Advancing the Inclusion of Persons with Disabilities 2004

Executive Summary

A Government of Canada Report 2004

Introduction

Advancing the Inclusion of Persons with Disabilities 2004 is the Government of Canada’s second comprehensive progress report on disability in Canada. In providing this report, the Government hopes to help Canadians better understand the answers to four related questions:

• What does inclusion mean, and what are its key elements?
• How close is Canada to fully including persons with disabilities in society?
• How can progress toward inclusion be measured?
• How does the Government of Canada help advance inclusion? 

To help answer these questions, Advancing Inclusion 2004 presents information about Canadians with disabilities, their families, the challenges they face in fully participating in Canadian society, and Government of Canada policies, programs and initiatives that address these challenges. 

The first federal report on disability, Advancing the Inclusion of Persons with Disabilities 2002,^[1] introduced an “accountability framework” - the first attempt at a framework that would allow Canadians to assess these questions. The 2002 framework identified important aspects of inclusion, provided indicators to measure those aspects and linked Government of Canada actions to the indicators. 

To improve the 2002 framework, the Government asked a range of interested parties, including 30 federal departments and agencies as well as 23 national disability organizations and Aboriginal groups, for their suggestions. Thanks to responses from them and others over the past two years, Advancing Inclusion 2004 has been able to build on the groundwork of the first report to present an improved accountability framework.

The new framework is built around six aspects of inclusion, or outcome areas (see Figure 1): 

• disability supports
• skills development and learning
• employment
• income
• capacity of the disability community
• health and well-being

These six outcome areas are understood by governments and the disability community to represent key aspects, or building blocks, of full inclusion. Not everyone needs equal support in all of the areas. But inclusion is most likely when the experiences of Canadians with disabilities in these areas are similar to the experiences of other Canadians.

Figure 1: Major aspects of inclusion

Disability Supports Health and Well-being Skills Development and Learning Inclusion Capacity of Disability Community Employment Income

For each outcome area there is a set of indicators of progress. Indicators are measures that governments use to identify issues, monitor progress and report to citizens. This report uses 29 indicators of progress (see Figure 2). Most of the indicators presented in the 2002 report are still here, and some new ones have been added.

This report also continues the approach used in 2002 of incorporating unique information about Aboriginal people with disabilities into each chapter.

In December 2003 the Government of Canada and provincial governments endorsed the Multilateral Framework for Labour Market Agreements for Persons with Disabilities.^[2] Advancing Inclusion 2004 is designed to meet the Government’s reporting commitments under this new initiative.

Advancing Inclusion 2004 addresses a range of issues so that it can broadly assess Canada’s success in including persons with disabilities. Provincial and territorial governments, municipalities, non-profit and voluntary organizations, researchers, the private sector and Canadians as a whole all do a great deal to advance inclusion. However, this report applies a narrower focus when reporting on actions to improve inclusion, and looks only at the Government of Canada’s contributions. 

An Overview of Disability in Canada

Disability is part of the human experience. One in eight Canadians has a disability - a total of 3.6 million people. For Canada’s Aboriginal population, the rate of disability is particularly high-more than one and a half times the rate for the non-Aboriginal population. Women are more likely than men to have a disability, regardless of age. Women on average also live longer, which makes them more likely to develop an age-related chronic condition that leads to disability.   

Three quarters of Canadians without disabilities know someone with a disability, most often a family member or friend. As well, an estimated 2.8 million Canadians provide support to a family member or friend with a long-term health condition or disability.

There are many types of disability, and many Canadians have more than one type. Disabilities related to mobility, agility and pain are the most common types in Canada, with hearing disabilities next.

Disability can affect us at any point in our lives. Some people are born with disabilities, while others experience them later in life because of accidents, illness or disease. In Canada disability rates are lowest among children and highest among seniors. Given Canada’s aging population and the higher rate of disability among seniors, more and more Canadians can expect to be affected by disability in the future, either directly or through caring for a relative or friend with a disability. 

More than 80% of Canadians believe there has been some progress in including people with disabilities in Canadian society over the past decade. Yet only one in ten believes these individuals are fully included today. Canadians feel that people with disabilities should have the opportunity to participate in life to their fullest potential-that this is part of the “Canadian way” of doing things. Most feel that while the solutions might be expensive, they are necessary and the social benefit is worth it. 

Government Action - Examples

For us to better understand disability in Canada, we need regular collection of detailed information, both national and regional, about people with disabilities. The Government of Canada is working to build the knowledge base on disability so that we can know more about disability and inclusion. The Government has developed three important new information sources:

• the 2001 Participation and Activity Limitation Survey (PALS)^[3]

• a 2003 report that explores definitions of disability in the Government’s major policies and programs

• a 2004 national survey of Canadians’ attitudes toward disabilities

Disability Supports

Disability supports are products and services that help people with disabilities carry out activities of daily life.  Having access to needed disability supports in ways that enable people to make choices, pursue their own life paths, and secure citizenship is the foundation for full participation at home, school and work, and in the community.

Many supports are directly for individuals with disabilities, but others assist family members. Accessible environments such as public buildings, transportation systems and information media are also essential for people with disabilities to be included in everyday life. 

Key Findings

• Over 2 million Canadian adults with disabilities need assistive aids and devices. About 67% of these adults have all their needs met.

• Roughly half of children with disabilities have all the assistive aids and devices they need.

• About two thirds of adults who need help with everyday activities get all the help they need.

• Family members play a major role in helping with everyday activities.

• Cost and accessibility are the two main barriers preventing people with disabilities from getting the personal supports they need.

• Transportation still presents challenges for many people with disabilities. Their ability to travel often depends on the accessibility of transportation systems.

• The publication of information in multiple formats in Canada is increasing but the number or publications is still minimal

Government Action-Examples

• Most supports for individuals and caregivers are provided through programs administered by the provincial and territorial governments. The Government of Canada plays a key role in supporting these programs through its financial transfers to the provinces and territories. 

• The Veterans Independence Program is a national home-care program that Veterans Affairs Canada offers to veterans and certain civilians who qualify. This program’s expenditures increased from $171.2 million in 2001-02 to $201 million in 2003-04 and are expected to continue upwards until 2010.

• In 2003 the Canada Mortgage and Housing Corporation introduced improvements to the Residential Rehabilitation Assistance Program for Persons with Disabilities. The program also received additional funding for a three year extension.

• In 2004 the Canadian Transportation Agency introduced the new Code of Practice for Removing Communication Barriers for Travellers with Disabilities. Transportation service providers covered by the code must implement its provisions by 1 June 2007.

• The 2004 federal budget introduced a new disability supports tax deduction to better recognize the cost of disability supports needed for work and school. The deduction, at an annual cost of $15 million, came in response to an early recommendation from the Technical Advisory Committee on Tax Measures for Persons with Disabilities. 

Skills Development and Learning

Skills development and learning opens many doors. It gives us more opportunities to be employed, to earn a good income and to gain a high standard of living for ourselves and our families. Like all Canadians, people with disabilities want and need the chance to learn, develop their skills to the fullest potential and make use of their talents and ideas. Canadians with disabilities want to participate in society as lifelong learners, but the evidence suggests that they still face barriers in this area.

Key Findings

• Of children with disabilities (aged 5 to 14), 95% attend school. Most of them go to a regular school. Children with learning disabilities are the most likely to use special education services.

• Among working-age adults with disabilities (aged 15 to 64), over one third have less than a high-school education, compared to one quarter of those without disabilities. 

• About one in ten working-age adults with disabilities has a university degree, compared to one in five without disabilities. 

• Aboriginal people with disabilities have a lower rate of post-secondary completion than other Canadians with disabilities.

• Many individuals with disabilities need one or more types of support to participate fully in education. Technical aids and human support are the school supports needed by most students with disabilities. 

Government Action-Examples

• The main responsibility for learning and skills development programs and services rests with the provincial and territorial governments. But others play a role as well-businesses, educational institutions, the voluntary sector and individuals themselves. The Government of Canada is committed to working with provincial and territorial governments and other partners to give all Canadians lifelong access to skills development and learning.

• The 2004 federal budget introduced a new upfront grant of up to $2,000 a year for students with permanent disabilities. It also announced a new grant for dependent first-year students (with and without disabilities) from low-income families who are in their first year of post-secondary studies.

• Indian and Northern Affairs Canada launched its Special Education Program in 2003. The program will work to improve the quality of education and the level of support services for qualifying First Nation children with moderate to profound special education needs.

Employment

Governments and the disability community agree-finding a good job is key to the quality of life and financial well-being of people with disabilities. Employment among Canadians with disabilities has shown modest improvement in recent years. But Canada, even with its aging society and potentially shrinking workforce, is not fully benefiting from the employment potential, skills and talents of people with disabilities. 

Key Findings

• The employment rate for persons with disabilities aged 16 to 64 increased by 5% between 1999 and 2002. 

• The representation of persons with disabilities in the federal public service has increased each year since 1997.

• Still, in 2002, employment rates were only 53% for people with disabilities compared to 76% for people without. 

• Aboriginal adults with disabilities are almost twice as likely to be out of the workforce as Aboriginal adults without disabilities.

• Many working-age adults with disabilities who are unemployed or out of the workforce have the potential to work if they have access to the necessary supports. 

• On average, people with disabilities earn an hourly wage nearly equal to (about 96% of) the wage of those without disabilities.

• Disability affects the employment of family caregivers. For example, over half of the parents of children with disabilities report that their child’s condition has affected the family’s employment situation.

Government Action-Examples

• Supporting the employment of persons with disabilities is a shared responsibility involving federal, provincial and territorial governments; employers; the voluntary sector; and individuals with disabilities themselves.

• The Government of Canada and provincial governments endorsed the Multilateral Framework for Labour Market Agreements for Persons with Disabilitiesin December 2003. Bilateral agreements were signed under this framework, which replaces Employability Assistance for People with Disabilities (EAPD). Under the new agreements the Government of Canada funds provincial labour market programs and services for Canadians with disabilities.

• The 2004 federal budget provided another $30 million a year to the Multilateral Framework for 2004-05 and subsequent fiscal years, bringing the total federal funding to $223 million a year.

• In the 2004 budget the Government of Canada committed to ensuring that its policies do more to promote the hiring and retention of people with disabilities in the Government. It also pledged to encourage similar action on the part of private employers in the federally regulated sector. 

• Launched in April 1999, the Aboriginal Human Resources Development Strategy helps Aboriginal people, including those with disabilities, prepare for, find and keep jobs. This program is available to all Aboriginal people-Inuit, Métis and First Nations, on or off reserve. In 2004 funding for the strategy was renewed for five more years, for a total investment of $1.6 billion (about $320 million a year).

• The Opportunities Fund for Persons with Disabilities is a $30-million-a-year employability program for people with disabilities who have had little or no attachment to the workforce. The program funds initiatives that help these clients increase their economic participation and independence by preparing for, finding and keeping jobs or becoming self-employed. The Opportunities Fund serves around 3900 people with disabilities each year. Program officials are now reviewing its current and future roles.

Income

Having enough income to meet their needs and to be active in their community is essential to the well-being and inclusion of people with disabilities. The income available to individuals with disabilities is affected by a number of interrelated factors, such as the ability to earn income through employment, the adequacy of income support programs and the cost and availability of disability supports. 

Key Findings

• The average after-tax income of working-age adults with disabilities (aged 15 to 64) rose by 6.7% between 1999 and 2002, but by 8.5% for those without disabilities. 

• On average, working-age adults with disabilities took in 80% of the household income of those without disabilities in 2002. For seniors with disabilities the amount was 95%.

• In 2002 15% of adults with disabilities (aged 16 to 64) lived in low-income households - more than double the percentage of adults without disabilities. 

• Among working-age adults, those with disabilities are three to four times more likely to have government transfers as their main source of personal income than those without disabilities. But the percentage of those with disabilities citing transfers as their main source of income fell by 5% from 1999 to 2002.   

• Aboriginal people, low-income families of children with disabilities, adults with severe disabilities and those living in small or rural communities face added income difficulties.

Government Action-Examples

• Provincial and territorial social assistance plans supply income to many people whose disabilities prevent them from gaining significant work experience. The Government of Canada provides critical support to these programs in the form of financial transfers. 

• The Canada Pension Plan (CPP) administers the country’s largest long-term disability insurance plan, available to any contributor who meets the eligibility requirements. The CPP was amended in 2004 to permit automatic reinstatement of disability benefits. Once the amendment comes into force, CPP disability beneficiaries who return to work will have their benefits quickly reinstated if they can no longer work because their disability recurs. 

• A new Child Disability Benefit was introduced in the 2003 federal budget. The benefit now provides up to $1,653 per child to help low- and modest-income families with the cost of caring for children with severe and prolonged disabilities. 

• A number of income tax measures make sure that people with disabilities and their caregivers are treated fairly. In August 2002 the Government of Canada responded to a House of Commons committee report concerning persons with disabilities by promising an evaluation of whether the disability tax credit is meeting its policy purpose. The evaluation was published in the 2004 Tax Expenditures and Evaluations report.

• In 2003 the Government created the Technical Advisory Committee on Tax Measures for Persons with Disabilities to advise the Government on how to improve tax fairness for persons with disabilities and those who care for them. The 2003 budget also set aside $25 million in 2003-04,^[4] and $80 million a year thereafter, to improve tax fairness for these Canadians, drawing on the advice of the advisory committee and the evaluation of the disability tax credit.

Capacity of the Disability Community

Individuals, organizations and communities all play an important part in advancing the inclusion of persons with disabilities in Canada. But to do this, they need support and resources to run programs effectively, to contribute to policy and program development, to be involved in civic and volunteer activities and to otherwise participate as full partners in society. Building the capacity of disability organizations is crucial to achieving these goals and to advancing inclusion.

Key Findings

• Most disability organizations work in the area of health and social services.

• Capacity trends in the disability community parallel those in the non-profit and voluntary sector as a whole.

• People with disabilities participate in community-building activities in many ways, including volunteering.

• Disability organizations face significant hurdles in obtaining the type of paid staff they need.

• The ongoing struggle to get financial resources demands a large commitment from disability organizations and sometimes limits their ability to meet their mandate.

• Almost half of disability organizations report capacity problems in areas such as administrative systems, information technology, software and databases.

Government Action-Examples

• The Voluntary Sector Initiative (VSI) was renewed in the 2004 budget at $3 million a year. Established in 2000, the VSI focuses on strengthening the voluntary sector’s capacity to collaborate and innovate. It does this through projects like Connecting People to Policy, which built the disability community’s capacity to participate in the policy process.

• The Social Development Partnerships Program (SDPP) was created in 1998 to fund national non-profit groups that work on social development for people with disabilities, children and their families, and other vulnerable or excluded groups. The program’s disability component (SDPP-D), funded at $13 million in 2004-05, focuses on the capacity of disability groups, helping them organize projects and respond to issues. The program also funds educational bodies, research institutes, professional associations and Aboriginal bands or tribal councils to develop their own strategies for including people with intellectual disabilities in work and community life. 

Health and Well-Being

Health is more than the absence of disease - it is the physical, mental, emotional and spiritual capacity to live fully. Many factors, including human biology, the health care system, individual behaviour and social and economic conditions, can affect health. The Government of Canada, following a “population health” approach, takes this full range of factors into account in its decisions and actions to protect and improve Canadians’ health. People with disabilities share the same desire for health and well-being as other Canadians. However, evidence shows that they face many disadvantages in this area.

Key Findings

• Over a quarter of adults with disabilities rate their health as fair or poor, compared to under 5% of adults without disabilities.

• Seniors with disabilities (aged 65 and over) have the poorest health of all Canadians.

• Chronic diseases account for 87% of disabilities and are strongly linked to poor health among people with disabilities.

• Serious injuries are a leading cause of disability in younger age groups, and injuries are a significant cause of disabilities that arise in senior years.

• Among people with disabilities, those who have higher incomes, post-secondary education and full employment throughout the year report better health.

• People with disabilities are more likely to report not getting needed health care than those without disabilities.

• Aboriginal people with disabilities are more likely to rate their health as fair or poor than non-Aboriginal Canadians with disabilities.    

Government Action-Examples

• The Government of Canada funds provincial and territorial health care systems, public health protection, health promotion and many health research projects that benefit people with disabilities.

• Health Canada funds and supports the Active Living Alliance for Canadians with a Disability. This group provides national leadership, support, encouragement and information to organizations and individuals with disabilities to promote health through active living.

• In 2002 Veterans Affairs Canada and the Department of National Defence launched a  strategy for assessing and treating post-traumatic stress disorder and other operational stress injuries. The strategy is for veterans, current and former Canadian Forces members, eligible RCMP personnel and families of those with post-traumatic stress disorder and other operational stress injuries resulting from military service.

• The First Nations and Inuit Home and Community Care Program offers an array of home-care services to First Nation and Inuit people with chronic and acute illnesses. The goal is to help these people maintain optimum health, well-being and independence in their own homes and communities.

Expenditures and Conclusion

Expenditures

Advancing the Inclusion of Persons with Disabilities 2004 focuses mainly on inclusion and the results of Government of Canada programs. However, for a more complete picture, it is also important to look at the Government’s total disability-related expenditures.   Figure 3 shows a breakdown of the roughly $7.5 billion the Government spent on disability in 2003-04. This breakdown reflects the cumulative effect of spending decisions over the past number of years.

Coming up with a single number for the Government of Canada’s disability-related spending is difficult. That is mostly because certain expenditures that may assist people with disabilities are not exclusively designed to do so. Government expenditures can be grouped into three categories: (1) measures that exclusively target people with disabilities and their families, (2) measures that have a significant disability-related component and (3) measures for the general population.^[5]

Income support expenditures have long been the cornerstone of the Government of Canada’s support for persons with disabilities. For the past four decades the Government has administered the country’s largest earnings replacement program, the Canada Pension Plan’s disability component. As well, recognizing its unique responsibility toward veterans with disabilities, the Government has historically contributed to income support for this group. Spending on the Veterans Disability Pension Program has risen in recent years, from over $1.3 billion in 2001-2002 to over $1.5 billion in 2003-2004. 

Besides income support measures, the Government has recently introduced or improved tax relief and tax benefits to recognize that people with disabilities and their caregivers face extra expenses. Since 1996 the Government of Canada’s investment in tax measures has doubled.

Other programs have become spending priorities as well. Programs that encourage skills development and employment, such as those under the Multilateral Framework for Labour Market Agreements for Persons with Disabilities, have seen added investments. So have programs related to disability supports, such as the Veterans Independence Program and the Canada Mortgage and Housing Corporation’s renovation programs.

Figure 3: Government of Canada expenditures 2003-2004 (millions)

Income support: $ 5,499 Tax measures: $1,345 Other programs: $ 626

Conclusion

The Government of Canada believes that the information in Advancing Inclusion 2004 represents a considerable step forward in assessing Canada’s progress toward full inclusion of persons with disabilities. Even so, how we understand disability and inclusion and how we measure them will continue to change over time. As a result, the accountability framework used in this report will evolve as governments and Canadians gain experience in measuring and reporting on inclusion. And we will continue to benefit from better information in the form of more surveys, research and program evaluations.

Advancing Inclusion 2004 shows evidence of limited improvement in some areas such as employment, and difficulty in others such as community capacity. This mixed assessment may be due to the complex and varied nature of disability itself and the many avenues we must take to achieve full inclusion. Nonetheless, the Government of Canada will continue to work with its many partners, both to reach the goal of full inclusion of persons with disabilities in Canada and to improve our ability to assess progress along the way.
 

Contributing Departments and Agencies

As this report has shown, many Government of Canada departments and agencies have programs and services for persons with disabilities. The departments and agencies listed below directly contributed information to this report and assisted with reviews and comments. Their participation is gratefully acknowledged.

• Agriculture and Agri-Food Canada 
• Canada Mortgage and Housing Corporation 
• Canada Revenue Agency 
• Canadian Heritage 
• Canadian Human Rights Commission
• Canadian Institute for Health Information
• Canadian International Development Agency 
• Canadian Transportation Agency 
• Citizenship and Immigration Canada
• Correctional Service Canada
• Department of National Defence/Canadian Forces
• Elections Canada
• Environment Canada
• Finance Canada
• Health Canada
• Human Resources and Skills Development Canada
• Indian and Northern Affairs Canada
• Industry Canada
• Justice Canada
• Library and Archives Canada
• Privy Council Office 
• Public Health Agency of Canada
• Public Service Commission of Canada
• Public Service Human Resources Management Agency of Canada
• Public Works and Government Services Canada
• Social Development Canada
• Social Sciences and Humanities Research Council of Canada
• Statistics Canada
• Status of Women Canada
• Transport Canada
• Treasury Board of Canada Secretariat
• Veterans Affairs Canada