International Labour Process Conference
Athens, April 2015
Models of Disability in Practice: Accounting for the Experience of Disabled Employees in the Workplace
Dr Laura Williams
University of Greenwich
Abstract
Research shows that disabled workers often have negative experiences in the workplace. However, despite the wealth of empirical evidence on discrimination and stigma, theoretical models of disability remain inadequate in comprehensively explaining the work experiences of disabled employees, as they fail to incorporate all aspects of the disability experience. This paper contributes by investigating whether the medical, social or impairment effects model of disability is best equipped to illustrate the work experiences of disabled persons. The data indicates that an expanded impairment effects model is most suitable to reflect the lived experiences of disabled graduates.
Keywords: Models of Disability; Medical Model; Social Model; Discrimination, Impairment Effects
Introduction
It is an established phenomenon that disabled people face disadvantage in the workplace, where their outcomes are unequal to their non-disabled peers (ODI, 2014; Schur et al, 2013). In specific, disabled graduates do not achieve employment that reflects their educational achievements (Burchardt, 2005; Tunnah and Leacy, 2013). Given this disadvantage, there is a growing body of literature that uncovers disabled peoples’ negative experiences at work (see: Barnes and Mercer, 2005; Foster and Fosh, 2010; Fevre et al, 2013; Roulestone and Williams, 2012). Other research focuses on the different types of discrimination, such as individual, institutional and structural (see Pincus, 1996), or, direct, indirect, associative, perceptive, harassment and victimisation, each having a specific legal definition in the Equality Act 2010. Irrespective of which type of discrimination terminology is used, the result is uniform, disabled people face increased discrimination in society that hinders them from full and meaningful employment in the labour market.
There is also a vast body of literature that considers theories which underpin the experience of disadvantage, creating models to conceptualise driving forces behind discrimination (Barnes and Mercer, 2005; Oliver, 1990; Thomas, 2007). The two key theories are the medical and social models of disability; the social model has recently been developed into a nuanced social model called the impairment effects model (Thomas, 2007). This article seeks to reconcile the two bodies of literature on the discrimination faced by disabled people and the models used to understand disability. Using a qualitative study of disabled graduates to comprehend the experiences of disadvantage in employment and applying the different theoretical perspectives, the article focuses on which model most accurately depicts the experience of disadvantage and discrimination.
Competing Models of Disability
Disability research uses the term ‘model’ to generate theory to explain phenomena, using an abstract system or mechanism (Llewellyn & Hogan 2000). Models in disability research are useful to understand how society, the body and impairment interact to create disadvantage. Within the extant literature, the two dominant models that explain the mechanisms of discrimination and disadvantage are the medical model and the social model.
The medical model focuses on the individual and the physiological damage resulting from disease or damage (Llewellyn & Hogan 2000; Oliver, 1992). It attributes discrimination to individuals’ functional limitations (Barnes & Mercer, 2005), and therefore, medical-ises the experience of disability. Under the medical model, disabled people are considered tragic burdens and helpless victims and their exclusion from the labour market is justified on the basis of their, presumed, lack of productivity (Barnes & Mercer, 2005). Although disabled people were disillusioned with the medical model of disability and collectivised to change the way they were viewed in society (Barnes, 1999), it remains dominant in the UK equality legislation. The Equality Act 2010 defines a person’s disability according to medical parameters, which focus on a person’s functional limitations.
The politicisation of disabled people’s dissatisfaction with how they were being represented in society resulted in the emergence of the social model (Barnes, 1999). The social model shifted the focus from the individual’s functional limitations to the barriers in society that hindered participation for people with impairments. The social model locates disability and discrimination as a result of the values of society, modes of production, political economy, physical environments, and the welfare system (Oliver, 1990). Under this social model, it is society which dictates what is “normal” and this view of normality disables those with impairments, who fail to replicate such “normality” (Llewellyn & Hogan 2000). Therefore, the social model claims that if society were organised equitably there would be no disadvantage (Oliver, 1992). Using the social model, disability is caused by institutional, personal and interpersonal processes of oppression and exclusion which are present in most societies, irrespective of their culture or level of economic development (Roulstone et al, 2012). Barnes, (2012) reports that the social model has been so influential in the field of disability studies, that without it, the discipline would not exist.
While the social model promotes the inclusion of disabled people and is a move away from the reductionist medical model, several authors have criticised the social model for being as exclusionary and reductionist as the medical model (Pinder, 1995). The social model excludes the body and reports disadvantage as purely the result of societal forces. In particular, it fails to adequately address the issue of pain, which is an embodied experience and, therefore, cannot be purely socially constructed (Pinder, 1995; Zola, 1991;Best 2007). According to Shakespeare, (1996) focusing simply on the socially constructed disadvantages or functional impairments provides only a partial understanding of disability, which is as negative as only focusing on the body’s functional limitations (Pinder, 1995).
According to the social model, all impairments can be catered for by altering the processes of society and society’s view of ‘normal’ (Barnes, 2011). However, this leads other authors to believe that because of the nature of some impairments, full inclusion in the labour market will never be achieved (Abberley, 1996; Gleeson, 1999; Shakespeare, 1996). Therefore, those who cannot work will be more disadvantaged as they will be viewed as deviant from the norm (Abberley, 1996; Gleeson, 1999; Shakespeare, 1996). Barnes, (1999) proposes that barriers such as these can only be overcome after a, “radical formulation of the meaning and organisation of work” (Barnes, 1999:7).
The social model ignores social differences within disabled people’s lives, such as gender, minority and ethnicity (Humphrey, 2000). Disabled people are not a homogenous group as being disabled does not preclude an individual from being a member of another minority group, e.g. Lesbian, Gay Bisexual and Transgender (Healy et al, 2011). Wider calls in the literature have encouraged disability studies to incorporate disability and ethnicity (Bell, 2010), sexuality (Shakespeare et al, 1996) and social class (Gallagher and Skidmore, 2006). Foster and Williams (2011) suggest that attention should be paid to the theory of intersectionality to explore the nature of the interaction between these multiple memberships that is essential to discovering shared oppressions and integrated interests of disabled people.
Further criticisms are levied at the social model for silencing impairments, where those with invisible impairments feel hindered about talking about their impairment, for fear of breaking the rules of the social model (Humphrey, 2000). Humphrey’s (2000) reports that those with invisible disabilities felt they would be disloyal to the disability cause if they mentioned their impairment.
In response to the criticisms of the medical and social models of disability, Thomas (2007) introduces the idea of impairment effects. The impairment effects model is a non-reductionist materialist ontology of the body and draws on the idea of disablism to encompass the body and society in the understanding of discrimination. Impairment effects relate to the impairment itself; the effect an impairment has on a person to carry out daily tasks, such as a person with one hand being unable to hold a kettle and fill a saucepan simultaneously. Thomas (2007) views impairment effect neutrally, but proposes that disablism occurs if this person is told they are not able to have children or work because of the impairment effect. Disablism is, therefore, the interaction of bio power and bio politics, where the issues of impairment and disability interact (Thomas, 2007). The notion of disablism echoes early feminist interpretations of disadvantage caused by social oppression (see Morris, 1991). The body is simultaneously biological, material and social – bio social. Bodily variations are only seen as impairments in certain cultures, defined by what a society views as ‘normal’, therefore the bio material intersects with the bio social and both need to be considered (Thomas, 2007).
Given the competing models of disability present in the literature, what model explains the discrimination faced by the disabled graduates in the sample? This research question will be explored by answering questions such as: what discrimination do the disabled graduates face, why does this occur and what contingencies explain variation in the pattern?
Methodology
Disabled graduates were the focus of the research because extant literature shows the poor employment opportunities of graduates, where returns on education are low (Brown and Hesketh, 2004; Qenani et al., 2014). Disabled graduates face compounded disadvantage where their educational qualifications do not result in the same level of employment as non-disabled graduates (Tunnah and Leacy, 2013). Therefore, given this bleak picture of disabled graduate employability it was interesting to ascertain which model of disability more accurately helps understand their experiences of work.
An inductive, exploratory approach guided the research. The results emanate from a UK wide study of 67 participants that was completed during 2010-2011, during an economic downturn in the UK. The research results therefore, may be limited to being relevant to economic downturn, where research shows that recessions have a greater impact on disabled people (Hogarth et al. 2009). This point, therefore, means the disadvantage experienced by the disabled graduates could be more marked than in buoyant economic periods. The data on which the article is based was part of a wider research project that examined the labor market experiences of disabled graduates in regard to recruitment and selection, implementation of equality legislation, the role of external agencies to support disabled graduates and benefits received in lieu of employment.
A qualitative approach of eliciting personal narratives gave voice to the disabled graduates, based on the work of Albrecht (1992) who stated that the people who live with impairments are the experts on the impacts of disability, not doctors, social workers or researchers. Using personal narratives allows the research to address concerns by Watson (2012) that disability research has been unable to uncover the experience of living with a disability. The personal narratives allow unique insight into the lives of the disabled graduates and their personal experiences. Rich data were gathered through common understandings that were generated through a shared disability identity between the researcher and participants. A broader debate in the disability literature focuses on the impact of non-disabled researchers, researching disability issues. It has been advocated that disabled people are most suitable to undertake disability research (Barnes and Mercer, 2005; Charlton, 1998; Morris, 1992; Shakespeare, 1996), while Stone and Priestly (1996) argue that only disabled researchers should engage in disability research. The benefits of this shared understanding are richer contextual data created through more “natural” conversation between the researcher and participant and the production of relevant research created through increased reciprocity.
The research included a wide variety of participants in order to provide a context to the stories of the disabled graduates. While the graduates remained the focus of the research, including additional employment actors added depth and breadth to the research. Support organisations were interviewed because it became apparent that they played a large role in the disabled graduates’ lives and the best method of collecting this data was by interviewing representatives of these organisations. The Member of Parliament was interviewed to gather data about the situation surrounding the implementation of the Disability Discrimination Act 1995 to obtain information which was not available in the public domain. The Disability Employment Advisor was interviewed to ascertain the type of support disabled people receive from the Jobcentre Plus and to uncover key issues the DEA faced in supporting disabled people. The Access to Work employees were also interviewed because they were significant in the disabled graduates’ working lives. Therefore, it was important to speak to them directly to see how they supported disabled people and the issues they faced.
To ensure the disabled graduates’ anonymity, the additional actors interviewed were from different organisations to the disabled graduates. Despite the important role of line managers identified in existing literature, HR managers were selected in lieu of line managers because it was more likely that HR would have greater experience of dealing with disability in the workplace and be more aware of organizational policies regarding equality and are seen as key mediating agents (Hoque and Noon, 2004). The increased range and breadth of participants facilitates data triangulation to allow increased confidence in the results, deeper understanding and explores the interactivity of social life and a variety of perspectives (Dingwall, 1992).
A purposive opportunist sampling strategy was used, with advertisements placed in media channels such as Linked-In, general disability and impairment specific websites and the published disability press. The sample was difficult to locate, with the disabled graduates being contacted first. Any graduate who volunteered and had graduated or experienced university since 1995[1] and self-defined themselves as disabled was included in the sample. The sample did not formally represent the disabled population; however it provided insight into the experience of employment from a number of different perspectives; workers, employers, and external actors. Potential implications of the sampling process are; a bias towards those who are more IT literate. Mossberger at al., (2008) reports that those who use the internet are more socially aware and have greater access to educational capital and citizenship activities, and therefore more likely to be aware of their rights. Secondly, a greater proportion of disabled graduates in the sample worked in the disability sector, which was unanticipated. Therefore, organisation specific results will be more related to the third sector and less relevant to public and private sectors. Another sampling bias is the high portion of graduates with higher degrees. This bias was also unanticipated but would seem to reflect that those who are unable to access the labour market want to be productive and continue to study. It would appear this is could be a feature of the population because the sampling process did not favour those with higher degrees. For example, poster advertising which was distributed through universities and alumni communications did not yield any participants.