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Poverty, livelihoods and social benefits

In this article, we discuss the cycle of disability and poverty.
© The London School of Hygiene & Tropical Medicine

This is an additional video, hosted on YouTube.

Poverty

Although not specifically about children with developmental disabilities, the video above makes us think about the cycle of disability and poverty. Research shows again and again that people with disabilities are more likely to be poor.1 This link was shown throughout the world, for children and adults, men and women, and people with different types of impairments. The association works in both directions – disability and poverty are both a cause and a consequence of each other.
Conditions associated with poverty can increase the risk of childhood developmental disability. For example, women living in poverty may not access nutritious food or prenatal care during pregnancy, and are more likely to have unsafe deliveries, factors which can increase the risk of developmental disability. Similarly, children who are poor may also lack access to healthcare and good nutrition, and live in more unsafe environments, increasing their risk of developmental disability.
Disability can also lead to poverty for children with developmental disabilities.
A young girl leans an arm against a wooden building and looks into the camera © Bill Wegener
(1) First, people with disabilities are less likely to work. When they do work, they are more likely to work part-time and in less secure roles, and their earnings are often significantly less than people with disabilities.2 This is a major concern for children with developmental disabilities, especially as they begin to reach young adulthood and start seeking more independence. Additionally, increased caregiver demands may make it difficult for parents of children with developmental disabilities to work.
(2) Second, children with disabilities are less likely to attend school, and educational achievement is a strong predictor of future earnings. Improving access to inclusive education is key to reducing poverty amongst people with disabilities. For example, a study from China found that each additional year of schooling for children with disabilities led to a 5-8% increase in wages in adulthood.3
(3) Third, children and adults with disabilities often must contend with additional disability-related costs for services and items that are necessary for people with disabilities to participate in society on an equal basis as others. This includes the cost of assistive devices, medical treatments, rehabilitation, personal assistance and transport. Healthcare costs are often a major source of additional costs, particularly in countries without universal healthcare. When these costs are not covered by the State, children with disabilities may experience poorer health and exclusion from school, future employment and social life. However, meeting these costs can put financial strain on disabled households and lower their standard of living. For example, studies have found disabled households spend 8-70% of their income on disability-related costs.4
As a consequence, people who are poor are more likely to become disabled, and disability will often further exacerbate poverty.
A girl is kneeling in front of a painted wall and laughing Azucena Tzina Sicay (6) from Guatemala. © CBM/argum/Einberger

Role of the healthcare professional

It is important to take the vulnerability to poverty of children with developmental disabilities into account when delivering family-centred care, as poverty has a great impact on the capacity of the family for care. Healthcare professionals can improve a child’s opportunity to reach their full potential (and draw themselves out of poverty) by improving access to healthcare services and collaborating with other services. As we are discussing throughout this week, advocating for social inclusion and education can also help break the cycle
Many countries provide social benefits to people with disabilities. These may take the form of regular payments to help with extra costs of daily living or healthcare costs, such as transport and medication. Parents are often unaware of the social benefits available to them, and healthcare professionals are well placed to provide this information. This doesn’t require a large commitment from a healthcare professional. A simple leaflet with relevant phone numbers and websites is more than useful. Healthcare professionals may also help with the application process, for instance, providing certification of the child’s disability.

Discussion

  • In your setting, what factors might increase the risk of poverty amongst people with disabilities?
  • If you are a healthcare professional, what actions could you take to help alleviate poverty among children with developmental disabilities?
  • What would support you to take these actions?
© The London School of Hygiene & Tropical Medicine
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Integrated Healthcare for Children with Developmental Disabilities

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