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People with disabilities are bearing the brunt of Covid measures

The coronavirus response will disproportionately affect people with disabilities for years to come

In the USA, for data purposes a person is counted as disabled if she answers “yes” to one of six questions relating to vision, hearing, mobility, self-care, cognition, and intellectual ability. The last category is captured by questions relating to “independent living”, such as “Are you able to go shopping or visit the doctor on your own”.

Serious difficulty walking or climbing stairs (mobility) remains the most commonly identified disability in the USA (13%), more than vision (6%) and hearing (5%) combined. Those who identify their principal problem as self-care (4%), such as difficulty bathing themselves, may fall into a number of other categories, including cognitive and (11%) and intellectual disabilities (7%).

The lives of individuals with autism are given focus and meaning by routine and core relationships

The understanding of disability has changed radically over two generations, with greatly increased recognition for and formal diagnosis of cognitive and intellectual disabilities. However, much else is constant: the workforce participation rate has always been dire for those with disabilities. In 2019, in a booming pre-Covid economy, only 21% of Americans with disabilities were employed or looking for work. Of this fraction, the greater part had mobility (34%) or hearing (31%) disabilities. These disabilities together cover 90% of the disabled workforce over the age of sixty. However, younger workers are far more likely to have cognitive or intellectual disabilities. Of workers aged between 18 and 44, almost half have a cognitive disability, and the number may be as high as three-quarters when one includes those with disabilities that impede independent living and self-care.

Workforce participation rates relate directly to educational attainment. Far fewer disabled students (73%) than others (90%) graduate from US high schools with a diploma, and of those that go on to attend college, very few graduate. According to Disability Statistics, a project at Cornell University, only 15% “of non-institutionalized persons aged 21 to 64 years with a disability in the United States” have a bachelor’s degree or higher.

In 2019, the weekly earnings of those who did not earn a high school diploma was $592. For those with a bachelor’s degree the average (median) salary was more than twice as much at $1248. For those with a master’s degree it was almost $1500 a week. The median salary for disabled workers across all professions is just two-thirds of that paid to other workers. By far the most common occupation for people with disabilities is as janitors or building cleaners.

The situation in the UK is somewhat better and it had improved considerably between 2013 and 2019. In that time, according to the ONS, “the disability employment gap has reduced; with the latest data showing roughly half of disabled people were in employment (53.2%) compared with just over four out of five non-disabled people (81.8%)”. However, this was far more likely to be part-time employment. Moreover, disability is defined very broadly as having “a self-reported long-standing illness, condition or impairment, which causes difficulty with day-to-day activities”. In compiling its statistics the UK government asks only two questions: Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more? Do any of your conditions or illnesses reduce your ability to carry out day-to-day activities?

Many autistic children cannot tolerate or even understand virtual education

In the UK, autism is not accurately captured by these two questions, but it is subsumed into the amorphous category of “disability”. Autism is not a physical or mental health condition. It is a cognitive disability; a neurodevelopmental condition, that has specific diagnostic criteria which include (A) “persistent deficits in social communication and social interaction across multiple contexts”; and (B) “restricted, repetitive patterns of behaviour, interests, or activities”. Most people with autism manifest a series of co-occurring conditions, which include motor abnormalities (79%), gastrointestinal problems (up to 70%), epilepsy (up to 30%), intellectual disability (45%), and sleep disorders (50-80%). The lives of individuals with autism are given focus and meaning by routine and core relationships. The removal of these structures leads to intensified distress and anxiety.

In the UK, 85% of those who responded to a survey conducted by the National Autistic Society reported heightened anxiety or depression due to Covid restrictions and regulations. The report, Left Stranded, was published in September. It highlighted several areas in which autistic families have suffered more than others during this plague year. Autistic adults who live independently may rely on the help of others to leave the house, to go shopping, to bathe and dress themselves. Those who live in residential care have that help, but face different problems. We are all now familiar with the crises residential care homes have faced in 2020. Many autistic children cannot tolerate or even understand virtual education.

Left Stranded was delivered to chancellor of the exchequer, Rishi Sunak. It appears to have been lost in his junk folder. As Caroline Stevens, Chief Executive of the National Autistic Society said of Sunak’s November Spending Review, the British government “again missed the opportunity to commit the essential funding” needed by autistic families. It is hard to comprehend where Sunak would find that essential funding.

This brings us to something very few will have noticed: UNESCO’s week-long celebration of people with disabilities, which ended on 3 December. Its main theme was “Building back better: towards an inclusive, accessible and sustainable post Covid-19 world by, for and with persons with disabilities”. Verbosity aside, the theme is too important to be centred on a virtual symposium or digital booklet launch. If the data from 2019 looked bad for people with disabilities, at least they were improving in both the USA and UK.

That direction of travel has been reversed not by Covid-19, but by misguided and draconian regulations and restrictions that have prioritized hospital capacity and excess deaths over every other consideration. The devastation will continue to affect the people with disabilities disproportionately for years.

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