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Researching Relevant Policy Issues on Disability

Cameron Crawford March 30, 2011

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Overarching framework and policy / program goals • In Unison

– Disability supports – Employment – Income – Citizenship and social inclusion

• Social and economic costs of disability

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Disability supports

• Improve access to disability supports • Enhance portability of supports • Help offset the cost of disability supports (by

providing greater assistance for disability costs)

• Separate access to supports from eligibility for income and other programs

• Facilitate consumer control, as well as flexibility and responsiveness in the provision of disability supports

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Employment

• Reduce reliance on income support programs • Promote access to the training programs available to

all Canadians and enhance employability through better access to education, training and transition mechanisms

• Increase the availability of work-related supports (and provide more assistance to offset work-related disability costs)

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Employment

• Encourage employers to make appropriate job / workplace accommodation (and promote broader understanding and application of the concept of job accommodation)

• Promote work and volunteer opportunities for persons with disabilities

• Facilitate access to and support for community economic development and self-employment for people with disabilities

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Income

• Encourage economic independence by removing barriers and financial disincentives to working

• Detach eligibility for disability supports from income programs

• Improve access and reduce administrative duplication through greater coordination of income programs, and improve coordination of assessment procedures and rehabilitation between income programs

• Ensure availability of income support for periods during which individuals are not able to support themselves because of labour market factors or issues arising from disability

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Citizenship and social inclusion • Facilitate reasonably comparable access to health and

mental health services, and other conditions supportive of good health, irrespective of disability

• Ensure reasonably comparable access to affordable, adequate housing irrespective of disability

• Ensure personal safety and security irrespective of disability status

• Ensure reasonably comparable scope for the exercise of personal liberty and self-determination, irrespective of disability status

• Enable reasonably comparable freedom of movement irrespective of disability status

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Citizenship and social inclusion • Create equitable and accessible conditions for personal learning

and development that are not solely related to employment • Entrench recognition of status as person, and reasonably

comparable levels of recourse to formal justice and other dispute resolution measures

• Establish equitable conditions for the ownership of private property, and conditions that safeguard against arbitrary deprivation of property

• Facilitate comparable participation in community activities and in the civic, political and cultural affairs of society, irrespective of disability status

• Secure reasonably comparable conditions and opportunities for people to engage in personal relationships with others

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Research questions

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General points

• Compare the situation of people with and without disabilities wherever possible (and relevant)

• Track patterns over time to see whether things are improving, staying the same or getting worse

• This presentation provides an overview of near-term, ongoing research and information requirements that could, for the most part, be fulfilled using surveys such as PALS, SLID, NPHS/CCHS, GSS, RCF

• It does not present ideas for ‘Future Research’ covered in the paper that was distributed

• It does not include reference to information that was once available in HALS but dropped from PALS

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Overall

• How many Canadians have disabilities? What kinds of disabilities are experienced and what factors help account for this?

• What disability supports do people need and are they getting the supports they require?

• How well are people with disabilities integrated into the paid labour force?

• What is the income situation of people with disabilities?

• How are people with disabilities faring across other areas of citizenship and social inclusion?

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Basic profile

• How many Canadians have disabilities? What kinds of disabilities are experienced and what factors help account for this? – Prevalence and kinds of disability, by province/territory – Severity (and causes) of disability – Age, gender, visible minority status, Aboriginal person

status, immigrant status, family living arrangements – Trajectory of disability (congenital? stable? progressive?

cyclical/episodic?) – Chronic health conditions associated with disability – Changes in general health / mental health and factors that

help account for this – Context-specific disability (e.g., at work or school only) – Who and how many others are directly affected by disability?

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Disability supports

• What disability supports do people need and are they getting the supports they require? – Patterns in utilization, incl. number who use/receive, kinds

of supports used/received, level/frequency of utilization – Direct providers, e.g., family, service agency, government – Magnitude of gap between what’s needed and received – Demographics of need and access to support – Reasons why people don’t receive – Most difficult to access supports – Relationship between receipt of disability support and

receipt of public income support – Extent of personal control in everyday decision-making

where receiving help with activities

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Employment

• How well are people with disabilities integrated into the paid labour force? – Labour force status, recent work history, number of jobs

held in reference year, mean hours usually worked in the reference week

– Frequency and duration of spells of unemployment – Distribution by occupational and industrial classifications – Reasons why people are unemployed or not in the labour

force – Analysis of employment by kind, size and unionization of

workplace / employer – Disabilities/health difficulties that help explain the lack of

employment – Profile of people with stable attachment to employment

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Employment (cont’d)

• How well are people with disabilities integrated into the paid labour force? – Barriers to employment – Extent of participation in work-related training – Kinds of training (on-the-job, classroom, other) – Results of training – Barriers to training – Kinds of supports needed for employment – Kinds of needed supports that are actually available – Extent of participation in voluntary work – Percentage self-employed and distribution by industrial

sector

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Income

• What is the income situation of people with disabilities? – Income level by income sources and overall

income – Income adequacy (quintiles, LICO) – Extent of need / unmet need for disability

supports by income source – Barriers to employment by income source – Extent of reliance on charity / food bank for food;

extent of food insecurity

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Other Citizenship and Inclusion Issues • Health • Housing • Personal safety and security • Liberty and self-determination • Freedom of movement • Opportunities for personal learning and development • Equality of recognition and treatment under the law,

judicial other justice processes • Property ownership • Civic, political and cultural participation • Involvement in personal relationships

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Health

• Self-reported general health, physical activity level and health-risk behaviours

• Comparative patterns of health-related service utilization and reasons why needed services are not received

• Extent of non-reimbursed costs for medications

• Share with health insurance and the number of policies held

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Housing

• Comparative patterns in home ownership, types of housing, adequacy of housing

• Need for and receipt of accessibility features

• Numbers of people with disabilities in residential care facilities, by type of facility

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Personal safety and security

• Extent to which people experienced and / or reported violence or abuse and perceived adequacy of the response, e.g., by law enforcement

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Liberty and self-determination

• Degree of personal control in making decisions about everyday activities

• Extent to which people have not been able to do various community leisure activities for reasons other than the effects of disability

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Freedom of movement

• Extent of geographic mobility within and between CMAs • Extent to which people consider themselves housebound • Extent of need for specialized transportation, level of

availability, nature and extent of difficulties using • Extent of difficulty using regular air, ground and water

transportation available to the public • Usual mode of transportation to work • Frequent use of taxis because accessible transportation is not

available • Extent of difficulty making long distance trips and factors that

account for the difficulties

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Opportunities for personal learning and development (not just work-related)

• Highest level 0f education • Extent of enrolment in formal learning, kinds

of schools / programs, and kinds of certification sought

• Supports needed for school; availability of those supports

• Kinds of certificates obtained

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Equality of recognition and treatment under the law, judicial and other processes

• Extent to which people have experienced employment-related or other forms of discrimination

• Kinds of victimization experienced, extent to which issues are reported to police and others, extent to which cases go to court, victim satisfaction with responses

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Property ownership

• Total personal and family income (money as a means of property acquisition)

• (Extent of threat or force used to destroy or take personal possessions; extent of experience of theft)

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Civic, political and cultural participation • Extent and nature of voluntary work • Frequency of participation and barriers

to more participation in community leisure activities

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Involvement in personal relationships • Marital status and economic family member status • Extent to which people have social support such as:

– someone to confide in or talk to about private feelings or concerns

– someone who can be counted on to help out in a crisis situation

– someone they can count on to give advice when making important personal decisions

– someone who provides love and affection

• Frequency of contact with family and friends

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Social and economic costs of disability • Impacts of disability on others in terms of

amount of time dedicated to providing informal support, implications for employment, income, personal activities, stress and wellness

• Direct financial cost of disability supports to individuals, families, public programs, etc.

• Cost to the economy of lost productivity arising from disability

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X

X

X

X

- Relationships X

X

- Learning and development X

X = Revised assessment