Journal of Disability Policy Studies

In recent decades, there has been a push to incorporate the World Health Organization “Health for All” principles in national, regional, and local health policy documents. However, there is still no methodology guiding the appraisal of such policies with regard to the extent that they address social inclusion. In this article, the authors report on the development of EquiFrame, a novel policy analysis framework that was used to evaluate the disability and rehabilitation policies of Malawi, Namibia, Sudan, and South Africa. The policies were assessed in terms of their commitment to 21 predefined core concepts of human rights and inclusion of 12 vulnerable groups. Substantial variability was identified in the degree to which the core concepts and vulnerable groups were featured in these policy documents. The overall summary rankings for the disability policies of the countries studied were as follows: Namibia–High, Malawi–Low, and Sudan–Low. The rehabilitation policy of South Africa was ranked as Low. The results support the idea that adequate disability and rehabilitation policies remain mostly undefined. EquiFrame may offer a useful methodology for evaluating and comparing human rights and social inclusion across policy documents.

This paper analyses the labor-market transitions among older people with disabilities in Europe as compared to their non-disabled counterparts. Particular attention is paid to the workers’ transitions to and from self-employment. Using data from the two first waves (2004 and 2007) of a panel data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we estimate employment transition matrices for disabled and non-disabled individuals aged 50 years or over, taking into account the possible transitions in disability status that individuals may experience throughout our panel data. The results show that older people with disabilities (especially females) who are self-employed in 2004 are less likely to remain in the same labor status three years later. In contrast, transitions from self-employment to “out of labor force” were relatively higher for disabled individuals as compared to non-disabled ones. In addition, the results vary when we take into consideration the disability trajectories. Areas of future research and policy recommendations are given.

This article presents the findings from research to identify key barriers and opportunities in the provision of workplace accommodations for employees with disabilities in the United States. Using the policy Delphi method, a multiround, iterative polling technique used to assess key stakeholder perceptions, the study probed on five areas: awareness, policy/regulatory, economic, technology, and social. For each of these areas, the Delphi panel was asked to comment on the reliability of forecasts, importance of issues, desirability of goals, and finally, the feasibility of policy options. The Delphi study concluded with a set of 22 policy options to address barriers to the provision of workplace accommodations. Many of these options take a collaborative approach, but they emphasize involvement of federal agencies such as the Office of Disability Employment Policy in the U.S. Department of Labor and the Americans with Disabilities Act (ADA) Task Force of the U.S. Department of Justice.

Mental health disability imposes an enormous cost to patients, families, and society. Across free market countries, the rate of mental health disability is growing and now constitutes about one third of all disability claimants. Living on disability benefits begets demoralization and passivity. This article reviews (a) the current status of mental health disability and mental health disability systems, (b) the encouraging findings related to research on evidence-based treatments and supported employment, and (c) policy changes that might ameliorate the problem of rising rates (and costs) of mental health disability. Mental health treatments, employment services, and disability policies powerfully shape the disability experience. Evidence-based mental health and employment services can ameliorate disability and could potentially prevent disability if applied as early interventions. Yet evidence-based mental health treatments and supported employment services are rarely available. Furthermore, current disability policies tend to trap people in a “disability benefits culture.” Policy changes should recognize that people with mental health disabilities usually want to work, that they are often able to work when provided with appropriate mental health and vocational services, and that employment is highly therapeutic. Disability policies need to strengthen work incentives for beneficiaries, providers, and employers.

Many individuals with developmental or intellectual and other disabilities are on waitlists to receive supportive services through state Medicaid waiver programs. Being waitlisted can place considerable burden on the ability of a caregiver to maintain employment outside the home. This article reports on results of a survey of 442 caregivers of individuals waitlisted for services within the Florida Medicaid program. Logistic regression was used to model characteristics of caregiver and clients that are associated with the need for additional supports in order for the caregiver to maintain employment. Male caregivers and caregivers in fair or poor health were more likely to report needing support. Caregivers of clients who had behavior problems or problems with self-care were also more likely to need support to maintain employment. Policy responses to these findings include a call for increased supports or prioritization of services for caregivers who are in poor health or those who care for individuals with particularly problematic behaviors.