Unveiling the Costs of Disability: Evaluating Policies and Accessibility for Health Equity

According to the Canadian Survey on Disability, 27% of Canadians aged 15 and older live with one or more disabilities that limit their daily activities (Statistics Canada, 2023). Among these individuals, 45% reported experiencing financial hardship during the pandemic, and Canada’s Material Deprivation Index reveals that approximately 53% of people with disabilities live in poverty (Mendelson et al., 2024; Statistics Canada, 2023). These alarming statistics stem from limited educational and labour market opportunities that disproportionately affect people with disabilities, undermining their financial stability (World Health Organization & The World Bank, 2011). Moreover, the additional costs associated with living with disabilities strain already limited financial resources (Mitra et al., 2017). As financial stability is a critical social determinant of health, the interconnected challenges of disability, financial instability, and health have become increasingly concerning.

In acknowledgement of these challenges, the Canadian government has introduced various programs and policies, such as the Disability Tax Credit, Registered Disability Savings Plan, Child Disability Benefit, and Disability Supports Deduction, to alleviate the financial burden on individuals and families affected by disabilities. In 2022, the government expanded these efforts through the Disability Inclusion Action Plan, which includes a key pillar focused on improving financial security for people with disabilities (Government of Canada, 2022). However, much of the policy discourse has centred on meeting minimum standards of support rather than addressing the broader goal of ensuring good health and well-being of people with disabilities (Sheppard & Yin, 2024). Furthermore, these policies are often perceived as complex, and opaque, making them challenging to navigate (Finlay et al., 2023; Prince, 2004). Bureaucratic delays, intricate application processes, and a lack of expertise among healthcare and financial professionals, further hinder access, exacerbating health inequities (Finlay et al., 2023). Thus, the limited accessibility of disability policies, combined with the intersection of disability, financial instability, and health, underscores the urgent need to critically evaluate and improve these policies and their accessibility to foster health equity among people with disabilities.

Recognizing the profound health inequities faced by people with disabilities, this multi-stage project aims to comprehensively explore how the additional costs of disability, subsequent financial instability, and limited accessibility to disability policies and programs impact health and well-being of people with disabilities.

• Phase 1: Scoping Review

We will begin by conducting a scoping review on the cost of disability and its impact on health equity among people with disabilities in the Organization for Economic Cooperation and Development (OECD) countries. This review will synthesize existing knowledge, identify gaps in the literature, and highlight key factors contributing to financial instability and health disparities. This foundational understanding will guide subsequent stages of the project.

• Phase 2: Policy Analysis

The project will then critically analyze existing Canadian federal and provincial disability policies and support programs to assess their adequacy in fostering healthy living for people with disabilities. This policy review will identify strengths and weaknesses within the current support systems and offer insights into areas requiring reform or enhancement. 

• Phase 3: National Survey

Finally, we will develop and implement an accessible national survey to capture the experiences of people with disabilities and their caregivers in navigating government disability policies and programs. Furthermore, building upon the nine areas essential for good health: food and nutrition, housing, transportation, physical activity, social participation, personal care, healthcare, professional development, and saving for the future (Morris & Deeming, 2004; Sheppard & Yin, 2024), participants will rank where they allocate most of their income and disability benefits. This data will identify the least supported areas critical for good health and inform targeted policy recommendations.

• Goals and implications

This project aims to identify gaps in disability policies and programs and provide policy recommendations to enhance the effectiveness and accessibility of disability support systems in Canada. By addressing these gaps, the project seeks to foster health equity and improve the health and well-being of people with disabilities.