PHYSICAL DISABILITY

Research Highlights

• There is little consensus about the definition of physical disabilities, and as a result, it is often categorized under the broad term “disability”.
• One out of every seven Canadians aged 15 and over reported some level of disability (2001).
• Persons with disabilities are more likely to report that they have low levels of support in a variety of areas that contribute to overall well-being.
• The main social service issues affecting individuals with physical disabilities in Guelph-Wellington are:
  • Obtaining mobility devices, especially for individuals who are living on limited or fixed incomes. 
  • Attitudinal barriers to obtaining and maintaining employment. 
  • Need for modified work structures in or around the workplace.
  • Accessible transportation - the cost of purchasing, operating and maintaining accessible vehicles is high.  As a result, there are limited transportation options available for individuals with disabilities, especially for those who reside in rural areas and are in wheelchairs.

Research Profile on Health & Independent Living

What are Physical Disabilities?
There are many different types and degrees of physical disabilities and as a result there is little consensus among professionals and researchers concerning its definition.  As such, no single definition exists and therefore the subject is often categorized under the broad term “disability”.
 
According to the Ontario Human Rights Commission, Section 10 (01), a physical disability is defined as follows:

• Any degree of physical disability, infirmity, malformation or disfigurement that is caused by bodily injury, birth defect or illness and, without limiting the generality of the foregoing, includes diabetes mellitus, epilepsy, a brain injury, any degree of paralysis, amputation, lack of physical co-ordination, blindness or visual impediment, deafness or hearing impediment, muteness or speech impediment, or physical reliance on a guide dog or other animal or on a wheelchair or other remedial appliance or device.

Statistics Canada defines persons with disabilities as those who report difficulties with daily living activities, or who indicate that a physical or mental condition or a health problem reduced the kind or amount of activities they could do.¹
 
Disability and its Causes
Physical disabilities vary in cause.  They may be the result of an injury, natural aging, birth trauma, or disease/illness.  According to the 2000/01 Canadian Community Health Survey (CCHS)², of those reported using mobility support devices (96%), about half (47.9%) reported the main cause as disease or illness.
 
Causes of Disability among Mobility Support Device Users

Source: 2000/01 Canadian Community Health Survey

One-fifth (20.6%) reported that their disability stemmed from an injury.  Of these, 8.1% reported a work-related injury, 5.2% reported a home-related injury, 4.7% reported a motor vehicle injury, and 2.6% reported a sports injury.

Incidence and Prevalence
According to the 2001 Participation and Activity Limitation Survey (PALS)³:

• 14.6% of the population (3.4 million people) reported some level of disability.
• Of the 3.4 million adults reporting disabilities, 32.3% reported mild levels of disability (e.g. backache), 2.5% reported moderate levels (e.g. mild arthritis), and 41.1% reported severe or very severe levels (e.g. loss of mobility).
• The type of disability reported most often involved mobility. 71.7% of the respondents reporting some level of disability had difficulty walking, climbing stairs, or moving from one room to another.  This was followed by disabling pain (69.5%) and agility (66.6%).
• In general, the disability rate was higher among women.  About 1.9 million women (15.7%) aged 15 and over, reported having a disability, compared with just over 1.5 million men (13.4%).
• The highest rates occurred in the age group 75 and over, where more than one-half of both men and women reported a disability.

Seniors and Physical Disabilities
According to the 2001 PALS⁴, an estimated 1.45 million seniors aged 65 and over, (40% of the total population in this age group), reported some form of disability.  Of these, mobility problems affected the vast majority – nearly eight out of every 10 who reported disabilities.  Just over 1.0 million seniors also reported problems with agility.  For example, they had difficulty getting dressed or cutting food.  An estimated 573,000 seniors (40% of all those with disabilities) reported severe or very severe limitations.  The majority of these seniors were women, reflecting women’s longer life expectancy.

Children and Physical Disabilities
According to the 2001 PALS⁵ an estimated 155,000 Canadian children between five and 14 years old (4% of all children of this age group) had some form of activity limitation.  Approximately, 89,000 of these children (57%) experienced mild to moderate disabilities.  The remaining 43% or 66,000 experienced severe to very severe disabilities.
 
About a quarter of children with disabilities received help with everyday activities including personal care, such as bathing, dressing or feeding, or moving about within the home because of a condition or health problem.  Many of their parents reported that they weren’t getting the help they needed with their child’s condition.
 
A child’s condition has an impact on a family’s employment situation.  Examples of impact on employment include situations where family members had to work fewer hours or change their work hours to a different time of day or night in order to take care of the child.  According to PALS, of the 89,000 children with disabilities, 54% of their parents reported that their child’s condition had an impact on their family’s employment.

Use of Wheelchairs and other Mobility Support Devices:
According to the 2000/01 CCHS, about 155,000 Canadians who were living in private households needed a wheelchair to get around.  This represents 0.6% of the total household population aged 12 or older.  An additional, 540,000 individuals (2.1%) needed other devices such as braces, canes or crutches.
 
The proportions of Ontarians using mobility support devices exceeded the national average – 0.7% reported using a wheelchair and 2.4% reported needing other devices.
 
Overall, a slightly higher percentage of females than males reported using mobility support devices: 3.1% versus 2.3%.  This difference likely reflects the higher proportions of women in the older age groups.
 
And, as might be expected, the use of mobility support devices rises with age. 
 
The use of mobility support devices was associated with household income.  People in low- lower-middle and middle-income households were more likely than the overall population to use wheelchairs or other support devices, while those in the upper-middle or high-income households were less likely to do so.

Source: 2000/01 Canadian Community Health Survey

Social Support and Well-being
Persons with disabilities are more likely to report that they have low levels of support in a variety of areas that contribute to overall well-being.  According to the 1998/99 National Population Health Survey⁶, persons with disabilities were more likely to report lower levels of social support⁷ than their non-disabled counterparts.  Women with disabilities had the lowest levels of social support.  In fact, 6.2% of women with disabilities reported having little or no social support at all, compared with 5.6% for men with disabilities, and only 2.6% for women and men without disabilities.

Employment and Physical Disabilities
According to the 2001 PALS, just under one-quarter (22.3%) of employed persons with disabilities reported having had at least one period of unemployment in the previous year.  Both an individual’s age and severity of disability appear to leave persons with disabilities more vulnerable to unemployment.  For example, 27.7% of workers with severe or very severe disabilities faced unemployment within the previous year, compared with 22.2% among those with moderate disabilities, and 19.7% of those with mild disabilities.
 
As well, younger workers with disabilities are more likely than their older counterparts to face unemployment.  As seen above, 30.5% of workers aged 15 to 34 with disabilities faced unemployment within the previous year, compared with 20.6% of those aged 35 to 44, and 19.9% of those ages 45 to 64.  As documented here and in other studies, younger workers with disabilities tend to face higher levels of disadvantage in the labour market in a number of areas, and facing this type of disadvantage early in life can have a cumulative negative impact on one’s career possibilities.

Source: Calculations by the CCSD using data from Statistics Canada’s Participation and Activity Limitation Survey (PALS), 2001.

BILL 118 – ACCESSIBILITY FOR ONTARIANS WITH DISABILITIES ACT (AODA)

• On June 14, 2005, the AODA Act received Royal Assent.  It replaces the Ontario Disabilities Act, 2001.
• Bill 118 is an Act respecting the development, implementation and enforcement of standards relating to accessibility with respect to goods, services, facilities, employment, accommodation, buildings and all other things specified in the Act for persons with disabilities.
• Bill 118 includes the following significant changes:
  • will apply to both the public sector and the private sector
  • will include standards of accessibility and timelines for implementation of the standards
  • the Act and the standards which are yet to be developed will apply to ensure full accessibility within 25 years
  • regulation and enforcement provisions including penalties for non-compliance

Community Supports & Services (non-medical)
The Community Care Access Centre of Wellington-Dufferin (CCAC) provides a single point of access for information on and referral to government funded home and community services and long-term care homes.  Case Managers work with clients and their families/caregivers.  They assess clients’ needs and develop a plan of care, which may include coordinating and managing the delivery of homecare services or services for children in schools.

Guelph Services for Persons with Disabilities (GSPD) serves adults with physical disabilities living in Guelph.  Services include an aphasia program (assistance with speech development), community programs (opportunities for people with physical disabilities to participate in various social and recreational activities), one-to-one support (e.g. computer tutoring), and a resource library.  Attendant services include supportive housing at Willow Place and Victor Davis Memorial Court, outreach in individual’s residence on a prescheduled basis, 6:00 am to midnight, and volunteer opportunities.

Guelph (City of) Resource Services for People with Disabilities (RSPD) assists persons with disabilities in accessing municipal services (i.e. transportation, snow removal, etc.).  Supports include a subsidized bus pass, free parking pass for persons with a disability, disability group rental subsidies, and ACCESSability Guelph newsletter.  RSPD also offers a community services group to assist individuals experiencing access issues related to municipal recreation and leisure programs and services.  Programs include leisure support – one2one program, FAIR – Fee assistance program, staff support to the Barrier Free Recreation Committees, “Visit your first class for free” program, LAC – Leisure Access Card, and PAL – Personal Assistant for Leisure Activities Card.

Guelph (City of) Transit and Mobility Services provides door-to-door mobility services for persons unable to use public transit within the City of Guelph.  Drivers provide assistance to wheelchair passengers via wheelchair accessible ramps.  Walking assistance is also provided to ambulatory passengers.

KidsAbility provides therapy services for special needs children, birth to 18 years of age.  These include physiotherapy, occupational therapy, social work, therapeutic recreation and intensive behavioural interventions services for children with developmental delays or physical disabilities, or those at risk for difficulties.  This also includes assessment, intervention, consultation and resource information.  Other services available are seating and mobility services, augmentative communication services, and an orthopaedic and orthotics clinic.

Ontario March of Dimes provides a wide range of services across the province to enhance the independence and community participation of people with physical disabilities.  Services include employment assessment services, conductive education programs (merges elements of education and rehabilitation to help people with motor disabilities increase their independence and mobility), independent living attendant services, post-polio program, recreation and integration program, as well as an accessibility program (e.g. assistive devices).

Sunrise Therapeutic Riding and Learning Centre provides therapy, recreation, sport and life skills training programs for children and adults with special needs.  Programs include therapeutic riding lessons, job preparation training programs and an integrated summer day camp.

Employment Access is committed to providing client-centered services and supports to help persons with disabilities overcome barriers to obtaining, and maintaining employment goals.  Assistance is provided for individuals with disabilities to successfully obtain employment across diverse fields.  Programs include employment counselling, employment planning, employment preparation, and job development.

Torchlight Services provides vocational programs and services to adults with disabilities who are encountering barriers to entry into competitive employment. Programs and services are designed to address functional limitations. Programs include community options program to employment, torchlight industries, and torinday program.

Rainbow Programmes for Children offers Guelph and the surrounding area a summer recreational day camp experience for children and youth between the ages of 5-14.  They work with the Community Mental Health Clinic and other community professionals to bring children and youth with special needs to camp.

Ontario Disability Support Program (ODSP) – Ontario Ministry of Community and Social Services (administered through the County of Wellington) is intended to meet the needs of people with disabilities and help them to become more independent.  Services include income supports (provides financial assistance to people with disabilities) and employment supports (provides employment support to people with physical or mental disabilities which are expected to last one year or more that present a substantial barrier to employment).
 
Of the above mentioned services, the United Way of Guelph & Wellington funds the Guelph Services for Persons with Disabilities (Community Integration), the Ontario March of Dimes (Assistive Devices Program), the City of Guelph Resource Services for Persons with a Disability (Guelph-Wellington Barrier Free Committees, One-2One Program, Recreation Program for Persons with Disabilities, F.A.I.R., and Subsidized Bus Passes for Persons with Disabilities), and Rainbow Programmes for Children (Rainbow Day Camp).

Tax Credits

Caregiver Tax Credit – Canada Revenue Agency (CRA) allows Canadians to claim deductions and credits for individuals supporting people with disabilities.  The caregiver amount is a non-refundable tax credit, which reduces the amount of federal tax paid.
Medical Expense Tax Credit – CRA allows individuals to claim medical expenses paid in any 12-month period.  Total expenses have to be more than the lesser of: 3% of your net income or $1,813.
Disability Tax Credit – CRA allows Canadians to claim deductions and credits for individuals who suffer from a prolonged impairment.  Nearly 345,000 persons aged 15 and over reported having claimed a Disability Tax Credit on their income tax return for the year 2000⁸.  Nearly 80% of them or 277,000 persons reported receiving the tax credit.

What are the Social Service Issues in Guelph and Wellington?

Obtaining Assistive Devices
Many individuals with a physical disability require some type of assistive aid or device related to their disability.  Among Canadian children aged 5 to 14 with disabilities, over two-thirds (68%) require some type of aid or device.  This represents 104,840 school-aged children.  Among working-age adults (15 to 64 years) with disabilities, just over half (53%; 1,043,140 persons) have such a requirement.  Among seniors with disabilities (those aged 65 and older), two-thirds (66%) require some type of assistive aid or device (965,310 individuals). 
 
Devices are often very expensive and for individuals who are living on limited or fixed incomes obtaining such assistive aids is difficult.  According to the 2001 PALS:

• Among adults with disabilities who require some type of aid or device, approximately one-third (657,000) have unmet needs.
• Children with disabilities are less likely than adults to have their needs for assistive aids/devices fully met.  Just a little over half (54%) of children with disabilities who require some type of aid/device have what they need, while just under half (46%) have unmet needs.
• As the severity of the disability increases, so does the rate of unmet needs.  Among adults with disabilities, 18% of those with mild disabilities have some type of unmet need for an aid/device, compared with 50% among those with very severe disabilities. 

This data demonstrates that those most in need – that is, those with the most severe disabilities – are the least likely to have their needs met.
 
Among adults, the two most prevalent reasons for having an unmet need were that the assistive aids/devices were “too expensive” (cited by 66% or 315,420 individuals) and that the aid was “not covered by insurance” (cited by 50% or 236,940 adults).
 
The application process and the sourcing of funding takes time.  The client may have to rely on borrowed/rented equipment in the meantime or may have to continue without any assistive device while waiting.  This decreases mobility and increases dependence on others.

Obtaining and Maintaining Employment
One of the main barriers in obtaining and maintaining employment is accessing a modified work structure. This would include structures such as handrails/ramps; accessible parking; accessible elevators; modified workstations; accessible transportation; accessible washrooms; and “other” structures.  According to the 2001 Workplace and Employee Survey (WES), among employed persons with disabilities, 15% report that they need some type of “modified work structure” in or around the workplace. The most commonly required work structure is a modified workstation (required by 7%), followed by accessible parking (5%).
 
The rate of requirement for modified work structures in or around the workplace is even higher among persons with disabilities who are unemployed.  In fact, unemployed workers with disabilities are nearly twice as likely (28%) as those who are employed to require some type of modified work structure.  It may be that this requirement for modified workplace structures leaves an individual more vulnerable to job loss or to greater difficulty in finding employment.
 
Findings from the 2001 PALS indicate that there is a fairly high requirement for some type of workplace accommodation among those with disabilities, but these requirements are often for things that do not seem difficult to provide.  Since modified workstations and accessible parking are the most commonly required structures, and modified work hours and job redesign are the most commonly required aids, one might think that these items would be relatively simple to provide.  However, a fairly high number of individuals have unmet needs for these items, and these unmet needs can act as major barriers to their labour force participation and economic security. Employment, education and community awareness of creating accommodations in the workplace and a barrier free environment for people with disabilities is warranted.
 
A second main challenge in obtaining and maintaining employment for those with physical disabilities is attitudinal barriers.  Attitudinal barriers are one of the main reasons why people with disabilities are underrepresented in the workforce.  Negative stereotyping can contribute to persons with disabilities not even obtaining an interview. As such, their skills and abilities are often underestimated before they have an opportunity to market themselves.  Some employers may have the attitude that people with disabilities cannot do the same type of work or have the same level of efficiency as people without disabilities.  Attitudes about people with disabilities can govern how we relate and respond in all aspects of social interaction.  Continuing to educate employers in these areas is key to breaking down attitudinal barriers.

Accessible Transportation
The ability to travel, either locally or long distance is a crucial factor in social participation.  According to the PALS survey (2001), local and long distance transportation poses problems.  An estimated 4% of adults with disabilities reported being completely prevented from using public transportation services for travelling locally, including buses, specialized buses, subways and taxis. The percentage once again rose with the level of severity, from 2% of adults with mild or moderate disabilities to 5% of those with severe disabilities and 11% of those with very severe disabilities. Among respondents reporting that they had used public transportation, approximately 17% stated that they had some difficulty; the percentage rose from 6% of adults with mild disabilities to 14%, 24% and 35% respectively of adults with moderate, severe and very severe disabilities.
 
The cost of purchasing, operating and maintaining accessible vehicles is high.  As a result, there are limited transportation options available for individuals with disabilities, especially for those who reside in rural areas and are in wheelchairs. 
 
Results of a recent focus group by St. Joseph’s Health Centre and a survey conducted by United Way of Guelph & Wellington regarding volunteer transportation services show that:

• Highest need is for accessible transportation
• Demand for service currently outweighs supply
• Rides for medical purposes take priority over rides for social reasons.  There is a need to find a balance, as many social rides can be just as important as medical ones (e.g. grocery shopping, banking, etc.).
• Few volunteer transportation providers are able to offer services on the weekend in the evenings, nor book services on short notice.
• Individuals with disabilities report difficulties bringing attendants and/or family members (especially children in car seats) with them on trips.

The importance of supporting the transportation needs of clients in rural areas cannot be underestimated.   There is no public transit system in Wellington County, and transportation rides tend to be lengthy.  In the winter, weather conditions can compound transportation issues in North Wellington.  
 
Guelph recently acquired two accessible taxis, which are operated by Red Top Taxi.  The Guelph Police Services Board, who oversees the taxi by-law, has recently appointed a Taxicab Services Review Committee whose mandate is “to ensure that in the future the community of Guelph has a sustainable and affordable accessible taxicab industry”. 
 
The re-introduction of accessible taxis in the City of Guelph will help solve some the above issues; however, it will not relieve service needs in rural Wellington.

1. Statistics Canada (2001).  Participation and Activity Limitation Survey. Ottawa, Ontario: Statistics Canada.
2. Statistics Canada (2001).  Canadian Community Health Survey – Cycle 1.1.  Ottawa, Ontario: Statistics Canada.
3. Statistics from this survey must be interpreted with caution, as it includes limits by a physical as well as psychological or health condition.
4. Ibid.
5. Ibid.
6. Statistics Canada (1999).  National Population Health Survey, 1998/99.  Ottawa, Ontario: Statistics Canada.
7. An index based on the reported availability of: someone to help if you were confined to bed; someone to help take you to a doctor; someone to help prepare meals if you were unable to do so; someone to help with daily chores if you were sick.
8. Statistics Canada (2001). Disability Supports in Canada, 2001: Tax Credits.  In Participation and Activity Limitation Survey. Ottawa, Ontario: Statistics Canada.