The Disability Squeeze
The disability squeeze is the experience of simultaneously
have less income and more expenses due to a disability.
When it comes to work, the squeeze may come from having to
accept a lower paying job on one end and having to pay more for accessibility accommodations
in order to be able to work on the other.
...people
with disabilities often require additional disability-related goods and
services that those without disabilities do not.22,23 These needs are reduced by
existing disability policy supports. However, because such supports are often
insufficient, the remainder must be purchased OOP or foregone. Those who can
afford to purchase the remainder OOP incur disability-related expenses, while
those who cannot afford their needed items experience unmet needs. Many will
experience both OOP expenses and unmet needs. The disability squeeze results
from both forms of financial pressure and increases the risk for negative
social, economic, and health outcomes. From
<https://www.sciencedirect.com/science/article/pii/S1936657425001591?via%3Dihub>
When it comes to healthcare the squeeze is often created by having
more health needs on one end, and greater out of pocket expenses from uncovered
accessible equipment, transportation and health items generally not covered by
insurance (vision and hearing health being foremost.)
When these two squeezes combine, it can become a bind that
patients cannot escape from on their own.
However, public assistance is often designed to keep people barely
surviving within this cycle of poverty rather than giving them the resources to
be able to get out of it and live their best, healthiest life. Therefore, the
disability squeeze is also a health equity issue.
The disability itself is often not the problem, but rather
the entire social and economic system that puts the financial burden, time and
coordination of accommodations onto the person.
If each business, health care providers, and public policy had built in and
already functioning accommodations and policies for working, living and caring
for a diversity of patients it would greatly reduce the pressure of the squeeze
and lead to better health outcomes for people living with a disability.
Researchers at Stony
Brook University, the University of Tennessee, National Disability Institute
and the Oxford Institute of Population Ageing found that a household containing
an adult with a work-limiting disability needs on average 28% more income to
reach the same standard of living as a comparable household without one. At
median household income that is roughly $17,690 a year, paid in equipment,
repairs, transport, medication, accessible housing, delivery fees and hours
lost to paperwork. From
<https://www.forbes.com/sites/keelycatwells/2026/08/10/why-more-young-people-are-using-mobility-aids-and-why-thats-good-news-for-employers/>
Reducing that pressure comes from integrating access into
daily life and creating a culture and expectation of accessibility. The Americans with Disabilities Act, passed 36
years ago, directs federal, state and private entities to build into their
daily operations accommodations for those with disabilities. All citizens should have equal access to the
services rendered by governments and business open to the public whether in
person or virtually. Congress’s intent
was that each government and business would build access into their business
model. Since then, various guidelines,
best practices and regulations have been set to guide what access looks like
and how it is best implemented.
Funding
Congress did not fund the ADA specifically as the
expectation was that every entity would participate in creating a culture and
society that is accessible to all. The
government isn’t going to fund it because it is something everyone is expected
to do. It’s not a special program or added
convenience, it is assuring the basic human right to participate in society and
have equal access to goods and services. The cost of accommodation cannot be handed onto
the consumer either. Disabled consumers experiencing
the disability squeeze are already at a disadvantage; charging extra for
accessibility would only exacerbate the problem.
Have a Plan
Accessibility is something that should be worked into every
business plan and procedure manual before doors even open for business, not an
add on later once a customer in need shows up.
All of those sit
within an organization's control. This is a commercial point as much as a moral
one, because it moves the work of adaptation from the individual, who cannot
rebuild the station, to the institution, which can. From
<https://www.forbes.com/sites/keelycatwells/2026/08/10/why-more-young-people-are-using-mobility-aids-and-why-thats-good-news-for-employers/>
Businesses should not wait until consumers who need access come
and educate them on the law and methods of access. This is placing the burden on people who are
already dealing with the financial, time and health effects of the disability
squeeze. Public policy makers should not
make accessibly laws complaint based, but rather assure accessibility is required,
inspected and at the ready when consumers need it. Having working accessibility options are good
for consumers and good for business employees to. Employees never want to be left scrambling for
a solution when a consumer is right in front of them.
Accessible Prescription Labeling
In 2013 the United States Access Board drafted accessible
prescription labeling best practices.
The goal of the best
practices for accessible prescription drug container labels is to offer
guidance to pharmacies on how to provide accessible prescription drug container
labels to patients with visual impairments to enable them to manage their
medications independently and privately and have the confidence that they are
taking their medications safely, securely, and as prescribed. From
<https://www.access-board.gov/rx.html>
The key to providing
accessible prescription drug container labels is patient-centered communication
between pharmacists and patients with blindness and visual impairment and
patient representatives. Because the extent of visual impairment varies from person
to person, some patients may need prescription drug container labels in an
audible format, while others may need braille, and still others may need large
print. Additionally, it is important to keep in mind that visually impaired
patients who are not computer savvy may need hard copy braille or large print
labels, or a dedicated electronic method that is easy to operate. From
<https://www.blogger.com/blog/post/edit/2087516552394474395/5674862695633122502>
Prescription labeling was important enough to public safety to made into a law, it stands that it's important enough to provide that information in a format every patient can access. Pharmacies providing and covering the cost of accessible prescription
labels can ease the squeeze and simultaneously provide life-saving access to health information so patients can make
informed health care related decisions.
With current profit margins so low, no pharmacy wants to have unnecessary added expenses. However, increasing profit margins can't come from ignoring the basic human right to informed health care for vulnerable patients, who are often already bearing the financial and time burden of navigating the world with a disability.
