In the UK, around one in five working-age adults is disabled, meaning there are around eight million people of working age who report having a long-term illness, disability or impairment (for more than 12 months) that limits everyday activities such as mobility, communication or memory.
This is a very large group. The number of people making new claims and receiving disability benefits has literally doubled in the years since the pandemic. There has been a bit of a decline recently, with new claimants each month being “only” 50% higher than they were pre-COVID. We will spend £50 billion this year on a range of health and disability-related benefits for working-age adults.
Disabled people are a hugely important economic and social group, and we have enacted laws to protect them from discrimination. Disability is a protected characteristic under the Equality Act 2010, along with sex, ethnicity, age, etc. However, we know less about the prevalence, causes and impacts of disability inequalities than we do for other protected characteristics. For example, the first analysis of the impact of the COVID-19 outbreak on disabled workers was published long after the worst of the pandemic had passed.
Part of the reason for this may be that it is perceived to be difficult to define or describe who is disabled. Some people may be “clearly” disabled – for example, those who are deaf, use wheelchairs, or have cerebral palsy or other lifelong disabilities. For others, there may be a subjective element to how people assess how functionally limited they are in their daily lives.
That’s no excuse for ignoring the issue: even if there is a certain degree of subjectivity, how people assess their own ability to perform tasks has a significant impact on their quality of life, their choices, and ultimately their future well-being.
A paper published last week by our colleagues at the Institute for Fiscal Studies is both timely and incredibly important. It takes a detailed look at disability rates, who is disabled, and what is happening to their outcomes.
It is reasonable to assume that age is the most important factor in disability. In fact, overall disability rates increase with age: more than one in ten people in their late 50s are receiving disability benefits, compared with around 4 percent of people in their 20s and early 30s.
However, that is a mistake.
When it comes to reporting long-standing limiting disabilities, education is a more important determinant than age: More than a quarter of unqualified people in their early 30s report a disability, a proportion that rises to half in their late 50s. University graduates in their 50s and even early 60s are less likely to report a disability than unqualified 30-year-olds.
The same pattern can be seen in benefit receipt: Decades ago, recipients of disability benefits (benefits for people unable to work due to illness) were primarily older people. Today, people with less education are more likely to receive such benefits, regardless of age. Younger people with less education are significantly more likely to receive benefits than their more educated counterparts.
Mental health problems are important here, and have become even more important over time, especially among young people, but these patterns are not entirely driven by such problems. Both physical and mental health problems are more prevalent among less educated people, and poor physical health is a more important driver of differences in disability rates in later life. Less educated people have more health problems, and the rate of increase with age is much faster.
The disparities in reported disability are mirrored in disparities in suffering pain. Again, older people overall are more likely to report living with pain than younger people, but younger people with less education report more pain than working-age older people with higher qualifications. This is not simply a difference between university graduates and those with no qualifications at all: 30-49 year olds with GCSE or A-level qualifications live with more pain than 50-64 year olds with a degree.
Naturally, this has economic and social implications: Overall, there is a 30 percentage point difference between the employment odds of disabled and able-bodied people.
Governments and others are concerned about the growing economic slowdown among people in their late 50s and early 60s since the pandemic. Let’s look at who is working and who isn’t: 80% of people aged 55 to 59 who don’t report a work-related disability are working. For people with disabilities, that figure drops to 40%. And the gap is largest among the least educated. Even within that group, three-quarters of people without disabilities are working, compared with just one-quarter of people with disabilities.
These variations in disability, pain, and employment rates, as well as health inequalities and differences in life expectancy between regions and between rich and poor, tell us something disturbing. I have focused on differences in educational attainment, which exist as a crude proxy for, or cause of, differences in opportunity, wealth, and social status. The lower you go down the social hierarchy, the more likely you are to suffer from illness, disability, pain, and mental health problems, and therefore the more likely you are to be economically inactive. The causes are complex, but the numbers affected, the misery created, and the economic cost make it clear that tackling these issues should be near the top of any list of social and economic priorities.
This article first appeared in The Times and is reprinted here with permission.