Guest editorial The benefits of inclusion: disability and work in the 21st century

Emile Tompa (Institute of Work and Health, Toronto, Canada) (Department of Economics, McMaster University, Hamilton, Canada)
Daniel Samosh (Centre for Industrial Relations and Human Resources, University of Toronto, Toronto, Canada)
Alecia M. Santuzzi (Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA)

Equality, Diversity and Inclusion

ISSN: 2040-7149

Article publication date: 20 April 2022

Issue publication date: 20 April 2022



Tompa, E., Samosh, D. and Santuzzi, A.M. (2022), "Guest editorial The benefits of inclusion: disability and work in the 21st century", Equality, Diversity and Inclusion, Vol. 41 No. 3, pp. 309-317.



Emerald Publishing Limited

Copyright © 2022, Emerald Publishing Limited

Changing perspectives on disability and work

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) was adopted in 2006 with 82 nation signatories (United Nations, 2019). The purpose of the convention was to elaborate upon and codify the rights of persons with disabilities while setting a path for implementation of legislation, policies, programs and practices that ensure those rights are activated and maintained (United Nations, 2006). To date, over 160 nations have signed the convention (United Nations, 2019), indicating global interest in implementing legislation, regulations, policies and programs on the rights of persons with disabilities.

Increased international attention on the rights of persons with disabilities is associated with a shift away from the medical model of disability, which characterizes disability as a deficit of the individual (e.g. Areheart, 2008). Historically, this model has been the focus of disability benefits programs (e.g. Withers, 2016). More inclusive approaches to disability are now being recognized, such as the social model of disability, which identifies disability as a societal rather than individual phenomenon (Oliver, 1983, 2013), and the human rights model of disability, which draws from the social model to highlight the centrality of upholding the rights and dignity of all persons in society (Office of Disability Issues, 2003).

The social model of disability was first developed in Britain during the 1970s and 1980s. However, the social understanding of disability has been advanced by activists and disability studies scholars in several countries. This understanding proposes that disability is a form of oppression caused by social barriers that exclude persons with impairments from participation in society. Attention is drawn to the role of environment and society in creating barriers. This approach very much underpins the human rights approach to disability.

Over the period that followed, the World Health Organization (WHO) and others integrated the social understanding and medical understanding into a biopsychosocial framework, known as the disablement process, which is described in the International Classification of Functioning, Disability and Health (ICF) (WHO, 2001) and in earlier work by the WHO (1980). In this framework, a health condition or impairment is a necessary but not sufficient condition for disablement. The social and built environments are seen as key factors that can be enabling or disabling. Earlier work by Nagi (1965, 1991) also took this approach. With this approach, disability is conceptualized as arising out of the complex interaction between a health condition or impairment, barriers in the physical and social environment, and personal factors (Kazou, 2017).

The human rights model of disability looks to societal norms, practices and structures to understand the barriers that persons with disabilities experience. This approach focuses on the social, attitudinal and physical barriers that restrict the life choices and participation of persons with disabilities. Quinn et al. (2002) explains that the human rights paradigm for persons with disabilities is inspired by the values of dignity, autonomy, self-determination and equality. Moreover, the human rights paradigm considers that “each individual is deemed to be of inestimable value, and nobody is insignificant. People are to be valued not just because they are economically or otherwise useful but because of their inherent self-worth” (Quinn and Degener, 2002, p. 14). This means that persons with disabilities have a stake in, and claim on, society regardless of considerations of economic or social utility. Thus, the onus is on all actors in society to create a new normal that ensures accessibility, inclusion and belonging for all people regardless of their abilities. With these changing perspectives on the root causes of disability comes the requirement for new approaches to framing disability in legislation, regulations, policies, programs and practices at the public policy level and workplace systems level.

Implementing new perspectives on disability into legislation, policies programs and practices

Importantly, there is an urgent need to evaluate the impact of new perspectives and approaches, including costs, benefits and whether policies are giving rise to their intended effects. This next step of evaluation is critical, as the implementation of disability policy does not, in itself, ensure that desired outcomes will be achieved (Acemoglu and Angrist, 2001; DeLeire, 2000; Kruse and Schur, 2003). Yet, in many cases, we do not have measurement frameworks to support evaluation for recent legislation, regulations, policies, programs and practices on inclusion, accessibility and belonging, or methods to apply frameworks across different contexts.

The impacts of legislation are especially relevant in workplace organizational processes. At the workplace systems level, there is an urgent need to improve the capacity of workplaces to leverage the opportunities offered by working age persons with disabilities. However, many employers remain apprehensive due to a lack of confidence, knowledge and skills about best practices in the provision of accommodations and social integration of workers with disabilities in the workplace. Evidence-informed legislation, policies, programs and practices are needed on how organizations can advance their human resource management systems to ensure that they have the ability to recruit, onboard, retain and promote persons with disabilities who have the requisite skill sets. This is sometimes described as “disability confidence.” Disabled World notes “a disability confident organization is a company that puts policies into practice to ensure people with disabilities are included […] thinks about the needs of people with disability when designing products and services […] knows what people with a disability can do and has identified ways to address barriers to employment or promotion for persons with disabilities” (Disabled World, 2014).

Despite movements toward disability confidence, the current state of affairs suggests a resistance to inclusion of workers with disabilities. Poor employment outcomes for persons with disabilities are a significant social problem, with critical implications for labour markets, social safety net programs, the economy and society in general. Researchers consistently report that persons with disabilities have disproportionately poorer employment outcomes (e.g. Morris, 2019; Till et al., 2012; Turcotte, 2014), even with appropriate qualifications and work readiness. Despite efforts to improve their employment levels by governments and other stakeholders, labour-force participation rates of persons with disabilities remains substantially lower than persons without disabilities. Among those working, many remain stuck in entry-level, low paying and precarious employment (International Labour Organization, 2011; Prince, 2014; Zarifa et al., 2015) – experiences that give rise to instability, lack of protection, insecurity and social and economic vulnerability (Tompa et al., 2007). These challenges are compounded for persons with disabilities from marginalized groups, who face additional systemic barriers to secure employment, based on their gender, sexual orientation, indigeneity and/or racial identity (Durst et al., 2016; Shaw et al., 2012).

A key factor to consider in the current context is that technological advancements and globalization have changed the nature of work, providing new opportunities for persons with different abilities and needs (Ekberg et al., 2016). New platforms for communication have enabled remote work opportunities, collaborations and partnerships that can be leveraged to engage persons with disabilities previously limited by barriers from transportation, communication, work hours and work environments (Schur, 2003). Exploitation of these opportunities has accelerated in the context of the COVID-19 pandemic, with many positions becoming remote (Li et al., 2020). Prior to the pandemic, projected labour shortages were a significant threat to many developed economies. For example, 40% of small and medium-sized businesses in Canada reported difficulties finding new workers (Cocolakis-Wormstall, 2018), and it is projected that recruitment challenges would worsen over the next decade (Fang, 2009; Miner, 2014). Persons with disabilities represent a largely untapped talent pool to fill impending shortages for the benefit of business, the public sector and society at large.

Traditionally, programs and research on employment of persons with disabilities have focused on preparing individuals for employment (Mueser et al., 2016). These are important. However, little attention has been given to employer attitudes towards, interest in, and capacity for hiring and accommodating persons with disabilities (Delman et al., 2017). Without attention to employer needs and improving the literacy of workplace stakeholders on inclusive practices, the fundamental context of the workplace will remain unchanged and barriers and assumption unchallenged (Chan et al., 2010). Currently, workers with disabilities must find ways to fit rather than the workplace contexts being flexible, accessible and accommodating. An innovative approach, known as demand-side capacity building, switches the focus to increasing workplace accessibility and employer capacity to leverage the full potential of persons with disabilities through more inclusive hiring, mentorship and career advancement opportunities; responsive and inclusive management and effective strategies for sustainable employment relationships for all individuals who can and want to work. This focus differs substantially from previous supply-side focused efforts common in this arena.

To facilitate a demand-side focus on improving the work environment, barriers to equity must be removed. The workplace barriers that persons with disabilities encounter are varied and can be found across the employment cycle from recruitment to termination or retirement (Bonaccio et al., 2020). Recognizing the complex nature of disability barriers, researchers have argued that approaches to inclusion need to be multipronged and multilevel to produce change. Samosh (2021) developed a model of career success by persons with disabilities, called the “three-legged stool”, that highlights how career advancement for this population is most likely under conditions that individual level, group level as well as organizational and societal level facilitators are present in combination. Prior research has examined individual level facilitators, such as career self-management strategies (e.g. Kulkarni and Gopakumar, 2014), group level facilitators, such as social networks both internal and external to the workplace (Kulkarni, 2012; Shah et al., 2004), and organizational and societal level facilitators, such as legislation, organizational policy and organizational climate (Araten-Bergman, 2016; Stone and Colella, 1996; Von Schrader et al., 2014). Recognition that facilitators at all these different levels are required together provides impetus for our attention to multiple levels of measurement in this special issue on disability inclusion.

Goals for the special issue

In this special issue, we focus on innovative, international research that contributes to the conceptualization and application of accessibility, inclusion and belonging across several social domains, with a focus on the public and workplace policy systems levels. Although we include evidence from different units of measurement in scope (e.g. individual, organizational and national), our intent is to provide a forum for contributions that provide insights into societal and/or organizational systems related to accessibility, inclusion and belonging. Research on the impact of legislation and policy on individual worker experiences is also included. Emphasis has been given to how individual experiences inform evaluation of legislation and policy. Also in scope is research measuring organizational processes or management systems (e.g. Karapetrovic and Willborn, 1998; Yazdani et al., 2015) that draw on data from several units of measurement to inform those systems.

All contributions in this special issue were double-blind peer-reviewed before consideration for publication. We are delighted to share with you the 11 studies that have been selected for inclusion following a rigorous review process. They reflect a diversity of research perspectives that use different methods (e.g. conceptual, qualitative and quantitative). We have clustered them into three broad categories: (1) societal/market/community level, (2) organizational level and (3) individual level.

Cluster one: societal/market/community level

In the first cluster, we have five studies. In a study by Tompa and colleagues (Development and implementation of a framework for estimating the economic benefits of an accessible and inclusive society), the researchers develop a framework for estimating the economic benefits of a fully accessible and inclusive society. The framework is then operationalized using data from Canada. This study advances the measurement paradigm of a methodology frequently used in the health economics discipline called cost of illness or burden of disease studies. The framework extends this paradigm to the social realm, conceptualizing and quantifying the gap between the ideal of a fully inclusive and accessible society and the current situation in Canada. A broad range of social domains are included in the framework, with labour market participation as one of them. Their estimate results in a surprisingly large magnitude of 17.6% of gross domestic product (GDP) for reference year 2017 in Canada. The employment component (labelled as output and productivity) is 3.2% of GDP. This study sheds light on the substantial economic benefits that could be realized by society from a move towards greater accessibility and inclusion of persons with disabilities in a broad range of social domains. This first attempt at a comprehensive measure of the cost of exclusion/benefits of inclusion provides invaluable information for governments, disability advocates and industry leaders to measure the benefits of legislation, policies, programs and practices targeted at improving accessibility and inclusion.

The second study by O'Loughlin and colleagues (Inclusion of Indigenous workers in workplace mental health) describes the development and evaluation of a mental health initiative for Indigenous workers, specifically an e-mental health application. The co-creation process with researchers and members from the Nokiiwin Tribal Council involved sharing circles (similar to focus groups) where work experiences and knowledge of mental health issues were shared. Qualitative data analysis helped inform the development of an app for use during workplace mental health crises. Through the analysis, five themes related to the inclusion of Indigenous workers were identified: (1) connecting with someone who understands and respects Indigenous culture; (2) respecting Indigenous traditions helps workers feel included; (3) positive experiences enable inclusivity; (4) trusting relationships promote workplace inclusivity and (5) feelings of exclusion can move beyond the workplace. These themes represent issues that impact Indigenous workplace mental health. The app developed from this research provides information on work-related mental health resources for Indigenous workers and a mechanism to connect with peer support. This is the first e-mental health application for Indigenous workers and managers within workplaces.

The third study by Doyle and McDowall (Diamond in the rough? An “empty review” of research into “neurodiversity” and a road map for developing the inclusion agenda) is a review focused on informing the development of a roadmap for inclusion of neurodiverse persons, with a focus on employment. Through the review, the authors highlight the inadequate scope and focus of academic attention on neurodiversity and employment to date across the fields of applied psychology and management studies. Their attention then focuses on proposing a new research agenda that considers the micro-, meso- and macro-levels. Given that research will take time to develop in the field, in the interim, the authors recommend applying the principles of universal design to human resource processes. They advocate starting with a move from the medical to social perspective, then embracing context-sensitive and inclusive research and interrogating policy and practice based on legal compliance.

The fourth study by Wu and colleagues (Now protected or still stigmatized? A 25-year outlook on the impact of the Americans with Disabilities Act) is an assessment of progress made in the USA over the 25 years following the enactment of the Americans with Disabilities Act, which was signed into law in 1990. The law was broadly scoped to address discrimination against persons with disabilities in various areas of society, including employment, public accommodations and transportation. Drawing on data collected from a diverse sample of persons with disabilities and allies without disabilities, the authors use statistical methods to address a series of research questions, largely focused on the impacts of the Act. They find that the law has had favourable effects in different life domains, but benefits are unevenly distributed across demographics groups. Going forward, research should strive to address some of these limitations and better disentangle the perspective of persons with disabilities, their allies and third parties trying to implement and abide by the Americans with Disabilities Act.

The fifth study by Hernández González (Market reactions to the inclusion of people with disabilities) investigates stock market price reactions to the disclosure of information of an organization's action towards persons with disabilities reported in financial journals, using statistical modelling techniques. They find that investors value inclusion and reject discrimination. Responses to positive and negative information are somewhat different such that the impacts of negative action are immediate, whereas the impacts of positive action require a day or more to be realized. There are also differences based on type of event. Impacts from employment and customer events are more pronounced than philanthropic events. These findings highlight the importance of organizational culture in terms of inclusion and diversity for stakeholders and markets.

Cluster two: organizational level

In the second cluster, we have three studies. In a study by Gould and colleagues (Building, sustaining and growing: disability inclusion in business), the authors investigate the unique and the complementary aspects of disability inclusion and diversity strategies. Through semi-structured interviews with businesses that have received national recognition for supporting workers with disabilities, they provide insights about policies, practices and processes for fostering disability inclusion. Respondents described strategies to build, sustain and grow disability inclusion by framing disability similarly to other diversity categories. They note that the disability inclusion process is largely synergistic with the broader diversity framework. However, disability remains a highly stigmatized social category, and there are few individuals championing organizational efforts to promote disability inclusion. Yet, champions play a critical role in building, sustaining and growing disability inclusion, so they need to be supported in their efforts to advancing policy and practice.

The second study by Gewurtz and colleagues (Retaining and supporting employees with mental illness through inclusive organizations: lessons from five Canadian case studies) explores organizational strategies and work practices that promote retention and support of workers living with mental illness. They adopt a qualitative case study approach to profile organizations that have taken steps towards promoting inclusion of workers with mental illness. Two key themes are noted in depictions of supportive workplaces: (1) relationship-focused workplaces and (2) flexible, inclusive work practices. Though the study focuses on organizations working towards inclusion, the authors note that stigma associated with mental illness and the rigidity of some workplace processes continue to limit support and retention. In response, they emphasize the importance of communication processes and support mechanisms to reinforce flexibility, inclusion and oversight of employees with mental illness.

The third study in this cluster by Suresh and Dyaram (Diversity in disability: leaders' accounts on inclusive employment in the Indian context) explores inclusive employment in India through qualitative interviews with senior executives in service and manufacturing organizations. Findings highlight organizational determinants that enable/disable employment of persons with varied types of disabilities. The study brings to the fore the uneven representation of persons with varied disabilities and the organizational determinants that favour the employment of persons with certain types of disabilities over others. Specifically, they find that most organizations employ persons with orthopaedic, hearing and vision disabilities. The unique contextual factors that bear on employment decisions include country-specific legislation, nature of clientele served and other industry/market dynamics. Additionally, the study highlights that barriers which shape decisions are sometime objective (e.g. architectural barriers) and other times subjective (e.g. personal biases) in nature.

Cluster three: individual level

In the third cluster, we have three studies, two of which focus on disability disclosure and the third on employee perceptions of autism employment programs. The first study by Santuzzi and colleagues (The benefits of inclusion for disability measurement in the workplace) draws attention to the underreporting of disability in organizations. This is a persistent problem in many organizations, which results in inaccurate organizational metrics on disability representation and can hamper worker access to needed accommodations and supports. The authors survey 160 working adults with disabilities in the USA to unpack the factors that drive underreporting and factors that can mitigate it. They find that anticipated disability discrimination and inclusion are central to understanding reactions to disability disclosure requests. This research highlights implications for workplaces on the importance of work environment in creating a context wherein workers feel comfortable disclosing their need for accommodation.

In the second study by Kulkarni (Hiding but hoping to be found: workplace disclosure dilemmas of individuals with hidden disabilities), the author attends to issues of disclosure at work for individuals with hidden mental health conditions. The author interviews 15 individuals from India who had chosen not to disclose their conditions. The author finds that three types of disclosure dilemmas were present in interviewee experiences. The study findings support and add to those of Santuzzi and colleagues, with recognition of work context as central to the reinforcement of disclosure issues. Several strategies for promoting more inclusive environments are suggested, such as providing counselling services, stakeholder training and opportunities for selective disclosure.

The third study by Spoor and colleagues (Employee Engagement and Commitment to Two Australian Autism Employment Programs: Associations with Workload and Perceived Supervisor Support) highlights the dearth of research on autism employment programs and examines managers and co-worker attitudes of two of these programs. Specifically, the authors explore commitment to and engagement with autism employment programs among 229 workers in Australia who were not direct participants in the program. They find that factors such as perceived workload changes and supervisor support affect continued commitment to the programs among managers and co-workers, underscoring the importance of social context to the success of such programs.

Key messages and the way forward

The 11 studies in this special issue provide important insights for legislation, policies, programs and practices and highlight areas warranting additional research to help advance the field. A key message is the need for legislation, policies, programs and practices to embrace a broader conceptual understanding of disability, specifically the social or human rights model, and strive to engender culture change and a new normal that is accessible and inclusive by design, where workers with disabilities have agency to choose their career path and where all persons are valued and feel they belong. There is also need for different research methods, including multi- or trans-disciplinary, co-design approaches, in which persons with lived experiences and other actors in the policy arena are directly involved in the research process. Consideration of the micro-, meso- and macro-contexts is important, with a focus on structural factors, such as norms, culture, and built environment standards. Consideration of demand-side factors is also critical, in contrast to the historical focus that has been predominantly on the supply-side. Lastly, ongoing measurement, evaluation and a continual improvement approach are critical to ensuring progress towards the ideal of a fully accessible and inclusive society.

We hope that this special issue of applied research studies will help inform legislation, policies, programs and practices and research going forward. Given our focus on employment, we seek to promote and transform organizational human resources practices, such that organizations are disability confident, labour markets are diverse and inclusive and persons with and without disabilities have equality of opportunities and choices in careers, jobs and work (Disability and Work in Canada, 2019).


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