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People with disabilities uniquely vulnerable to pandemic impacts

It is also a difficult and stressful situation for the people who work with this vulnerable population, who are already under-supported and underpaid.

Ottawa (20 April 2020) ― It has become clear that the impacts of the COVID-19 pandemic are highly unequal, as recent NUPGE research highlights. This is true of not only the health impacts of the disease itself but also of the economic and social impacts as a result of the pandemic.

The crisis is having disproportionate impacts along lines of existing inequity, thus reinforcing (or even exacerbating) those inequities. This is evident in the marked, yet often under-recognized impacts on people with disabilities.

Vulnerable to health impacts, discrimination

While no one is immune to the coronavirus, there are certain populations that face a higher risk of experiencing severe symptoms of COVID-19. This includes seniors, people with compromised immune systems, and people with underlying health conditions.

Not every person with disabilities will necessarily be more vulnerable to severe symptoms, but those with underlying health conditions will be more at risk. We saw reports of panic buying during the pandemic’s early days, which left people with disabilities and underlying conditions without access to much-needed supplies or services like wipes, gloves, or grocery deliveries (The Guardian).

Another concerning issue is the risk of medical discrimination. What happens when there are limited medical supplies. Whose health is prioritized? This situation puts health care workers in an impossible position and has the potential to disproportionately impact vulnerable or marginalized populations (The Globe and Mail). Reports from Italy and the U.S. raise serious concerns about discrimination against older people, people with disabilities, and people with underlying health conditions.

In Ontario, disability rights organizations have raised concerns that the province’s COVID-19 triage protocols would involve deprioritizing people with disabilities for critical care. The groups are urging the provincial government to ensure that decision-making protocols are not discriminatory.

British Columbia has released an ethical decision-making framework for COVID-19.  The guidelines note that allocating health care resources must be done consistently across populations regardless of factors like age, ability, race, or class. In other words, care must be guided by principles of equity and fairness.

Economic inequality and insecurity

People with disabilities may also be disproportionately affected by the economic shocks that result from the pandemic.

People with disabilities most frequently report employment as their source of income. But they also face barriers to employment, experience low earnings and high rates of underemployment, according to Statistics Canada, and are more likely to experience precarious employment (Canadian Research Institute for the Advancement of Women). In Canada, people with disabilities earn 56% of what those without disabilities earn. Women with disabilities are impacted the most: according to Statistics Canada data, they earn less than women without disabilities and less than men with or without disabilities. Further, disabled women who live alone report the lowest income on average.

These factors mean that people with disabilities are more vulnerable to the job loss, loss of income, and financial strain that we are seeing as a result of the pandemic. Workers with disabilities may also face barriers in getting to work or accessing accommodations during the pandemic.

As NUPGE has previously reported, the COVID-19 pandemic is having pronounced impacts related to housing, particularly for those who are already precariously housed, struggling to pay bills, or experiencing homelessness. Of particular concern is that people living with a disability or mental illness are already more likely to experience homelessness (Canada Without Poverty). Estimates suggest they account for up to 45% of the homeless population in Canada.

Governments must not neglect group homes

Furthermore, there are unique concerns facing people with disabilities who live in group homes (also known as community living, residential care, or supported living arrangements). These are places where a vulnerable population resides in physically close quarters. This poses challenges with preventing and controlling COVID-19, as we have seen with long-term care homes. Clear protocols and precautions must be in place.

It is particularly difficult in cases where residents with intellectual disabilities may have difficulty understanding the pandemic, the restrictions that are in place, or why routines have changed.

This also creates a difficult and stressful situation for the people who work with this vulnerable population, who are already under-supported and underpaid. These workers must be supported in order to do their jobs and to keep their residents or clients, and themselves, safe. Both the residents and staff in this sector must not be forgotten.

Lack of access to programming, supports

Pandemic response measures, such as physical distancing, are also impacting the daily activities and supports for people with disabilities.

There have been reports of day programs being temporarily shut down, and respite care being limited or cancelled altogether (CBC News). Not only does this impede access to much-needed care and supports for people with disabilities, but it will isolate them. It also places additional pressure on their families and caregivers.

A recent article published in The Lancet argued that protective measures should be prioritized for people living with disabilities. They woud allow care workers and families to continue to safely offer support and empower people with disabilities to meet their daily needs and commitments.

Disproportionately high rates of violence against women with disabilites

Another area of concern is violence. The pandemic presents increased risk of violence, particularly domestic violence as NUPGE has cautioned, because people spend more time in their homes during a time of high stress and isolation.

Women with disabilities are particularly vulnerable, as they already face disproportionately high rates of gender-based violence, including domestic violence (Centre for Research & Education on Violence Against Women and Children). Furthermore, women with disabilities face unique barriers to accessing supports.

Disability justice during and after the pandemic

Health experts and disability advocates have called for a COVID-19 response that is inclusive of people with disabilities and prevents the reinforcing of inequality and discrimination.

And this must not end when the pandemic does. As with the host of structural inequities illuminated by the crisis, recognition of these inequities and genuine efforts to address them must persist if we are to rebuild after the crisis as a more just and equitable society.