"I'm really pleased you've raised this issue. I was sampled for the Labour Force Survey some years ago (late 1990s and early 2000s) and had a few (can't remember how many) face to face interviews. Each time I struggled to know how to answer the 'disability' question. I lived in a house that was adapted to meet my needs as a wheelchair user, I drove an adapted car, and I was working in an environment where adjustments had been made to enable me to do what I needed to do. So when the interviewer asked me the 'disability' question my true answer would have been to say that I did not experience restrictions as a result of long-standing sickness or disability/impairment. My actual answer varied according to how stroppy I was feeling at the time about the inadequacy of the survey questions. If I answered that I was not restricted I felt this made me invisible as a wheelchair user, as someone who has an impairment. If the survey had been designed with a clear understanding of the difference between impairment and disability/disabling barriers it might have enabled a truer picture of both."
I think the assumption that more inclusive environments would only lead to less reporting of disability among people with less severe impairments completely ignores the fact that severely disabling environments do cause many people to assume (often correctly) that their impairment should be and needs to be classed as severe, in order for them to be able to survive. Whereas, if we had more inclusive environments, these people also wouldn't perceive their impairments as severe.
According to the dominant definitions in the social security system in the UK, I suppose my variety of impairments is classed as severe, in that I was awarded PIP at the enhanced rate of both elements based on a paper decision this time around. However, if I lived in an accessible home that I can heat properly, that would make it much easier for me to move around in and use my own home, and if I had an accessible kitchen that doesn't require me to stand up to prepare food, I wouldn't depend on social care for basic things like food preparation. I would immediately feel less impaired. I think this potential impact of the hypothetical brilliantly inclusive disability policy would also reduce the number of people with so-called “severe” impairments who report disability.
But I think this points to another quite significant problem in that people's self-perceptions of the degree or level of severity of their impairment and the public or authorities' perceptions of the level and degree of severity of their impairments can differ significantly. . The link between severity of impairment and degree of disablement is really not as straightforward as people think. It bothers me that people still misunderstand the social model of disability so much that they think that severity of impairment is an adequate predictor for degree of disablement experienced - whereas personally I hypothethise that the most reliable predictor of degree of disablement experienced or not is the presence or absence of wealth or surplus income, combined with whether degree of wealth and income inequality in one's environment and community has destroyed community support and ties or not.
This is interesting. So if the prevalence-adjusted disability employment gap has gone up, while the non-adjusted one has gone down, is the implication here that we have more people reporting themselves as disabled with less severe impairments, whose employment rate is lower than non-disabled people, but not as much lower as people with more severe impairments? This would chime with the emphasis on the rise in anxiety/depression following the pandemic. In which case, I'm not sure this finding is as dramatic or unexpected as it might seem at first?
Thanks Bernard - yes, the prevalence-adjusted DEG rise is exactly what we would expect if more people with less severe impairments are reporting a disability. There's other things going on here as well, which is why I think the measure is problematic. But one response is that we need to split apart employment trends in more vs. less severe disability (which is possible in other approaches, and my next post covers).
Also, I'd seen the new questions that you'd developed - their great, I've sent them around a few people. Have you been in contact with GSS to see if they can change the standardised impairment question to your version?
Yeah, good to have a quick email exchange with them to see where it all goes next. The GSS categories needed improvement, so really glad that someone did this, and did it really well!
A comment from the fab Jenny Morris (https://www.blogger.com/profile/16720416037156377048 and https://disability-studies.leeds.ac.uk/library/author/morris.jenny/) by email:
"I'm really pleased you've raised this issue. I was sampled for the Labour Force Survey some years ago (late 1990s and early 2000s) and had a few (can't remember how many) face to face interviews. Each time I struggled to know how to answer the 'disability' question. I lived in a house that was adapted to meet my needs as a wheelchair user, I drove an adapted car, and I was working in an environment where adjustments had been made to enable me to do what I needed to do. So when the interviewer asked me the 'disability' question my true answer would have been to say that I did not experience restrictions as a result of long-standing sickness or disability/impairment. My actual answer varied according to how stroppy I was feeling at the time about the inadequacy of the survey questions. If I answered that I was not restricted I felt this made me invisible as a wheelchair user, as someone who has an impairment. If the survey had been designed with a clear understanding of the difference between impairment and disability/disabling barriers it might have enabled a truer picture of both."
I think the assumption that more inclusive environments would only lead to less reporting of disability among people with less severe impairments completely ignores the fact that severely disabling environments do cause many people to assume (often correctly) that their impairment should be and needs to be classed as severe, in order for them to be able to survive. Whereas, if we had more inclusive environments, these people also wouldn't perceive their impairments as severe.
According to the dominant definitions in the social security system in the UK, I suppose my variety of impairments is classed as severe, in that I was awarded PIP at the enhanced rate of both elements based on a paper decision this time around. However, if I lived in an accessible home that I can heat properly, that would make it much easier for me to move around in and use my own home, and if I had an accessible kitchen that doesn't require me to stand up to prepare food, I wouldn't depend on social care for basic things like food preparation. I would immediately feel less impaired. I think this potential impact of the hypothetical brilliantly inclusive disability policy would also reduce the number of people with so-called “severe” impairments who report disability.
But I think this points to another quite significant problem in that people's self-perceptions of the degree or level of severity of their impairment and the public or authorities' perceptions of the level and degree of severity of their impairments can differ significantly. . The link between severity of impairment and degree of disablement is really not as straightforward as people think. It bothers me that people still misunderstand the social model of disability so much that they think that severity of impairment is an adequate predictor for degree of disablement experienced - whereas personally I hypothethise that the most reliable predictor of degree of disablement experienced or not is the presence or absence of wealth or surplus income, combined with whether degree of wealth and income inequality in one's environment and community has destroyed community support and ties or not.
I briefly mention that I don't like the healthy life expectancy stats, but don't explain this in detail - so it's great to see that John Burn-Murdoch at the FT setting out why he doesn't like them either - see https://www.ft.com/content/766eee31-d73d-441d-8772-6fd426d2b7e2?syn-25a6b1a6=1
This is interesting. So if the prevalence-adjusted disability employment gap has gone up, while the non-adjusted one has gone down, is the implication here that we have more people reporting themselves as disabled with less severe impairments, whose employment rate is lower than non-disabled people, but not as much lower as people with more severe impairments? This would chime with the emphasis on the rise in anxiety/depression following the pandemic. In which case, I'm not sure this finding is as dramatic or unexpected as it might seem at first?
Also you might be interested in recent efforts to develop survey questions about disability that are more in line with the social model: https://natcen.ac.uk/transforming-disability-data-collection-wales-embracing-social-model
Thanks Bernard - yes, the prevalence-adjusted DEG rise is exactly what we would expect if more people with less severe impairments are reporting a disability. There's other things going on here as well, which is why I think the measure is problematic. But one response is that we need to split apart employment trends in more vs. less severe disability (which is possible in other approaches, and my next post covers).
Also, I'd seen the new questions that you'd developed - their great, I've sent them around a few people. Have you been in contact with GSS to see if they can change the standardised impairment question to your version?
Thanks Ben. I'll look out for your next post.
Would you like me to put you in touch with my colleagues who led the question development work?
Yeah, good to have a quick email exchange with them to see where it all goes next. The GSS categories needed improvement, so really glad that someone did this, and did it really well!