The Relationship Between Material Hardship and Income among US Women with and without Disabilities

Background and Purpose Previous research has established that women with disabilities have elevated rates of poverty as compared to the rest of the US population. However, little is known about the extent to which these women live with material hardship, or how income and hardship is related for them. We sought to address 2 research questions: (a) What is the extent of material hardship for US women with and without disabilities? (b) What is the relationship between income and material hardship among women with and without disabilities?

Methods Multivariate logistic regression was employed to analyze the 2002 National Survey of America's Families (NSAF) to describe the relationship between income and material hardship among US women with disabilities ((n=4,130) and women without disabilities (20,731 nondisabled women). Nine measures of hardship were analyzed in 4 domains: food insecurity, housing instability, telephone disconnection, and inadequate health care. Simple bivariate analyses included an examination of unadjusted rates of hardship for each indicator, mean number of hardships, and the proportion of women reporting hardship in >1 of the 4 domains. Women were also stratified by their household income in relation to the federal poverty level (FPL) to examine their rates of hardship relative to income. Multivariate logistic regression was used to examine the likelihood of experiencing hardship, adjusting for marital status, number in family, age, race, income, and education.

Results Across all 9 indicators and across all income strata, women with disabilities experienced significantly elevated rates of material hardship as contrasted with nondisabled women.

Outcomes were worst for poor and low-income disabled women. For example, 53% and 45% of poor and low-income disabled women experienced hardship in >1 hardship domains, respectively.

Although hardship declines as income rises for all women, those with disabilities showed worse outcomes at every income level, and experienced significant levels of hardship well into middle-and upper-income ranges. For example, 19% of disabled women with income ≥300% of the federal poverty level reported hardship related to health care and the mean number of hardships experienced by disabled women at this income level was 1.14.

Disabled women's rates of hardship remain significantly higher than nondisabled women's rates, even when individual characteristics were controlled: in multivariate analyses, disabled women were at least twice as likely to experience each indicator of hardship as nondisabled women.

Conclusions and Implications Despite being eligible for a host of income transfer and other social welfare benefits, women with disabilities still experience substantially higher rates of material hardship than nondisabled women. Hardship is experienced at rates that far exceed their rates of income poverty. These results suggest that public policy needs to be changed in order to efficiently and effectively target those who are most in need of assistance, including women with disabilities, to obviate deprivation. The federal poverty level, used to define income poverty as well as to determine eligibility for a host of US social welfare programs, does not accurately capture women's experiences of material hardship, and these discrepancies are significantly worse among women with disabilities.