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I am currently a junior at Rice University interested in contributing information on topics related to poverty, justice, and human capabilities. I hope to create articles that will help further individuals knowledge in these important areas.

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The world’s poor are significantly more likely to have or incur a disability within their lifetime compared to more financially privileged populations. The rate of disability within impoverished nations is notably higher than that found in more developed countries. Though no one explanation entirely accounts for this connection, recently there has been a substantial amount of information illustrating the cycle by which poverty and disability are mutually reinforcing. Physical, cognitive, mental, emotional, sensory, or developmental impairments independently or in tandem with one another may increase one’s likelihood of becoming impoverished, while living in poverty may increase one’s potential of having or acquiring special needs in some capacity.

Extent
A multitude of studies have been shown to demonstrate a significant rate of disability among individuals living in poverty. Persons with disabilities were shown by the World Bank to comprise 15 to 20 percent of the poorest individuals in developing countries. Former World Bank President James Wolfensohn has stated that this connection reveals a link that should be broken. In his words, “people with disabilities in developing countries are over-represented among the poorest people. They have been largely overlooked in the development agenda so far, but the recent focus on poverty reduction strategies is a unique change to rethink and rewrite that agenda.” The link between disability and development has been further stressed by Judith Heumann, the World Bank’s first advisor for international disability rights, who indicated that of the 650 million people living with disabilities today eighty percent live in developing countries. According to the United Kingdom Department for International Development 10,000 individuals with disabilities die each day as a result of extreme poverty showing that the connection between these two constructs is especially problematic.

Causes
According to the World Bank “persons with disabilities on average as a group experience worse socioeconomic outcomes than persons without disabilities, such as less education, worse health outcomes, less employment, and higher poverty rates.” Researchers have demonstrated that these reduced outcomes may be attributable to a myriad of institutional barriers and other factors. Furthermore, the prevalence of disabilities in impoverished populations has been predicted to follow a cyclical pattern.

The vicious circle
Experts attribute the connection between disability and low socio-economic attainment to many systemic factors, which promote a “vicious circle.” This relationship is hypothesized to perpetuate in a cyclical fashion where disability can lead one to be deprived of access to essential resources thus causing them to fall into poverty and likewise poverty places individuals at a much greater risk of acquiring a disability due to the general lack of health care, nutrition, sanitation, and safe working conditions that the poor suffer from. Researchers assert that this cycle is made especially problematic by the lack of alternatives those who live in poverty are given necessitating that they put themselves in harms way, thus more greatly suffering from the acquisition of preventable impairments as a consequence. This can be seen in statistics, which demonstrate that well over half of the incidences of childhood blindness and hearing impairment found in Africa and Asia were considered preventable or treatable with the proper resources. Additional research conducted by Oxfam also supports this theory, estimating that 100 million people living in poverty suffer from impairments acquired due to malnutrition and lack of proper sanitation.

Discrimination
Prejudice held against individuals with disabilities, otherwise termed ableism, is shown to be a significant detriment to the successful outcomes of persons in this population. According to one study following the lives of children with disabilities in South Africa, the children in the sample described "discrimination from other children and adults in the community as their most significant daily problem."

Further discrimination may lead disability to be more salient in already marginalized populations. Women and individuals belonging to certain ethnic groups who have disabilities have been found to more greatly to suffer from discrimination and endure negative outcomes. Some researchers attribute this to what they believe is a “double rejection” of girls and women who are disabled on the basis of their sex in tandem with their special needs. The stereotypes that accompany both of these elements lead females with disabilities to be seen as particularly dependent upon others and serve to amplify the misconception of this population as burdensome. In a study done by Oxfam the societal consequences of having a disability while belonging to an already marginalized population were highlighted stating, “A disabled women suffers a multiple handicap. Her chances of marriage are very slight, and she is most likely to be condemned to a twilight existence as a non-productive adjunct to the household of her birth… it is small wonder that many disabled female babies do not survive.” This connection is also purported to exist in more industrialized nations. In the United States, for example, 72% of women with disabilities live below the poverty line.

Health care
Another reason individuals living with disabilities are often impoverished is the high medical costs associated with their needs. One study conducted throughout villages in South India demonstrated that the cost of treatment and equipment needed for individuals with disabilities in the area ranged from three days of income to upwards of two years’ worth, with the average income spent on essential services being three months worth of income. This figure does not take into account the unpaid work of caregivers who must provide assistance after these procedures and the opportunity costs leading to a loss of income during injury, surgery, and rehabilitation. Studies have also shown that access to medical care is significantly impaired when one lacks mobility. Researchers report that in addition to the direct medical costs associated with special needs the burden of transportation falls most heavily on those with disabilities. The consequences of this are especially salient for the rural poor whose proximity to urban environments necessitates extensive movement.

Institutional barriers
Researchers assert that institutional barriers play a substantial role in the incidence of poverty in those with disabilities.

Accessibility
Physical environment may be a large determinant in one’s ability to access ladders of success or even subsidence. Professor Rob Imrie who studies urban planning surmised that most spaces contain surmountable physical barriers that unintentionally create an “apartheid by design,” whereby individuals with disabilities are excluded from areas because of the inaccessible layout of these spaces. This apartheid has been seen by some as especially problematic with regard to public transportation, education and health facilities, and perhaps most relevantly places of employment. Physical barriers are also commonly found in the home, with those in poverty more likely occupy tighter spaces inaccessible to wheelchairs. Beyond physical accessibility other potential agents in exclusion include a lack of Braille and shortage of audio tape availability for those who are blind and deaf.

Education
The roots of unemployment are speculated to begin with discrimination at an early age. UNESCO reports that 98 percent children with disabilities in developing countries are denied access to formal education. According to the World Bank at least 40 million children with disabilities do not receive an education thus, experts assert, barring them from obtaining knowledge essential to gainful employment and forcing them to grow up to be financially dependent upon others. This is also reflected in a finding obtained by the World Development Report that 77 percent of persons with disabilities are illiterate. Beyond simply the skills obtained researchers speculate that the societal value of education and the inability of schools to accommodate special needs children substantially contributes to the discrimination of these individuals. It is important to note that the deprivation of education to individuals with special needs may not be solely an issue of discrimination, but an issue of resources. Children with disabilities often require specialized educational resources and teaching practices largely unavailable in developing countries.

Employment
Some sociologists have found a number of barriers to employment for individuals with disabilities. These may be seen in employer discrimination, architectural barriers within the workplace, pervasive negative attitudes regarding skill, and the adverse reactions of costumers. According to sociologist Edward Hall "more disabled people are unemployed, in lower status occupations, on low earnings, or out of the labour market altogether, than non-disabled people." Statistics show that individuals with disabilities in both industrialized and developing countries are generally unable to obtain formal work. In the United States 14.3 of a projected 48.9 million people were employed. Similarly in Belgium only 30 percent of persons with disabilities were able to find gainful employment. In the UK 45 percent of adults with disabilities were found to live below the poverty line. Reliable data on the rate of unemployment for persons with disabilities has yet to be determined in developing countries.

Sociologists Colin Barnes and Geof Mercer demonstrated that this exclusion of persons with disabilities from the paid labor market is a primary reason why the majority of this population experiences far greater levels of poverty and are more reliant upon the financial support of others. In addition to the economic gains associated with employment, researchers have shown that this has also been demonstrated to reduce discrimination in persons with disabilities. One anthropologist who chronicled the lives of persons with disabilities in Botswana noted that individuals who were able to find formal employment “will usually obtain a position in society equal to that of non-disabled citizens.” Because the formal workplace is such a social space the exclusion of individuals with disabilities from this realm is seen by some sociologists to be a significant impediment to social inclusion and equality.

Equity in employment has been strategized by some to depend on heightened awareness of current barriers, wider use of assistive technologies that can make workplaces and tasks more accessible, more accommodating job development, and most importantly deconstructing discrimination.

Implications
The relationship between disability and poverty is seen by many to be especially problematic given that it puts those with the greatest needs in positions where they have access to the fewest resources. Some researchers refer to the link between disability and poverty as a manifestation of a self-fulfilling prophecy wherein the assumption that this population is a drain of resources leads society to deny them access to avenues toward success. This in turn bars these individuals from the opportunity to make meaningful contributions that disprove this negative stereotype, leading them only to live out the limitations others place upon them. Oxfam asserts that this negative cycle is largely due to a gross underestimation of the potential held by individuals with disabilities and a lack of awareness of the possibilities that each person may hold if the proper resources were present.

The early onset of preventable deaths has been demonstrated to be a significant consequence of disability for those living in poverty. Researchers show that families who lack adequate economic agency are unable to care for children with special medical needs, resulting in preventable deaths. In times of economic hardship studies show families may divert resources from children with disabilities because investing in their livelihood is often perceived as an investment caretakers cannot afford to make. Benedicte Ingstad, an anthropologist who studied the lives of families with a member with disabilities, asserted that what some may consider neglect of individuals with disabilities “was mainly a reflection of the general hardship that the household was living under." One Oxfam study converging on this matter concluded that in areas of extreme poverty the rejection of a child with disabilities was not uncommon. The report also went on to show that neglect of children with disabilities was far from a deliberate choice, but rather a consequence of a lack of essential resources – services which “are seized upon” when they are made temporarily available.

Beyond tangible resources, time poverty has also been demonstrated to be a significant barrier to the rehabilitation of individuals with disabilities. Studies show families who work long hours to make ends meet are often unable to dedicate adequate time to the rehabilitation process. Experts point to the Western world as a demonstration that the association between poverty and disability is not naturally dissolved through development. A conscious effort toward inclusive development is seen as essential in the remediation process.

Current initiatives
The United Nations has been at the forefront of initiating legislation that aims to deter the current toll disabilities take on individuals in society, especially those in poverty. In 1982 the UN published the World Programme of Action Concerning Disabled Persons, which explicitly states that  “…particular efforts should be made to integrate the disabled in the development process and that effective measures for prevention, rehabilitation and equalization of opportunities are therefore essential.” This doctrine set stage for the UN Decade of the Disabled Person from 1983 to 1992, where at its close the General Assembly adopted the Standard Rules of the Equalization of Opportunities for Persons with Disabilities. The Standard Rules encouraged states to remove social, cultural, economic, educational, and political barriers that bar individuals with disabilities from participating equally in society. Proponents claim that these movements on behalf of the UN helped facilitate more inclusive developmental policy and brought disability rights to the forefront.

Criticisms
Critics assert that the relationship between disability and poverty may be overstated. Cultural differences in the definition of disability, bias leading to more generous estimates on behalf of researchers, and the variability in incidences that are not accounted for between countries are all speculated to be part of this supposed mischaracterization. These factors lead some to conclude that the projection that 10 percent of the global population belongs to the disabled community is entirely too broad. Speculation over the projection of a 10 percent disability rate has led other independent studies to collect varying results. The World Health Organization updated their estimate to 4 percent for developing countries and 7 percent for industrialized countries. USAID maintains the initial 10 percent figure, while the United Nations works off half of that rate with a projection of 5 percent. The percentage of the world’s population with disabilities remains a highly contested matter.

The argument that development should be channeled to better the agency of individuals with disabilities has been contested on several grounds. First, critics argue that development is enacted to harness potential that most individuals in this population do not possess. Second, the case that health care costs for many persons with special needs are simply too great to be shouldered by the government or NGO’s has been consistently made, especially with regard to emerging economies. Furthermore, there is no guarantee that investing in an individual’s rehabilitation will result in substantial change in their agency. Lastly, is the proposition of priorities. It is argued that most countries in need of extensive development must focus on health ails such as infant mortality, diarrhea, and malaria that are widespread killers not limited to a specific population.

Critique with respect to potential solutions has also been made. In regards to implementing change through policy critics have noted that the weak legal standing of United Nations documents and the lack of resources available to aid in their implementation have resulted in a struggle to achieve the goals set forth by the General Assembly. Other studies have shown that policy on a national level has not necessarily equated to marked improvements within these countries. One such example is the United States where some researchers purport that “the employment of disabled individuals has increased only marginally since the ADA was passed.” This is seen as a flaw in legislation where individuals who do not have access to adequate resources are required to engage in litigation when employment discrimination occurs, though they lack the structural support necessary to initiate this change.