During the course of our lives, we all encounter challenges and hardships, sometimes severe. People with disabilities, however, can experience these difficulties on a more frequent basis and find that these challenges have much greater short and long term impact. As highlighted by the World Health Organization (WHO), the challenges faced by people with disabilities do not just involve physical obstacles. Here is the WHO definition of these barriers on the Centers for Disease Control and Prevention (CDC) site:
"Factors in a person’s environment that, through their absence or presence, limit functioning and create disability. These include aspects such as:
- a physical environment that is not accessible;
- lack of relevant assistive technology (assistive, adaptive, and rehabilitative devices);
- negative attitudes of people towards disability; and
- services, systems and policies that are either nonexistent or that hinder the involvement of all people with a health condition in all areas of life."
There are certain areas of life where this long term impact and reduced accessibility for people with disabilities plays out in particularly significant ways.
Inferior healthcare outcomes
Data indicates convincingly that people with disabilities can expect to receive poorer healthcare than that received by those without disabilities. Though variations occur based on specific circumstances, people with disabilities typically are subject to higher incidences of health conditions related to age, are more vulnerable to secondary health problems that could be prevented with additional preventable care, and face increased co-morbidities such as "diabetes, malnutrition, HIV, tobacco-smoking and alcohol-use."
Finally, lack of access to common rehabilitation support and services and a lack of appropriate assistive devices compound the problem. These shortcomings in access can lead to long term impact.
Reduced educational opportunities
Children with disabilities often enter school at a lower rate than other children. Children with disabilities are also less likely to remain in school and experience a typical educational path of advancement and improvement. As a result, increasing education gaps are seen in all age groups and found in countries with both low and high average incomes. For example, countries known for above average enrollment in primary schools, such as many in Eastern Europe, often find that many children with disabilities do not ever attend school (PDF).
Reduced economic participation
It is well documented that people with disabilities face greater levels of unemployment than the general population. The Bureau of Labor Statistics (PDF) reported that:
19.3 percent of persons with a disability were employed...In contrast, the employment-population ratio for persons without a disability was 66.3. The unemployment rates for both persons with and without a disability declined from the previous year to 7.3 percent and 3.5 percent, respectively.
For people with disabilities who are employed, they often earn less than their peers.
Increased levels of poverty
People with disabilities experience higher rates of poverty. Generally, persons with disabilities and families with a disabled member face greater rates of deprivation of living essentials such as food, good housing, clean water, and sanitation than those without a disability. It is axiomatic that people with disabilities must pay more to survive as a result of the additional costs for support services, medical care or assistive devices. As a result, people with disabilities and their families are more likely to experience poverty than those without disabilities with similar levels of basic income.
Increased dependency and lower levels of participation
All of the foregoing challenges and the necessary reliance on often unresponsive institutions and service providers in the long term leave some people with disabilities both isolated and increasingly dependent on others. In one survey of non-elderly adults (PDF) in the United States with disabilities, 42% indicated that they frequently did not leave their beds or chairs simply because they lacked the assistance to do so. Also, support provided for people with disabilities often comes from social networks or families. Over time, complete reliance upon these groups for help can have a negative impact on the support people and families as well, leading to a struggle to sustain this assistance for the long term.
Unfortunately there is also evidence that residential institutions (PDF) themselves are often unresponsive and in part responsible for the reduction of autonomy for residents with disabilities. This often occurs as a result of the practice of separating people with disabilities from the broader residential community.
The foregoing examples show that in all important areas of life where benefits act as a boost for those without disabilities, people with disabilities are too-often left out. Each shortcoming in the areas of healthcare, education, employment, income, and participation feed on each other, stifling improvement across the board. Left unaddressed, the long term impact on people with disabilities can create a cycle not only perpetuating the repetition of these same challenges for people with disabilities but also increasing the likelihood that the impact on people with disabilities will only increase.