Disability is a Cause and Consequence of Poverty

Disability is both a cause and consequence of poverty.

It is a cause because it can lead to job loss and reduced earnings, barriers to education and skills development, significant additional expenses, and many other challenges that can lead to economic hardship.

It is also a consequence because poverty can limit access to health care and preventive services, and increase the likelihood that a person lives and works in an environment that may adversely affect health.

The result? Poverty and disability go hand in hand. The poverty rate for working-age people with disabilities is nearly two and a half times higher than that for people without disabilities. Indeed, recent research finds that half of all working-age adults who experience at least one year of poverty have a disability, and nearly two-thirds of those experiencing longer-term poverty have a disability. People with disabilities are also much more likely to experience material hardships--such as food insecurity; inability to pay rent, mortgage, and utilities; or not being able to get needed medical care--than people without disabilities at the same income levels. The same goes for families caring for a child with a disability.

In addition to income poverty, individuals with disabilities are also nearly twice as likely to lack even modest precautionary savings in case of an unexpected expense or other financial shock. Fully 70 percent of individuals with disabilities responded that they "certainly" or "probably" could not come up with $2,000 to meet an unexpected expense, compared to 37 percent of individuals without disabilities.

Yet the intersection of disability and poverty is too rarely discussed. In fact, until recently the U.S. Census Bureau's annual report detailing income, poverty, and health insurance coverage didn't even include poverty rates for people with disabilities. It does now, and the data released earlier this week put the poverty rate for working-age people with disabilities at 28.4 percent in 2013, compared to 12.4 percent for those without disabilities.

Yesterday the Senate Committee on Health, Education, Labor and Pensions, chaired by Senator Tom Harkin, took up this issue in a hearing and a report based on 400 interviews with people with disabilities who are struggling on the brink.

Toya, a woman in her thirties with Cerebral Palsy who was interviewed for the report, describes needing to buy new shoes each month because of her walking pattern. Another woman interviewed talks about having to purchase "special clothes because of my body distortions, and lots of day-to-day adaptive equipment that insurance doesn't cover." Anne, who is blind, relates that while she'd like to work a second job, the additional time it takes her to get ready for and take transportation to and from work makes it impossible.

Many of the interviewees discuss a lack of reliable accessible transportation. A man in his 30s with a physical disability describes his struggles with para-transit: "My work is located outside my local zone which requires long wait times at transfer stops. To go to work it could take me 2 hours-plus to travel 9 miles and I have to call the day before to arrange this at 6:00 a.m." The difficulty of finding affordable accessible housing is mentioned frequently as well. One woman describes her wait to obtain affordable housing through the "Section 8" program: "In order to find housing, you're put on a list that is years long. I keep having to call them and see if somebody died and make sure my name stays on the list."

Interviewees also discuss restrictive and outdated asset limits in the Supplemental Security Income program, which provides modest income support to individuals with significant disabilities and very low incomes and assets. Individuals are prohibited from having more than $2,000 in assets--nearly unchanged from the original level set in 1972. Had the asset limit been indexed to inflation when the program was established, it would be more than $8,500 today. As one woman put it: "The requirements of SSI make it difficult to save money, such as for medical emergencies, internship experiences, or purchasing expensive equipment."

It's critical to note the progress that has been made in the past several decades. The Americans with Disabilities Act, enacted nearly 25 years ago, prohibits discrimination on the basis of disability and guarantees that people with disabilities have "equal opportunity" to participate in American life. The Individuals with Disabilities Education Act (IDEA), enacted the same year, requires that students with disabilities be provided a "free, appropriate public education" just like all other students. The Workforce Innovation and Opportunity Act expands access for people with disabilities to education and training programs, programs for transition-age youth and young adults transitioning to adulthood, vocational rehabilitation, and more.

But as Chairman Harkin noted at yesterday's hearing, much work remains. In order to break the link between poverty and disability, it's imperative that disability be expressly contemplated as part of a broader antipoverty agenda, not as a separate issue or afterthought.

Policymakers have a number of policy solutions at their fingertips that could make a real difference today. Expanding Medicaid would make it possible for more low-income Americans to access preventive care, and reduce financial strain for low-income individuals with disabilities. Ensuring paid leave protection and paid sick days would benefit both workers with disabilities and workers who care for family members with disabilities. Raising the minimum wage would boost the incomes of many workers with disabilities, who are especially likely to work in low-wage jobs. Likewise, boosting the Earned Income Tax Credit for workers without dependent children would benefit many workers with disabilities, who are less likely to have children.

In addition, investing in affordable, accessible housing would enable more people with disabilities to obtain safe and stable housing and live independently. And investing in accessible transportation would enable more people with disabilities to take jobs that they currently can't get to and from without spending hours in transit. We also need to update the SSI asset limits and improve the program's work rules so that beneficiaries can keep more of their earnings and save for the future. Similarly, simplifying the work rules in the Social Security Disability Insurance program would make it easier for beneficiaries to test their capacity to work.

These are just first steps, but they would go a long way to ensuring that poverty and disability no longer go hand in hand.