[Preface 9/6/13: I am enjoying the app.net discussion thread on this with @duerig and @clarkgoble. When reading this, try substituting TRREP - Trait that Reduces Relative Economic Productivity for the word "disability". Also, please note disability is not inability. In my experience parenting/coaching two children with disabilities I think of managing disability like building a railroad across mountainous terrain. Sometimes reinforce, somethings divert, always forward.]
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Anosmia is not a disability.
Well, technically, it is. Humans are supposed to come with a sense of smell. For most of human existence anosmia was a significant survival problem. At the least, it helps to known when food has gone bad. So Anosmia is a biological disability.
In today's America though, there's not much obvious economic downside to anosmia. Diminished appetite is more of a feature than a defect. There are many jobs where a keen sense of smell is a disadvantage -- including, I can assure you, medical practice. Anosmia is a biological disability, but it's not an economic disability. Not here and now anyway -- once it would have been.
Disability is contextual, it's the combination of variation, environment and measured outcome that defines disability.
What about if I lose my right leg? Am I disabled then? Well, if I delivered mail I'd have a problem -- but in my job an insurance company would snort milk out its proverbial nose if I tried to claim longterm disability.
I think you can see where I'm going with this. Stephen Hawking is an extreme example -- you can have a lot of physical disability and not be economically disabled.
So how can I become disabled?
Probably not through my "risky" CrossFit hobby, but my benign bicycle commute is another matter. Until that glorious day when humans are no longer allowed to drive cars, I'm at risk of a catastrophic head injury. An injury that may impact my cognitive processing, my disposition to use cognition ("rationality"), my judgment and temperament -- and leave me as completely disabled for high income work as if I were 85 [1]. At that point, barring insurance, I'm economically disabled and impoverished.
Clearly, acquired cognitive injury can be disabling. So what of congenital cognitive disorders like low functioning autism or severe impulse disorders? Impulsivity, inability to plan, very low IQ ... Clearly disabling. Without income support from family or government, extreme poverty is likely.
Ahh, but what of those born with average IQ, average rationality, average judgment, average temperament? Employment is likely -- but earnings will be limited. To be average in the economy of 2013 is to sit on the borderline of poverty -- and of disability. The difference will be decided by other factors, factors like race, location, and family wealth. An average person who looks and acts "white" and is born to a middle class family in Minnesota may make it into the dwindling middle class (for a time), an average person who looks and acts "black" and is born to a poor family in Mississippi is going to be impoverished.
Which brings me to my question - for American adults are poverty and disability the same thing? Not entirely -- race, residence, and family income have an impact, particularly within some ill-defined "middle range" of "native disability". Not entirely -- but they are clearly related.
How related? Consider this OECD graph of poverty rates across nations with very different cultures, attitudes and histories:
![pov_taxtrans.png Pov taxtrans](//lh4.ggpht.com/-KfPV06RiW9c/UlCDh_qYIAI/AAAAAAAAAZA/evqo36i0D4Y/pov_taxtrans.png?imgmax=800)
Across Finland, Denmark, Sweden and the US we see a "natural" or baseline (pre-transfer) adult poverty rate of 24-32%, with Swede and the US both at 28%. Not coincidentally, 30% is what I suspect our baseline rate of mass disability is today.
We can and should deal with poverty-enhancing factors like racism, unfunded schools and the like. That will make a difference for many -- and, if all goes well, we might get the US baseline poverty rate to be more like Denmark's. We'll go from 28% to 24%. Ok, maybe, in a perfect world, we get our baseline rate from 28% to 20%. Maybe.
To really deal with poverty though, we need to understand what real disability is. Economic disability in 2013 isn't a missing leg, it's poor judgment, weak rationality, low IQ, disposition to substance abuse. To conquer poverty, we will need to conquer disability - either with Danish style income transfers or with something better.
I think we can do better.
- fn -
[1] Social security is simply a form of insurance for age-related disability with an arbitrary (but pragmatic) substitution of chronology for disability measurement.
See also