post-infection, consistent findings indicated higher risk for men (RD for hospitalization, 0.90; severe cases, 0.54; and fatality, 0.65), individuals with disabilities (RD for hospitalization, 2.27; severe cases, 2.29; and fatality, 2.37), and those from lower socioeconomic groups (SII for hospitalization, 1.778; severe cases, 0.089; and fatality, 0.451). While the infection risk was nearly ubiquitous, not everyone faced the same level of risk post-infection. To prevent further health inequalities, it is crucial to develop a thoughtful policy acknowledging individual health conditions and resources.

Decomposing Disability Inequality in Unmet Healthcare Needs and Preventable Hospitalizations: An Analysis of the Korea Health Panel.

Objectives: This study examines the inequality between people with and without disabilities regarding unmet healthcare needs and preventable hospitalization. Methods: We used the Korea Health Panel of 2016-2018; the final analytical observations were 43,512, including 6.95% of persons with disabilities. We examined the differences in contributors to the two dependent variables and decomposed the observed differences into explained and unexplained components using the Oaxaca-Blinder approach. Results: Unmet healthcare needs and preventable hospitalizations were 5.6% p (15.36% vs. 9.76%) and 0.68% p (1.82% vs. 0.61%), respectively, higher in people with disabilities than in those without, of which 48% and 35% were due to characteristics that the individual variables cannot explain. Decomposition of the distributional effect showed that sex, age, and chronic disease significantly increased disparities for unmet healthcare needs and preventable hospitalization. Socioeconomic factors such as income level and Medical aid significantly increased the disabled-non-disabled disparities for unmet healthcare needs. Conclusion: Socioeconomic conditions increased the disparities, but around 35%-48% of the disparities in unmet healthcare needs and preventable hospitalization were due to unexplained factors, such as environmental barriers.

Disability policy and practice in Malawian employment and education.

Malawi is a landlocked country in Southern Africa with a population of 17.5 million. It has taken great strides in addressing disability inequality in recent years. Despite this, Malawian trade unions, educators and disability activists report wide-reaching disability discrimination at an infrastructural and individual level. Situated at the intersections between disability studies and medical sociology, alongside work of postcolonial and Global South scholars, this article highlights how neo-colonial and Anglocentric dominant framings of disability do not necessarily fit the Malawian workforce, as they ignore cultural and structural differences in the causes and maintenance of ill health and disability. Building on interviews with workers with disabilities, trade unionists, educators, government representatives and disability activists in Malawi's two biggest cities, the article emphasises the need to address specific local contexts; while policy asserts a model of social oppression, in practice, disability inclusion requires recognition of the social determinants of disability and inequality, and the economic, political and cultural context within which disability resides. Sharing co-designed approaches to engaging with disability definitions, stigma, language, infrastructure and resources, this article highlights the necessity of grounding disability and medical sociological theory in localised framings and lived experiences.

Childhood disability, social class and social mobility: A neglected relationship.

Disability theorists have long highlighted the role of institutional, social, and environmental barriers in constructing disability, emphasizing its parallels with other socially constructed axes of stratification. However, despite theoretical developments toward sociological understandings of disability, social stratification and life-course research have largely neglected childhood disability as a social division. As a result, we still know little surrounding the socio-economic attainment of disabled children and young people. Drawing on Next Steps data, this research note highlights stark overlooked inequalities between disabled and non-disabled young people's activity status and social mobility in early adulthood. We specifically focus on the importance of social class for disabled young people's outcomes, emphasizing the need for intersectional analyses of disability inequalities. We also outline longitudinal survey data enhancements necessary for life-course research on childhood disability and its intersections.

Do Disability Inequalities Grow with Development? Evidence from 40 Countries

With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across countries by development level. Using internationally comparable data on disability inequalities in 40 countries, we assess disability inequalities through the use of regression analyses with a variety of development measures. Results support the hypothesis only partially: disability inequalities related to education, employment, and multidimensional poverty are found to be significantly larger in countries at higher levels of development. However, this is not the case for rates of access to water, sanitation, clean fuel, electricity, housing, and assets. These results, overall, hold when using different development and outcome indicators, and when focusing on specific subgroups of the population. The potential implications of these findings are discussed. Further research is needed to understand, for education and employment, the factors and processes that contribute to larger disability inequalities in countries at higher levels of development and what strategies might be pursued to reduce them.

Disability policy and UK political parties: absent, present or absent-present citizens?

In his study of disability and policy making in Canada, Michael Prince conceptualised the idea of ‘absent citizens’ to describe how people with disabilities were marginalised in the political process and disability policy treated in a piecemeal fashion. This article examines whether disabled people in the UK also constitute absent citizens by analysing the election manifestos produced by the two main parties over the past decade. The research finds an asymmetry in the parties’ attention to disability policy from 2017 onwards when disabled people were present as part of the wider critique of the Conservative’s austerity agenda. Conversely, disabled people constituted a sort absent-presence for the Conservatives, as they were subjected to policies which disproportionately affected them, yet this was not made explicit. Finally, there is evidence to suggest a similar piecemeal approach to disability policy, but it would be difficult to frame disabled people as totally absent citizens. Points of interest Disabled people in the UK have been disproportionately affected by the austerity politics of the past decade, but UK political parties have not always recognised or responded to disability inequality. This paper looks at disability policy pledges contained in UK political party manifestos since 2010. This paper finds a lack of attention paid to disability policy in 2010 and 2015 but an increased number of disability policies in Labour’s manifestos in 2017 and 2019. This paper argues that although disabled people are absent from earlier Conservative manifestos they were subjected to policies that negatively affected them, making disabled people simultaneously absent and present. Finally, this paper also argues that the approach of the political parties to disability policy can best be described as piecemeal.

Depression and diabetes: The role of syndemics in the social inequality of disability

Most countries including Brazil have steep social gradients in the prevalence of disability. Many disorders contribute to that, and one individual often suffers from more than one disabling disease. The question is to what extent the syndemics framework that assume clustering and interaction between comorbid disorders influence the inequality in disability. We used the National Health Survey of Brazil (PNS 2013 N = 60.202 aged 18+ years), and studied prevalent self-reported disability, diabetes and depression. We estimated age- and sex-adjusted prevalence differences across levels of education and interactions as departure from additivity with linear probability models. The Brazilian population shows social inequalities in the prevalence of both diabetes and depression, and the impact of the disorders on disability is differential, i.e. stronger among the low educated. There is both clustering and interaction between the two disorders, but the two mechanisms seem to play a negligible role in explaining the inequality in disability, whereas the most important mechanism is the differential impact the two disorders have on disability. A majority of patients suffering from both disorders has however a precarious position on the labor market with a combination of disability and only primary school or less education. The syndemics framework is helpful in understanding how comorbidities impact people's lives in a specific context of social inequality, and the interaction between clustering disorders are very visible on the population level. Clustering and interaction between diabetes and depression does not however contribute much to the social disparities in disability, but the group suffering from this comorbidity represent a significant need for vocational rehabilitation.

Trends in inequalities in disability in Europe between 2002 and 2017

BackgroundMonitoring socioeconomic inequalities in population health is important in order to reduce them. We aim to determine if educational inequalities in Global Activity Limitation Indicator (GALI) disability have changed between...

Trends in the Social Class Inequalities in Disability and Self-Rated Health: Repeated Cross-Sectional Surveys from Finland and Sweden 2001-2018.

Objectives: To assess time trends in the social class inequalities and in total inequality in disability and self-rated health (SRH) in two oldest old populations. Methods: The data came from the Finnish Vitality 90+ Study (2001, 2003, 2007, 2010, 2014 and 2018; n = 5,440) and from the Swedish Panel Study of Living Conditions of the Oldest Old (2002, 2004, 2011 and 2014; n = 1,645). Inequalities in mobility and activities of daily living (ADL) disability and SRH were examined cross-sectionally and over time using relative and absolute measures. Results: Lower social classes had greater mobility and ADL disability and worse SRH than higher social classes and the inequalities tended to increase over time. Findings were remarkably similar in both studies and with absolute and relative measures. Total inequality, referring to the variance in health outcome in the total population, remained stable or decreased. Conclusion: The study suggests that the earlier findings of improved mobility and ADL are largely driven by the positive development in higher social classes while findings of decline in SRH are related to the worsening of SRH in lower social classes

Activating the ‘ideal jobseeker’: Experiences of individuals with mental health conditions on the UK Work Programme

Active labour market programmes (ALMPs) are critical preparation mechanisms to assist people to enter the workplace. This article analyses qualitative data from a hard-to-access group of individuals with mental health conditions (MHCs) participating in a large-scale UK ALMP, the Work Programme (WP). Using the lens of the ‘extended social model of disability’ and the concept of the ‘ideal worker’, the article demonstrates that ableist norms of the ‘ideal jobseeker’ were embedded within the Programme’s design, prioritising individuals with certain abilities and behaviour over others. Second, the article extends Acker’s framework of inequality regimes to demonstrate that formal and informal inequality practices within the Programme maintained, rather than challenged, disability inequality. This was visible along four dimensions: (1) ALMPs as organising processes producing disability inequality; (2) the visibility of disability inequality; (3) the legitimacy of disability inequality; and (4) control and compliance derived from hierarchical social relations within ALMP design and implementation, involving either stabilising or destabilising effects on disabled jobseekers. The theoretical and practical contributions of this article demonstrate that the design of the WP as an employment preparation mechanism pushed disabled jobseekers further away from paid employment, rather than towards workplace inclusion.

Disability-friendly public space performance

Sustainable development goals no. 11 mentioned the need for reduced inequalities in disability. However, this equality in urban public spaces is not yet optimal. Public space is not yet sufficient in providing facilities for persons with disabilities. The purpose of this research is to measure the performance of public spaces based on perceptions of persons with disabilities. The approach method uses Importance performance analysis (IPA). IPA is considered a useful tool in examining customer satisfaction. Based on the results of surveys and IPA calculations, the performance of public spaces according to disabilities is generally not in accordance with their expectations. The performance components of public space ranged from 41.28% to 95% of the expectations of people with disabilities. Based on these results, better efforts from the city government and the community are needed to develop more disability-friendly public spaces.

Desigualdad en los Derechos Humanos de las mujeres mayores: caso estado de Zacatecas

De acuerdo con la Organización Mundial de la Salud (OMS), 2015, entre 2000 y 2050, a nivel mundial, la población de adultos mayores de 60 años pasará del 11% al 22%. En México, de acuerdo con el Consejo Nacional de Población (CONAPO), 2019, alcanzará cerca de 34%. Referente al Estado de Zacatecas, México, se estima que irá del 11.08% en 2015 al 14.5% en 2030. Este fenómeno significará un problema social que implica pobreza, discapacidad, abandono y enfermedades, entre otras condiciones, que, de no considerarse, se verán violentados los Derechos Humanos de sus habitantes. El objetivo del presente estudio consistió en evaluar y determinar la desigualdad de los Derechos Humanos que viven las mujeres mayores, en el Estado de Zacatecas, México, para lo cual se utilizó un cuestionario aplicado a 2.566 personas. Se hizo un análisis factorial exploratorio, en el que se encontraron tres factores: el primero de ellos denominado apoyo familiar, el segundo abuso físico y psicológico, el tercero, dependencia física y servicios. Además, mediante la Chi Cuadrada de Pearson, se encontraron relaciones estadísticamente significativas entre ser mujer y desigualdad económica, laboral y discapacidad. Por tanto, se concluye que, en el caso del Estado de Zacatecas, existe una transgresión de los Derechos Humanos de la Mujeres Mayores.

Educational inequalities in disability linked to social security coverage among older individuals in five Latin American countries.

Although Latin American populations are ageing rapidly, many countries have important shortcomings in terms of access to social security coverage. Despite significant improvements regarding access to healthcare, the coverage gap in terms of pensions represents a major challenge for public health and equity in the region. The principal aim of this study was to systematically assess the association between social security coverage and disability among older individuals in five Latin American countries, as well as the extent of existing inequalities and its determinants. To do so we use cross-sectional and comparative data for individuals aged 60 and older in Chile, Colombia, El Salvador, Paraguay and Uruguay from the Longitudinal Social Protection Survey (ELPS). We used multivariate regression to assess the association between disability and healthcare as well as pension coverage. Concentration indices (CI) and an Oaxaca-Blinder decomposition approach were used to assess overall inequalities in disability according to education as well as their components. With the exception of El Salvador, we find significant inequalities in disability disfavoring lower educated individuals. With regards to healthcare, we find no significant association of healthcare coverage with disability in any of the five countries, nor does it explain educational inequalities in disability. However, pension access was associated with lower risks of disability in Chile, Colombia, Paraguay and Uruguay, and explains a substantial share of educational inequality in Chile, Colombia and Paraguay. Whereas significant changes have already been made regarding universal healthcare coverage, the results suggest that expanding access to pensions may not only lead to improvements in health among older individuals in the region, but also substantially reduce socio-economic inequalities in health and successful ageing.

Socioeconomic inequalities in disability in Europe: contribution of behavioral, work-related and living conditions.

Previous studies have shown the existence of social inequalities in disability in many European countries. However, it is not clear what factors are associated with these inequalities. The aim of this study was to assess the contribution of behavioral factors, work-related factors and living conditions to educational inequalities in disability. We pooled data from the seventh wave of the European Social Survey (2014) which included self-reported disability measured with the Global Activity Limitations Indicator for 19 European countries. We used multivariate logistic regression to determine the contributions of behavioral factors, work-related and living conditions to educational inequalities in disability among respondents aged 30-79. We found that adjusting simultaneously for three groups of determinants (behavioral, work-related and living conditions) reduces the greatest proportion of inequalities in disability in both men and women, in a range >70%. Each group of determinants contributes substantially to explain inequalities in disability. Inequalities in disability are a major challenge for public health in most European countries. Our findings suggest that these inequalities can be reduced by diminishing inequalities in exposure to well-known health determinants.

Twice upon a time: Examining the effect socio-economic status has on the experience of dyslexia in the United Kingdom.

From the mid-1990s, there have been a number of campaigns aimed at raising awareness of dyslexia and social inclusion. In conjunction with these campaigns, educational and employment policies have been implemented that advocate inclusive and workplace adjustments for people with dyslexia. This study aims to explore the intersectional relationship between dyslexia and socio-economic status. The findings analyse adult perceptions of education and employment, which have been shaped by 23years of social policies promoting anti-discriminatory practice. The study applies a quantitative approach, which collected data from a national survey conducted from 2015 to 2017. The sample consists of 442 adult participants who reported having dyslexia. The social model of disability has been applied in this study to interpret the data findings from a disability studies perspective. The article suggests that socio-economic status significantly affects issues of diagnosis, educational, and employment experiences. The findings illustrate an intersectional relationship between socio-economic status and disability inequalities, which have an effect on the experiences of people with dyslexia in adulthood.

Assessing changes in social determinants of health inequalities in South Africa : a decomposition analysis

BackgroundDespite various policy interventions that have targeted reductions in socio-economic inequalities in health and health care in post-Apartheid South Africa, evidence suggests that not much has really changed. In particular, health inequalities, which are strongly linked to social determinants of health (SDH), persist. This study, thus, examines how changes in the SDH have impacted health inequalities over the last decade, the second since the end of Apartheid.MethodsData come from information collected on social determinants of health (SDH) and on health status in the 2004, 2010 and 2014 questionnaires of the South African General Household Surveys (GHSs). The health indicators considered include ill-health status and disability. Concentration indices and Oaxaca-Blinder decomposition of change in a concentration index methods were employed to unravel changes in socio-economic health inequalities and their key social drivers over the studied time period.ResultsThe results show that inequalities in ill-health are consistently explained by socio-economic inequalities relating to employment status and provincial differences, which narrowed considerably over the studied periods. Relatedly, disability inequalities are largely explained by shrinking socio-economic inequalities relating to racial groups, educational attainment and provincial differences.ConclusionThe extent of employment, location and education inequalities suggests the need for improved health care management and further delivery of education and job opportunities; greater effort in this regard is likely to be more beneficial in some way.