Challenges for People with Disabilities
By Sarah Calvert
Published Fall 2021
Special thanks to Hannah Pitt for editing and research contributions
Summary+
A variety of societal barriers still prevalent in the United States today contribute to several challenges faced by people with disabilities. These barriers include limited accessibility, inadequate educational structures, and poverty, and negatively impact the quality of life for people with disabilities. Such factors often lead to undesirable consequences for people with disabilities such as social exclusion, negative stereotypes and perceptions, financial hardship, and challenges in the areas of both physical and mental health. Some of the best practices to help reduce the consequences of these factors focus on creating environments—in areas such as the workplace or on college campuses—that seek to accommodate people with disabilities and anticipate the challenges they may face.
Key Takeaways+
Key Terms+
Americans with Disabilities Act—The Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities in several areas, including employment, transportation, public accommodations, communications, and access to state and local government programs and services.1
Autism spectrum disorder—A developmental disability characterized by persistent impairments in social interaction and the presence of restricted, repetitive patterns of behaviors, interests, or activities.2
Cerebral palsy—A group of neurological disorders that appear in infancy or early childhood and permanently affect body movement, muscle coordination, and balance.3
Comprehensive transition program—A postsecondary degree, certificate, or non‐degree program sponsored by a college or career and technical education center that is approved by the US Department of Education and is designed to support students with intellectual disabilities as they continue to receive instruction in academic, career, and independent living to prepare for gainful employment.4
Disability—A physical or mental impairment that substantially limits one or more major life activities.5
Disability adjusted life years (DALYs)—The sum of the years of life lost due to premature mortality (YLLs) and the years lived with a disability (YLDs) due to prevalent cases of the disease or health condition in a population. One DALY represents the loss of the equivalent of one year of full health.6
Fair Housing Amendments Act of 1988—Prohibits discrimination by direct providers of housing . . . whose discriminatory practices make housing unavailable to persons because of race or color, religion, sex, national origin, familial status, or disability.7
Individuals with Disabilities Education Act—A law that makes available free public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children.8
Multiple sclerosis—Involves an immune-mediated process in which an abnormal response of the body’s immune system is directed against the central nervous system.9
Persons with disabilities (PWDs)—Refers to those who have long-term physical, mental, intellectual, or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.10
The Rehabilitation Act of 1973—Prohibits discrimination on the basis of disability in programs conducted by federal agencies, in programs receiving federal financial assistance, in federal employment, and in the employment practices of federal contractors.11
Section 504—A national law that protects qualified individuals from discrimination based on disability. The nondiscrimination requirements of the law apply to employers and organizations that receive financial assistance from any federal department or agency, including the US Department of Health and Human Services (DHHS).12
Social inclusion—A desired goal that requires equality of opportunity and participation in the rudimentary and fundamental functions of society.13
Supplemental Nutrition Assistance Program (SNAP)—The largest federal nutrition assistance program. SNAP provides benefits to eligible low-income individuals and families via an electronic benefits transfer card. This card can be used like a debit card to purchase eligible food in authorized retail food stores.14
Unconscious bias—Social stereotypes about certain groups of people that individuals form outside their own conscious awareness.15
Context
Q: What has the progression of this issue looked like over time?
A: The rights of persons with disabilities in the United States have significantly improved over the past sixty years, allowing for equal opportunity in employment and education. Prior to the mid-twentieth century, voices from the disabled community were pushed aside and neglected. However, the challenges facing people with disabilities (PWDs) began to enter the spotlight in the 1940s and 50s, when veterans from World War II who were permanently disabled in combat started reaching out for help and assistance. However, public transportation, bathrooms, and most buildings were still not designed in ways that allowed disabled people to access them.16
Beginning in the 1960s, alongside other prevalent civil rights movements, persons with disabilities began advocating for better inclusion in the workplace, education, and other areas of everyday life. This movement led to significant changes in American legislature that aimed to improve the rights of PWDs. The Rehabilitation Act of 1973, the Individuals with Disabilities Education Act, the Fair Housing Amendments Act of 1988, and the Americans with Disabilities Act are all examples of these laws.17
One of the most groundbreaking pieces of legislation was the Americans with Disabilities Act, which was officially signed into law in July 1990. According to Robert L. Burgdorf Jr., who penned the initial draft of the Americans With Disabilities Act in 1988, the act was meant to combat “widespread, systemic, inhumane discrimination against people with disabilities.”18 The Act addressed exclusion of children with disabilities in the realm of education, appalling conditions of residential treatment institutions for disabled persons, the lack of transportation accommodations for persons with disabilities, and the frequent denial of basic citizen rights, such as voting. This act was so influential in improving challenges experienced by PWDs that its anniversary is celebrated annually through Disability Pride parades; these parades are typically held in large cities such as New York City and Chicago. While legislation like the ADA facilitated numerous improvements for the disabled community, individuals with disabilities still experience many challenges and barriers that limit inclusion.
Q: What are the most common disabilities in the United States?
A: Disabilities in the United States generally fall into one of six broad categories: mobility, which involves disabilities that make it difficult to accomplish everyday physical tasks; cognition, which involves disabilities that affect memory, concentration, and decision-making; independent living, which involves disabilities that create difficulty in accomplishing everyday tasks while living alone; hearing disabilities; visual disabilities; and self-care disabilities, which make it difficult for an individual to dress or bathe themselves.19
These categories are not mutually exclusive. For example, an individual with a mobility disability might also experience difficulties related to independent living. Some of the most common disabilities in the United States include cerebral palsy, which affects roughly 764,000 US citizens,20 and multiple sclerosis, which affects nearly 1 million people in the United States.21 Additionally, more than 3.5 million Americans are diagnosed with an autism spectrum disorder.22
Q: Who is impacted by disability?
A: According to recent data presented by the CDC, 1 in 4 adults in the United States have a disability. This figure adds up to 61 million people, with mobility being the most common disability type. One in 4 adult women have a disability, and 2 in 5 non-Hispanic American Indians/Alaska Natives are disabled.23 Additionally, the rate of disability increases significantly with age; in 2018, PWDs constituted 24.4% of the population ages 65–74, compared to 10.4% of the population aged 21–64.24
The number of children (under the age of 18) in the US with disabilities increased from 3.9% in 2008 to 4.3% in 2019, comprising a population of over 3 million children. Within this age group, cognitive disabilities are the most common.25
Q: What sort of challenges do people with disabilities face?
A: The challenges faced by PWDs are as unique as the disabilities themselves, depending on the nature of their disability and its severity. However, some of the most common shared challenges include accessibility in physical environments and on the Internet, social exclusion, the absence of assistive technology, and barriers in healthcare and in the workplace. PWDs also experience other health challenges that may or may not be directly related to their disability. For example, many disabled adults are obese and have heart disease or diabetes.26
Many PWDs experience difficulties in several areas of accessibility. Challenges with accessibility make participation and inclusion for members of the disabled community harder to achieve. The World Health Organization has outlined some examples of common accessibility issues, including events that do not provide sign-language interpreters for attendees who are deaf or hard of hearing, buildings that do not include wheelchair-accessible bathrooms or elevators, or softwares that do not come equipped with screen reading software for blind users.27 These types of accessibility issues make a disabled person’s life more difficult and sometimes prevent the individual from accomplishing certain tasks or fully participating in social events.
In addition to accessibility challenges, PWDs are also more likely to experience difficulty in work-related areas, including finding employment. According to the 2020 data from the US Bureau of Labor Statistics, persons with disabilities were significantly less likely to be employed when compared with persons without disabilities in their same age groups.28 Although it is true that a good portion of the disabled population are older and likely retired, the employment rate for persons with disabilities is still notably lower in all age groups. In 2020, 29% of workers with a disability were employed part time, compared with 16% of workers for individuals with no disabilities. Employed persons with a disability were also more likely to be self-employed than those with no disability.
PWDs also encounter challenges while pursuing higher education. Despite low rates of college enrollment, students with disabilities are not necessarily uncommon in secondary education—in fact, in 2016, disabled students comprised 19% of the undergraduate population.29 In one survey conducted among over 13,000 students from 22 different colleges, nearly 12% of students reported having ADHD, almost 4% had a learning disability, 2% reported a hearing disability, and 2% had a vision impairment.30
According to a report from the US Bureau of Labor Statistics, an individual with a disability is less likely to receive a bachelor’s degree in comparison to a person without a disability—among surveyed adults in 2014, 16.4% of PWDs had received a bachelor’s degree, while 34.6% of people without disabilities had completed a bachelor’s degree.31
One of the biggest issues involving disabled students in college is the lack of research examining the challenges they face. For example, while some research has been conducted about students in higher education with cognitive or learning disabilities, not much research exists that examines challenges experienced by students with physical disabilities.32 Additionally, there is little existing research that thoroughly examines the effectiveness of services and offices available for disabled students on their college campuses.33
The research that does exist, however, highlights common problems that students with disabilities face. One study interviewed focus groups of disabled students from 10 different college campuses. The study found that, while university accessibility centers or other places designed for assisting students with disabilities were generally helpful, such places were often understaffed and could typically only help students in urgent situations. In the same study, participants also noted that they often felt alienated from their peers and reluctant to participate in campus activities.34 Additional updated research and studies involving focus groups of disabled students could perhaps help administrators and professors in higher education better understand the challenges faced by disabled students on college campuses, allowing them to find solutions to these challenges.
One common subset of disabilities include “invisible” or “hidden” disabilities: disabilities that are not as obvious to the naked eye. For example, some PWDs who experience chronic pain or have fibromyalgia might not exhibit visible struggles that others normally associate with disabilities. Like people whose disabilities are more visible, such as individuals who use wheelchairs or other recognizable assistive devices, people with invisible disabilities experience physical, mental, and emotional challenges that act as barriers in their daily lives. One main challenge that people with invisible disabilities face is judgement from the people around them—with no visual cues to signify their limitations, their peers or coworkers might view them as being unintelligent or unmotivated.35
Q: Where are disability rates and alleviation efforts concentrated in the US and around the globe?
A: While PWDs can be found in all ethnic, gender, and age demographics across the United States, rates of disability correlate with rates of poverty among PWDs. Rates of disability, for instance, are especially prevalent in areas high in poverty. In 2019, the poverty rate among PWDs was 25.9%, more than double the poverty rate of people without disabilities, which was 11.4%. This difference in poverty has remained consistent over the past decade.36
The population of PWDs is also significantly larger in southern states, such as Louisiana, Alabama, and Georgia.37 The state with the highest rate of disabilities is West Virginia, whose disabled population constitutes 19.8% of the general state population, while Utah has the lowest rate of 9.1%.38 No conclusive evidence currently exists for the prevalence of disability in the southern states; however, a report from the CDC pointed out that these states also have higher rates of heart disease and diabetes—conditions often associated with disability.39
PWDs are the world’s largest minority, with an estimated 15% of the world’s total population having a disability, equating to roughly 1 billion people.40 Since PWDs can be found in every continent, country, and culture, nearly all of the challenges discussed in this brief are not exclusively experienced only by PWDs living in the United States. These issues are prevalent in other countries as well. Several countries have legislature in place to protect the rights of PWDs, such as the United Kingdom’s Disability Discrimination Act or Canada’s Employment Equity Act. However, similar to the legislature present in the United States, these laws do not fully protect PWDs from unfair treatment. Unfair treatment often leads to negative outcomes such as discrimination, social isolation, and other challenges. Additionally, an estimated 80% of PWDs live in developing countries,41 and PWDs may experience even greater challenges in these countries due to increased rates of poverty or unequal rights.
Although PWDs in the United States experience the same challenges as PWDs all over the world, some critics are quick to point out the lack of benefits and programs in place to help PWDs in the US specifically. In comparison to other developed countries around the world, the United States allots a notably smaller percentage of its federal budget to helping PWDs (less than 1.5%)42 and the qualifications for those benefits are, in the words of those critical of US disability program budgets, “basically the most stringent in the entire developed world.”43 For the sake of comparison, countries such as Denmark and Norway dedicate over 3% of their budgets to help pay for public disability benefits. Italy, the United Kingdom, France, and Australia are other examples of countries that spend more money on programs to help PWDs than the United States spends.44
Contributing Factors
Accessibility
Most existing legislation for PWDs centers around improving several aspects of accessibility, promoting equal accessibility of buildings, transportation, healthcare, the work force, and more. However, despite the progress occurring in these areas, many barriers still exist within society that prevent PWDs from having full accessibility in the aforementioned areas of their lives. Although this brief will not directly address all areas of accessibility that present challenges for PWDs (e.g., web accessibility), several aspects of accessibility will be examined.
Physical Accessibility
One common area of accessibility issues is physical accessibility. In the past, most public transportation, bathrooms, and buildings were not equipped with aids to help PWDs. This issue is a main area that the ADA aimed to address, and the requirements laid out by the act included a requirement for establishments to include wheelchair accessible stalls in their bathrooms.45 The ADA did not completely eradicate physical accessibility challenges, but it did help to reduce them.
One recurring complaint about bathroom accessibility comes from parents of children with disabilities. One of their primary concerns with “accessible” bathrooms is that the stalls are not spacious enough for children with disabilities who require assistance going to the bathroom.46 Additionally, most bathrooms do not offer large enough (or clean enough) changing stations to accommodate older children with disabilities, and parents are forced to lay their children on the floor and change them there instead. For example, one mother pointed out that Disney World’s restrooms were inaccessible for older children with disabilities, and she had to change her son on the bathroom floor.47 One possible reason for a lack of progress in this area is a lack of awareness. One mother admitted that because most parents of children with disabilities know that the majority of public bathrooms are inaccessible, they prefer to take their children home early from the public places or events to use a bathroom at home. As another mother pointed out, this solution leads to its own problems: “Unfortunately, what we are now forced into more often due to my son's age is to go home before the end of the movie, the soccer game, the concert. And he is missing out on what his peers take for granted . . . Families like ours . . . don't go out!”48 Thus, the absence of public bathrooms that are accessible for children with disabilities exclude the children from exploring public places or fully participating in community events.
In addition to these problems with bathroom accessibility, PWDs still encounter physical barriers that prevent them from participating fully in everyday life. For example, some neighborhoods in the United States make it difficult to access sidewalks, despite recommendations outlined in the ADA for improving sidewalk accessibility. One study in 2020 reviewed plans to improve accessibility from a random stratified sample of numerous cities and counties within the United States. The study found that, from the sample of 401 “government entities” reviewed, only 54 (or 13%) contained such plans. Furthermore, only 7 plans (or 1.7% of the entire sample) met all the necessary ADA requirements. Moreover, 65% of curb ramps and 48% of sidewalks in these locations were deemed to be inaccessible. This study illustrates that, although legislation may be put in place to help increase accessibility for PWDs, many places still do not abide by the regulations and criteria, which lessens the actual impact of the legislation.49
Additionally, many workout and exercise facilities lack essential accommodations to make their establishments accessible to PWDs. Although these places might meet the ADA’s requirements for external accessibility, such as installing ramps for guests in wheelchairs, they are lacking in other areas, such as providing exercise equipment that can be used by patrons in wheelchairs or installing drinking fountains that are low enough to be used by guests in wheelchairs.50
Healthcare Accessibility
Adults living in the United States with disabilities experience notable difficulty accessing needed healthcare. One in 3 adults with disabilities between the ages of 18 to 44 do not have a regular healthcare provider. Furthermore, these adults admit to neglecting to take care of a health-related need due to an inability to pay for medical expenses.51 Compared to people without disabilities, PWDs are less likely to receive important healthcare services commonly taken advantage of by others, such as semi-annual dental cleanings and cancer screenings. These observations are alarming, because receiving proper health care is a crucial priority for PWDs as they are at a higher risk of experiencing health challenges.52
According to a 2020 report by the World Health Organization, some of the most significant healthcare challenges faced by persons with disabilities include inability to afford healthcare or treatment, barriers in the availability of services, inaccessible medical equipment, and healthcare workers who have insufficient knowledge or skills to help treat them. In fact, PWDs are “twice as likely to report healthcare provider skills inadequate to meet their needs, four times as likely to report being treated badly, and nearly three times as likely to report being denied care.”53
The ability to access medical equipment is crucial for many PWDs, because they typically frequent hospitals and require access to this equipment more often than people without disabilities. Examples of such medical equipment include examination tables, weight scales, radiological equipment, and mammography equipment.54 In 2007, the US Access Board released accessibility standards for such medical diagnostic equipment.55 Although these accessibility standards are legally required, several studies have revealed that many healthcare facilities still fail to follow them. For example, one study that examined equipment in 2,389 provider sites located in California found that only 8.4% of sites contained an accessible examination table, while only 3.6% had an accessible weight scale. The study added that although the study was limited to California, “the barriers observed are unlikely to be unique. In fact, it is possible that architectural access in California is greater than in older cities in the United States where there are larger numbers of older buildings.”56 Thus, despite laws in place to combat the problem, inaccessibility to medical equipment is arguably still a prevalent accessibility issue faced by PWDs across the United States.
One sector where the limited knowledge of healthcare workers is prevalent is in rehabilitation and physical therapy. One scholarly article examining several previous studies regarding disability and physical therapy found that some rehabilitation professionals have an insufficient understanding of their disabled clients’ needs and capabilities, which leads to barriers in receiving proper physical therapy treatment.57 Healthcare accessibility is arguably one of the most important issues facing the disabled community, as PWDs are more likely to require healthcare services and need physical therapy to improve their health.
Employment
PWDs often encounter barriers in the workplace, including struggling to find employment. The ADA protects PWDs from discrimination on the basis of disability in all aspects of a job, including during the hiring process, job advancement, or monetary compensation.58 However, several studies have found that employers still tend to turn down job applicants with disabilities, regardless of whether or not the disability affects the individual’s capability to complete the job’s tasks.
For example, one study sent out 6,016 fake work applications for an accounting position. One-third of these applicants claimed to have Asperger’s syndrome, one-third of the applicants mentioned a spinal cord injury, and one-third of the applicants had no disability. Asperger’s syndrome and a spinal cord injury were chosen for the study because both disabilities would not affect the worker’s ability to complete the job. Applications across all 3 categories claimed to have different levels of experience in the field. Employers’ interest in applicants with disabilities was 26% lower than applicants with no disabilities. Also, the study found that employers were even less likely to be interested in candidates with disabilities who were more experienced, meaning that better qualifications and training were irrelevant to employers when making the hiring decision.59
One survey that interviewed over 3,700 senior executives across 12 different industries found that there are several reasons employers hesitate to employ workers with disabilities, including fear of litigation, attitudes of coworkers or customers, general discomfort, and not knowing how much accommodations will cost.60 Therefore, some factors that limit PWDs from finding employment stem from hesitations, unconscious biases, or discrimination from company employers.
Additionally, PWDs tend to earn less money annually than people without disabilities. In 2016 the median earnings of US citizens with disabilities ages sixteen and older were two-thirds the amount of median earnings of people without disabilities, and this gap in wages has steadily increased since 2014.61 In 2019, 15% of PWDs ages 16 and older made less than $5000 per year, with an additional 19.4% earning less than $15,000 annually.62
Although there are likely several reasons for this pay gap, one notable contributor is a loophole that exists in Section 14(c) of the Fair Labor Standards Act (FLSA), which has existed since 1938. This section permits certified employers to pay disabled workers below minimum wage—a pay that is sometimes referred to as “subminimum wage.” Section 14(c) aims to encourage employers to hire more PWDs and give them job opportunities while also taking into account the possible diminished work that some persons with disabilities may perform.63 However, many companies have used this law to exploit and take unfair advantage of their disabled workers. For example, in 2018, the US Department of Labor took action against Rock River Valley Self Help Enterprises in Sterling, Illinois, which illegally paid its 250 disabled employees inappropriately low wages—sometimes even compensating their workers with gift cards instead of actual money.64
Some states have abolished subminimum wages for PWDs, including Alaska, Maine, Maryland, Nevada, New Hampshire, Oregon, and Vermont.65 However, the law remains in place in all other states, allowing employers to assign their disabled workers to repetitive, undesirable jobs while also paying them lower wages. As one disabled worker noted, his first paycheck was only $12, and he was assigned to monotonous tasks like assembling jewelry boxes or packaging ice packs.66 In 2020, some members of the US Commission on Civil Rights advocated for dissolving Section 14(c) altogether, noting that “the program suffers from wildly insufficient federal oversight and civil rights review, and apparently routine noncompliance.”67 However, Section 14(c) has not been overturned, and the benefits and drawbacks of the law continue to be debated by members of Congress.
Negative Social Perceptions
Unconscious Bias
Unconscious biases are preexisting judgements that an individual holds toward a certain group of people. These prejudices lay underneath conscious awareness and often occur automatically. In fact, most unconscious biases are formed from past experiences with similar individuals. While the concept of unconscious bias is generally used to discuss unfair treatments of and prejudice against minority groups on the basis of gender, race, or ethnicity, unconscious bias also applies to conversations about the disabled community. Studies show that many people exhibit unconscious bias toward disabled people and tend to unfairly favor abled people over PWDs.68
For example, Harvard University conducted an experiment from April 2004 to December 2015 that tested participants’ unconscious bias toward disabled people through surveys and sorting experiments requiring active participation. Of the 305,739 experiment participants, 68% of participants showed “some” automatic preference for abled people compared to disabled people, with 37% of participants exhibiting a “strong” automatic preference for abled people.69 In other words, participants who showed a preference for abled people unconsciously reinforced their beliefs of the superiority of abled people over PWDs. Unconscious biases trigger a multitude of consequences and can influence behavior, preferences in social circles, legislation, and employment opportunities.
Media Perceptions
Social perceptions of PWDs are further distorted in various forms of media, which reinforce incorrect and occasionally negative and harmful stereotypes about PWDs. These stereotypes are dangerous because they “distort reality—constituting a real barrier not only to understanding but also to the transformation of society that is really needed to embrace disability and not reject it out of fear and loathing.”70
One example of these negative stereotypes is found in the major motion picture, Me Before You, a story about a quadriplegic man who chooses assisted suicide after finding his life devoid of meaning. As one quadriplegic reviewer stated in his review in The Chicago Tribune, “the hazardous risk in movies like [Me Before You] is that it romanticizes and glamorizes an early exit for those who already feel marginalized, who feel they are living on borrowed time . . . the blatant subtext of Me Before You . . . only makes people like me feel we have to justify our preference not to commit suicide. In this right-to-die climate, we’re forced to defend our right to live, albeit as expensive, high-maintenance disabled folks.”71 As the United Nations points out, PWDs are “often negatively stereotyped and not appropriately represented”72 in the media. Movies such as Me Before You treat PWDs as “objects of pity, charity or medical treatment that [must] overcome a tragic and disabling condition or conversely, presented as superheroes who have accomplished great feats, so as to inspire the non-disabled.”73 This type of incorrect or idealized representation presented in the media is not only damaging to the self-perceptions of PWDs but can also contribute to the maintaining of incorrect perceptions about PWDs in the minds of the general population.
In addition to inaccurate portrayals in the media, there is a shortage of disabled actors and actresses, singers, and models employed to work in media-related fields. Although there are exceptions to this trend, as actress and comedian Maysoon Zahid, who has cerebral palsy, once put it, “Hollywood has a sordid history of casting able-bodied actors to play disabled [parts] on screen” instead of using actors or actresses with disabilities. When this happens, producers risk offending, alienating, or inaccurately portraying disabled members of their audiences, as illustrated in the case of Me Before You.74 Actors and actresses with disabilities tend to advocate for greater disability representation in the media. For example, Millicent Simmonds, a deaf actress who starred in A Quiet Place, mentions in several of her interviews that she would love to see more representation of disabled actors in movies, especially when characters in the movie have disabilities themselves.75, 76
Inadequate Educational Structures
One of the most noteworthy federal laws that aims to protect and aid students with disabilities is Section 504 of the Rehabilitation Act of 1973. This section requires institutions receiving federal aid, including schools and colleges, to allow PWDs equal access to educational opportunities. Section 504 also protects students with disabilites from discrimination.77 Although Section 504 improved several accessibility aspects involved with the education of disabled students, disabled students arguably still experience challenges, especially in areas such as social perception and acceptance. Although these challenges are faced by individuals with disabilities in all age groups, the following paragraphs will primarily focus on disabled elementary school students. For information involving college students, refer to the Context section of this brief.
Elementary School
The current structure of elementary education presents numerous obstacles for young students with disabilities. However, some existing legislation has helped eradicate some of these challenges. As previously mentioned, the Rehabilitation Act of 1973 introduced educational rights to PWDs. However, another law passed in 1975, entitled the Individuals with Disabilities Education Act (IDEA) brought even more rights to children with disabilities. IDEA paved the way to providing a free public education for children with disabilities. The law introduced special education and other services to help assist children and teenagers, and it currently supports educational programs and services for 7.5 million children and youth with disabilities.78
Although IDEA and other laws helped improve the availability of educational resources, children with disabilities still encounter social and academic barriers in their education. One study found that disabled elementary school students, particularly those enrolled in special education programs, typically had less academic achievements in comparison to their nondisabled classmates, were held to lower expectations by their peers and teachers, and were more likely to drop out of school in their later years.79 These outcomes sometimes happen as a result of social exclusion or due to educators’ inability to meet their disabled students' needs. IDEA requires disabled students to be included and integrated into the same classrooms as their nondisabled peers, except in some extreme cases.
Despite the efforts of IDEA to help students with disabilities in their education, one main problem comes from a lack of proper funding given to the schools to help support the needs of students with disabilities. When IDEA was first introduced, the act aimed to cover up to 40% of the programming expenses for students with Individualized Education programs (IEPs). However, federal funding has never covered the full amount—today, the government covers less than 18% of the total costs for IEPs.80 According to interviews conducted with Department of Education officials, state and local administrators, and parent organizations, most participants agree that additional federal funding would “improve outcomes for students with disabilities.”81 Also, some schools that receive IDEA related funding are not in “compliance” with the guidelines and aims of IDEA, so participants argued that schools who receive the funding should better adhere to the goals outlined by IDEA.82
Poverty
The rate of poverty among the disabled community has consistently been double the rate of poverty among people without disabilities over the past decades. A recent report from 2019 showed that the poverty rate among people without disabilities was 11.4%, while the poverty rate among PWDs was 25.9%.83 Additionally, according to a recent report from the National Council on Disability, PWDs make up more than half of United States citizens living in long-term poverty.84 As outlined in the employment and workplace accessibility section above, one contributing reason for the increased poverty rates among PWDs might be the gap in their wages, which might be aggravated by Section 14(c) of the FLSA.
While some PWDs experience poverty due to their low employment levels, some PWDs may also stay impoverished due to payments or debt related to medical expenses. In fact, 26.5% of households that have at least one member with a disability have outstanding medical debt, in comparison to 11.4% of households without any disability. Although scholars have not examined specific connections between disability and households with high medical debt (debt that reached above 20% of the household’s annual income), the US Census Bureau did find that 11.3% of households living below the poverty line had high medical debt, in comparison to 3% of households living above poverty level.85 Thus, if PWDs are more likely to live in impoverished areas, it is also likely that at least some of them have medical debt.
The Census Bureau also found a relationship between poverty and childhood disability rates. Their report states, “in 2019, children in the lowest income quintile—defined here as falling within the bottom 20% of the household income distribution in the United States in 2019—were more likely to experience disability than children in the highest income quintile.” Several scholars debate whether increased poverty leads to disabilities in children, especially behavioral disorders or intellectual disabilities, or whether caring for a child with disabilities leads to increased poverty. Both explanations are possible; regardless of the explanation for the correlation, poverty and disability are evidently connected to one another.
Consequences
Social Exclusion
One frequently overlooked consequence of having a disability is social exclusion. As one scholar notes, social exclusion among PWDs is a complex issue, because a PWD can be socially accepted in certain settings, such as within their immediate family, but may simultaneously experience social exclusion in other facets of their lives, such as at the workplace or in their local community.86 Additionally, social exclusion can happen to PWDs at any stage of their lives, including at young ages and while in elementary school. One study conducted in Ontario, Canada, interviewed fifteen elementary school students with cerebral palsy. The study found that the children were victims of “implicit” social exclusion, meaning that their peers were simply unaware of their disability or that the students with cerebral palsy required accommodations. Children who experienced implicit social exclusion, then, were excluded simply because they were unable to participate. This inability to participate was often due to a lack of accommodation that, if remedied, would allow the child to be included in activities with other students. Another type of exclusion observed in the study was “explicit” or intentional social exclusion, accomplished through methods such as “verbal and physical bullying.” Although this study was conducted outside of the United States, the negative social experiences reported by these children illustrate the different types of harmful repercussions that children with disabilities may face.87 This study explained that children with disabilities are also more vulnerable to social exclusion because they tend to have fewer friendships, which would likely protect them against bullying.
Adults with disabilities are also subject to social exclusion. In the realm of dating and marriage, some experts have asserted that people with more apparent physical disabilities or who use wheelchairs typically start dating at a later age and are married less often than people without disabilities. The first-marriage rate in the United States for people ages 18–49 is 48.9 per 1,000. However, this rate is almost exactly half for PWDs, sitting closer to 24.4 per 1,000 people, according to Philip Cohen, a sociologist at the University of Maryland–College Park.88 Although no explanation has been offered by the researchers themselves for this disparity, one possible reason might be due to the tendency of people without disabilities to create judgements based on stereotypes before getting to know the PWDs, causing them to refrain from dating PWDs.
In fact, another study that examined how PWDs present themselves on online dating sites found that while some participants were upfront about their disabilities in their dating profile, others preferred to wait to disclose information about their disability. These participants feared that nondisabled users would not consider or even reject them based solely on the fact that they had a disability.89 Childhood bullying and struggles with dating as an adult are only two examples of the wider umbrella of social exclusion, but these issues demonstrate how social exclusion too often stems as a consequence of having a disability.
Dealing With Negative Stereotypes and Perceptions
Another consequence of having a disability closely related to social exclusion is being subject to negative stereotypes and perceptions. Negative stereotypes about PWDs can be reinforced through the media or through a personal experience that an individual has involving a person with a disability. The consequences of these harmful stereotypes can be detrimental for PWDs in several areas of life, including in the workplace and in social circles. One study conducted in Australia, which reviewed several studies from multiple countries, asserted that negative stereotypes of PWDs “greatly affect their inclusion in their communities and their capacity to achieve basic goals.” Some of these negative stereotypes include beliefs that PWDs have a less important place in society or that PWDs are unable to contribute positively to their local communities. These stereotypes, among others, prompt people without disabilities to distance themselves from PWDs, leading to social exclusion and isolation.90
Additionally, negative perceptions of PWDs could be one reason for the high unemployment rates of PWDs, as two-thirds of the unemployed disabled population have expressed that they are searching for employment but have not been hired.91 A review of multiple studies concluded that negative perceptions held by managers toward PWDs was a critical factor in the decision not to hire a person with a disability.92 Furthermore, one survey given to employers exposed common unfavorable perceptions that employers held toward PWDs, including that PWDs require job accommodations, take more time to learn new tasks, and make other employees uncomfortable.93
Health
Physical Health
As a result of limited mobility or other physical challenges due to the nature of their disability, PWDs often experience additional health challenges. Many of these challenges stem from not being physically active. As the Physical Activity Guidelines for Americans from the Department of Health and Human Services has explained, regular physical activity is “one of the most important things people can do to improve their health.”94 Although PWDs notably benefit from regular physical activity, many of them do not regularly and consistently engage in these activities. In fact, one American study reported that merely 45.2% of US adults with mobility disability engage in aerobic physical activity, and only 39.5% met one or both components of the physical activity guidelines. As the study noted, “Efforts to make walking or wheelchair rolling a safe, viable option are important to helping decrease barriers that may limit the ability of those with mobility disability to engage in walking or other physical activity types.”95
Inadequate amounts of exercise often contribute to other health problems, such as obesity. In 2016, 38.9% of PWDs in the US above the age of 18 were obese, in comparison to 26.4% of those without disabilities.96 Additionally, the prevalence of diabetes is higher among PWDs in comparison to the general population, and the percentages of cardiovascular disease are “are 3 to 4 times higher.”97 One possible reason for these disparities is due to higher rates of obesity, which leads to health conditions such as diabetes. Also, cardiovascular disease can be both a cause and consequence of disability, as some scholars have noted that cardiovascular disease tends to lead to mobility problems and other disabilities.98
Mental Health
In addition to physical health challenges, PWDs also experience notable difficulties with mental health. A nationwide study found that adults with disabilities report experiencing frequent mental distress almost five times as often as adults without disabilities, and more than half of all adults with both cognitive and mobility disabilities report experiencing mental distress.99 One proposed reason for this disparity in mental health could be the financial hardships that also emerge as a consequence of having a disability An Australian study noted that young people with disabilities have poorer mental health than their non-disabled peers, and that these PWDs are more likely to experience financial hardship and low social support—two factors that are closely connected to mental health.100
Although mental health challenges are typically associated with intellectual or emotional disabilities, some studies have also found that people with physical disabilities experience mental health challenges. For example, one study found that people with physical disabilities who are unemployed, undereducated, or who feel socially excluded are more likely to “experience higher levels of psychological distress.”101
Declined mental health of PWDs can also be connected to other consequences of having a disability. For example, one Canadian study found that PWDs are more likely to be underemployed in the workplace—meaning, their talents, skills, and knowledge were grossly underutilized in their job positions in comparison to their nondisabled coworkers. The study asserted that PWDs who were underemployed were more likely to face discrimination in the workplace due to their disabilities, and that this underemployment caused lower levels of self-esteem, well-being, and overall mental health.102
In addition to underemployment, unemployment has also been found to lead to higher levels of psychological distress and depression, as well as lower levels of self-esteem.103 One review of multiple studies found that, for most PWDs, employment tended to contribute a sense of identity and normality, financial support, and opportunities for social interaction.104 Thus, when PWDs struggle to find employment, they likely encounter negative consequences, such as mental health problems or feelings of social exclusion.
Financial Hardship
Financial Burden Experienced by Caretakers
Financial hardship is experienced by many PWDs and their caretakers and is likely due to a variety of factors depending on the individual situation. According to a 2019 report, 41 million caregivers in the United States contributed approximately 34 billion hours of care to an adult with disabilities. Their unpaid service adds up to an economic value of nearly $470 billion per year.105 Put in perspective, this amount of unpaid “work” adds up to more than all out-of-pocket spending on health care in the United States during one year. Thus, one reason caretakers experience financial hardship is because some must balance working at their regular jobs with coming home to work long, often arduous hours of caretaking as well. In some cases, this limits the amount of hours that caretakers can work and may even limit the type of jobs they can work, as they may reject a job position that does not allow the needed flexibility for caretaking.
One study found that moderate levels of poverty are more common among adults who take care of their siblings with developmental and intellectual disabilities when compared to the general population. Although federal assistance programs, such as SNAP, seem to prevent these siblings from succumbing to extreme financial hardship, the programs do not completely alleviate the financial burdens of the caretakers.106
Increased Government Assistance
PWDs also experience direct financial difficulties as a result of the challenges they face. Due to factors such as dealing with significant medical expenses and employment challenges, PWDs often enroll in government programs for financial support, such as Social Security Disability Income, Medicaid, and Medicare. Approximately 45.5% of employed PWDs receive some sort of financial assistance, as well as 65.8% of PwDs that are unemployed.107 However, as some scholars imply, the low rates of unemployment among PWDs might indicate that these government programs do not provide sufficient means or resources for PWDs to overcome their long-term poverty challenges.
Best Practices
Microsoft
Microsoft is regarded today as one of the forerunners and primary advocates for making both the workplace and the workforce more accessible for employees with disabilities. One of the company’s goals is to help reduce the disparities that exist between the unemployment rates of PWDs and people without disabilities. The “Accessibility” page on their website provides numerous resources for employers, including providing informative blog posts and videos. These resources cover a variety of topics, including workplace inclusion, general accessibility, disability etiquette, and the hiring process. Furthermore, Microsoft’s website states that the company focuses on creating products that can be used by everyone, including PWDs. For example, the Microsoft Teams app provides a screen reader and live captions for meetings.108 Microsoft likely wants to focus some of its efforts on improving web and technology in these ways due to the current lack of discussion and acknowledgement of the need for such assistive tools within society today.
Microsoft’s own hiring process seeks to better include people with disabilities through three main avenues: first, to recruit, onboard, and develop neurodiverse individuals; second, to support and create jobs for people with intellectual developmental disabilities; and third, to hire PWDs to full-time positions in the company.109 Other resources provided by the company include the Disability Employee Resource Group, a place where employees can go for support, networking and community; Ability Hack, a week-long challenge that encourages employees with disabilities to work on creating solutions to real-world challenges;110 and Ability Summit, an annual conference that connects Microsoft employees and other PWDs to local business and government leaders to discuss solutions that allow for greater inclusion in the workforce and technology.111 Thus, Microsoft strives to overcome aforementioned barriers to PWDs finding employment by actively seeking, interviewing, including, and listening to the concerns of PWDs.
Although the company is definitely not perfect, Microsoft recognizes the ways that their company can continue to grow—both in the workplace and in the rollout of their new products—in ways that will greatly benefit PWDs. As Brad Smith, the president of Microsoft, stated in April 2021, “Digital technology can play a critical role in bridging barriers to communication, interaction and information.”112 Within the next five years, Microsoft plans to act on the three key elements of the company initiative to include more PWDs: first, by developing more accessible technology; second, by using technology to provide better opportunities for PWDs to enter the workforce; and third, by creating a workplace environment among employees where PWDs can feel included and welcomed. Microsoft’s initiatives will hopefully help close some current limitations or missing aspects of the company’s workforce accessibility resources.
Some drawbacks of Microsoft’s resources include the limitations of its reach—for example, only PWDs who apply and are hired to work at the company can truly benefit from its initiatives. Microsoft may advocate for greater disability inclusion and provide resources for other companies to reference, but the company cannot directly control whether or not other companies improve their efforts to hire more PWDs. Additionally, once an employee with disabilities stops working at the company, the resources provided by Microsoft become unavailable.
Aggies Elevated
Aggies Elevated is a Comprehensive Transition Program offered at Utah State University for students with intellectual disabilities. Through this program, students can receive a two year certificate in Integrated College and Community Studies. Aggies Elevated is one of few programs within the Intermountain Region that includes a residential living component, allowing students with disabilities to live on campus and build a sense of community with their fellow students.113
As the Aggies Elevated website states, the primary purpose of the program is to prepare students for employment after graduation. Thus, the program offers a unique set of courses called the Career Success Sequence. Classes included in this set of coursework include career exploration classes, a class focused on social skills, and internship seminars. All of these courses work together to help the students cultivate skills that will hopefully help them succeed in entering the workforce after graduation.114
The program not only aims to give these students marketable skills to help them find jobs but also wants to help these students learn how to live independently and have increased personal responsibility.115 Volunteers help students learn how to use the local bus system, plan meals, go grocery shopping, and attend social events.116 Programs like Aggie Elevated, then, can help students with intellectual disabilities navigate through aforementioned issues such as social exclusion.
Aggies Elevated has experienced notable success. The website claims that, although the average employment rate for a person with an intellectual disability is 17%, so far 21 of 24 of the Aggies Elevated program graduates are employed, leading to an 87.5% success rate.117 Despite these successes, however, there are arguably some gaps within the program worth addressing. First and foremost, the acceptance process for the program is self-described as “competitive,” and participating students, once admitted, are closely monitored in all aspects of their campus experience.118 Although the reason for this is likely to ensure that students can adjust to living more independent lives, in some instances, such close supervision can be overwhelming for the students.
For example, in 2020, the parents of a former Aggies Elevated student filed a lawsuit against Utah State University after the college expelled their daughter with down syndrome. Although the university responded to the lawsuit and claimed that it grossly misrepresented the real facts of the Aggies Elevated program, the student’s mother outlined several actions of the program that concerned her. First, one of the professor’s assistants wrote to the mother that they “had never had a student with Down syndrome” and didn’t know “what to do with her.” Second, the student was promised that she would receive the several resources outlined in the Aggies Elevated program, including a mentor to help her navigate campus and a tutor to help her with her homework, among other forms of assistance. However, the lawsuit claimed that the program never provided these resources.
After removing the student from a school dance for “dancing inappropriately,” school officials in charge of the Aggies Elevated program required the student to sign a restrictive behavior contract, and when she broke that contract, she was expelled. The lawsuit stated that the Aggies Elevated “subjected [the student to a version of college discipline that was wholly unlike that experienced by nondisabled students.”119 Even if some of the facts presented by the lawsuit were, as Utah University claims, exaggerated, the Aggies Elevated program could still benefit from examining the areas of their program that are inadequate to meet the needs of enrolled students with intellectual disabilities.
Preferred Citation: Sarah Calvert. “Challenges for People with Disabilities.” Ballard Brief. October 2021. www.ballardbrief.org.
Viewpoints published by Ballard Brief are not necessarily endorsed by BYU or The Church of Jesus Christ of Latter-day Saints
