As we approach our third year of living with the pandemic, the return to a true ‘normal’ seems to remain ever elusive. The disruptions brought on from the pandemic, social unrest, overdue reckoning for racial justice and equality, deep political divides, and a lengthy list of other domestic and global misfortunes has made the past few years exceptionally difficult for nearly every American and people around the
World. However, the impacts of the pandemic have been exceptionally difficult on persons living with disabilities.
Twenty six percent of adults in the U.S. live with some form of disability. One in ten San Franciscans (about 96,000) people reports a disability, according to the San Francisco Human Services Agency. Of these persons, 27% are African-American, 12% are Asian or Pacific Islander, 12% are Latino, and 12% are White. Despite making up a minority of the general population, Black and Indigenous People of Color (BIPOC) people are disproportionately represented in the disability population, and face intersecting oppressions on the basis of race and disability as a result.
Prior to COVID-19, people with disabilities already faced disproportionate discrimination in healthcare, employment opportunities where employers fail to understand their value and potential, and in society, where heavy stigmas are placed on their worth. Persons with disabilities generally have more healthcare needs than others – both standard needs and needs linked to impairments – and are more vulnerable to the impact of low quality or inaccessible health-care services than others.
How has the pandemic impacted those with disabilities?
For individuals with disabilities, the pandemic itself has of course been a primary challenge – those living with disabilities have been reported to experience a higher mortality rate from COVID-19. It is important not to conflate disability with health status. Many people with disabilities are healthy. However, underlying conditions like suppressed immune systems or urinary tract infection may increase the risk of severe symptoms associated with COVID. In fact, a 2022 NEJM Catalyst cross-sectional study revealed that having an intellectual disability was the strongest independent risk factor for presenting with a COVID-19 diagnosis and the strongest independent risk factor other than age for COVID-19 mortality.
In addition to this, the pandemic has disproportionately negatively impacted the social lives of people with disabilities – indeed, 46% of disabled people said the pandemic had a negative impact on their mental health, compared to 29% of abled people. Many persons with disabilities also suffer from anxiety, depression, and other mental health conditions which were triggered by the uncertainty brought on by the pandemic.
Risk of contracting COVID is higher for persons with disabilities.
Washing hands, social distancing, and following local health guidelines are arguably our strongest weapons to protect ourselves from the virus. However, for people with disabilities, these actions are easier said than done. Social distancing can be nearly impossible for persons who require special physical care to complete daily tasks, and washing hands can be a challenging task to perform for those with physical disabilities.
Access to Services
The lack of access to services disabled persons already faced prior to COVID-19 was made even more stark by the advent of the pandemic. The pandemic exposed how precarious access to health care services is in the United States – for communities of color, historic underfunding in healthcare and BIPOC neighborhood investment led to increased likelihood of mortality from COVID-19 in Black, Latinx, Asian, Pacific Islander, and Native American populations.
Unfortunately in the United States, people with disabilities are often overlooked or are an afterthought in policy making and community investment. Disabled persons have long faced barriers to inclusion in the workforce, healthcare, and other socioeconomic aspects of life. After not honoring, investing in, or enforcing rights of access and community living for people with disabilities, the United States faced staggering death rates in long-term living facilities, which have accounted for nearly one-third of COVID-19 deaths in the country. Reduced access to routine health care and rehabilitation compounded the
In addition to challenges to accessing usual care, according to a report from the National Council on Disability (NCD), people with intellectual or developmental disabilities and medically fragile or technology dependent individuals faced a high risk of being triaged out of COVID-19 treatment when hospital beds, supplies, and personnel were scarce. They were also denied the use of their personal ventilator devices after admission to a hospital, and at times, were denied the assistance of critical support persons during hospital stays.
Staff at medical institutions with limited resources are sometimes forced to make heart-wrenching decisions of who will receive life-saving facilities, such as intensive care beds or ventilators. Far too often, low priority is given to people with disabilities informed by biased assumptions made about their quality of life, and disabled people are triaged out of treatment, as in the case of a woman with an intellectual disability in a small Oregon hospital who was denied the ventilator she needed.
Unclear public health messaging or lack of accessible messaging
Confusing and inconsistent messaging pertaining to protocol to avoid exposure and general acknowledgement of the severity of the public health crisis has made navigating the situation difficult for people with intellectual disabilities to understand. Unclear messaging has severe impacts in a public health emergency such as COVID-19, and can be a matter of life and death, especially for this vulnerable community.
Accessibility is rarely prioritized in public health messaging. Many materials are not provided in accessible format – some broadcasts forgo captions, messaging rarely uses plain language, and assistive technology is not provided for those with vision or cognitive impairments. American Sign Language (ASL) interpreters are key players in nearly all press conferences, but populations with vision or hearing loss are often neglected. In matters of public health, health equity is vitally important – in the case of COVID-19, receiving accessible public health messaging can be a matter of life or death.
Many disabled persons participate in group living, such as Helpers’ own residential care homes. Group living provides social stimulation and group homes often employ counselors who provide assistance to residents with special needs. Residents in long-term care facilities and group homes are an especially vulnerable population group, as social distancing is more difficult to achieve.
Programs and social lives on pause
Many individuals with intellectual or physical disabilities require highly specialized programs and direct one-on-one support to be safe, learn, work, or perform daily living skills. For those on the autism spectrum or people with an intellectual disability, adjusting and adapting to the new changes and disruptions caused by the pandemic can be very challenging. For many people with disabilities, community programs, employment, and schools are the fabric of their social lives. Limited access to these vital social networks as we sheltered in place led to extreme isolation and mental health challenges.
Disability Employment and COVID-19
Research has shown that there is a consistent and clear labor force participation gap by disability status. People with disabilities also are more likely to be unstably employed, lower wages on average compared to non-disabled persons, and face discrimination from employers who undervalue their labor. In 2021, 21 percent of people with a disability participated in the labor force, compared to 67 percent of people without a disability—a disparity relatively unchanged since 2009.
According to Easterseal – a nonprofit dedicated to providing disability services – the pandemic exacerbated financial insecurity for people with disabilities, and indeed, only 18% of individuals with disabilities were likely to be employed than 62% of their non-disabled peers. The onset of COVID led to even lower employment rates for this vulnerable population, who were subject to layoffs at disproportionate rates. From March to April 2020, the number of employed working-age people with disabilities fell by 20 percent (950,000 people), while the number of employed working-age people without disabilities decreased by 14 percent.
Awareness of the unique risks people with disabilities experience to COVID-19 and understanding of the impact they have experienced from the pandemic helps us to improve our COVID response and ensure that we are being equitable in promoting public safety. Many of us either have a disability ourselves, or know a friend or loved one who lives with a disability. Working with and on behalf of people with disabilities to support engaged and enriching community living is a shared responsibility for us all.
- “The Impact of COVID-19 on People with Disabilities,” National Council on Disability, 2021.
- U.S. Bureau of Labor Statistics, “Labor Force Statistics from the Current Population Survey.”
- “COVID-19’s Impact on People with Disabilities,” Easterseals, 2021.
- Wong, Jasin et. al, “Employment Consequences of COVID-19 for People with Disabilities and Employers,” Journal of Occupational Rehabilitation, 2022.
- “Oregon Hospitals Didn’t Have Shortages. So Why Were Disabled People Denied Care?” NPR, 2020.