Still unequal – living conditions for people with functional impairments

This report deals with living conditions for adults with functional impairments who receive contributions according to the Swedish Social Services Act (2001:453), or the Act concerning Support and Service for Persons with Certain Functional Impairments (1993:387).

The study group consists of 57,500 people.

The main purpose of the report is to study the extent to which the goal of handicap policy – equal living conditions – has been fulfilled for this group. The report also aims at describing the study group outside of such things as age, sex, ethnic background and type of disability.

To study the extent that the goal of handicap policy has been achieved, the National Board of Health and Welfare has gathered data on the living conditions of both the study group and the total population. The empirical basis is built on two sources: revision of registry data from 2007 and data from a survey sent to a sampling of users in the fall of 2009.

Descriptions and comparisons of living conditions are made within a number of central areas of welfare: finances, work, education, housing, leisure, and health.

Beyond comparisons with the population, comparisons with other groups with functional impairments are also made. Certain tendencies in development for parts of the study group are also analyzed through reference to earlier studies.

About the study group

Persons receiving contributions according to SoL are on average older than persons receiving contributions according to LSS. The difference largely rests on many of the LSS contributions being granted as a consequence of congenital impairments. The share of those with developmental impairments and functional impairments are high among persons receiving LSS contributions. It is also common that persons with LSS contributions have speech impediments and impaired vision.

Among persons with SoL contributions, there is a large share with mental impairments. Approximately 10 percent of the study group were born in a country other than Sweden, while the corresponding portion of the total population is 16 percent. In contrast to the total population, the majority of the study group is unmarried.

Contributions and support

The study group in the report partly receives contributions according to SoL (housing support, daily activities, home help or special housing) and partly according to LSS (personal assistance, attendant services, a contact person, relief services, short-term stays away from home, short-term supervision, residence in a family home, residence with special services for adults or other specially adapted housing and daily activities).

Approximately half of the study group has some form of assistive devices. Half of the study group needs help from relatives one or more times a week.

Assistance claims in general

SoL and LSS contributions are often given in combination with other support, for example assistance according to the Assistance Claims Act (1993:388), that is, personal assistance granted by Swedish Social Insurance Administration.

The largest share with assistance claims is among people with daily activities according to LSS, which indicates that this subgroup has greater need of support. A little over 7 percent of the study group (4,200 people) have assistance claims beyond their SoL or LSS contributions.

Differences in living conditions

The results show significant differences in living conditions between the study group and the population in general.

In the area studied overall, with the exception of housing standards, the study group has worse living conditions than the population. In relation to the population, the group is characterized by a low level of education and an alienation from the labor market, while having weak personal finances and less active leisure time. The family picture also differs in comparison with general patterns in the population, such as fewer being married and having children.

Adults with functional impairments who receive support from social services thus live under other conditions than the population in general. Equal living conditions for this group are still a long way off. This applies especially to people receiving SoL contributions in the 20-29 age group. Many people with mental illness or mental impairments are found in this group.

In this report, the causes for this are discussed starting from four models of explanation:
• financial conditions
• lack of accessibility
• lack of support and services
• the extent and scope of the functional impairment.

Housing

The housing standard, measured as access to a kitchen or kitchenette and bath or shower in the residence, does not differ appreciably between the study group and the rest of the population.

The difference in relation to the total population is also small where access to a telephone and a TV in one’s own residence is concerned. On the other hand, the study group does not have access to computers and the Internet to the same extent as the rest of the population.

Finances

The financial situation of the study group is worse than for the rest of the population. The portion of people with wage income is smaller in the study group compared with both the total population and other groups of persons with functional impairments.

Disposable income is also lower for the study group than for other groups with functional impairments and for the total population.This is explained largely by many of them having sickness or activity compensation or financial aid as their main source of income. Both reimbursement mechanisms have time limits imposed, but there is reason to fear that they are a permanent source of income for these groups.

People with SoL and LSS contributions differ where receipt of financial aid is concerned. It is uncommon for persons with LSS contributions to receive financial aid and it is even more uncommon than in the total population.

This likely depends on the municipalities not being able to take out more in fees than the individual is allowed to keep as sufficient means for his/her own personal needs (the so-called reserve amount).

This can also depend on relatives providing financial support to a substantial extent. The reverse applies to people receiving SoL contributions. Here, financial aid is up to five times more common than in the total population, and especially common among the 20-29 age group.

Education

The study group has a substantially lower level of education than the rest of the population. The difference lies above all in a smaller portion continuing their studies after high school. In 2007, a little over 35 percent of the population had post-secondary education.

Among people with LSS contributions, barely 5 percent had post-secondary education, and among people with SoL contributions the portion was 16 percent.

It is also common that persons with SoL contributions only went to grade school. The share of the total population ages 20-64 who only went to grade school amounts to just over 15 percent. Among people with SoL contributions, the portion is almost 35 percent.

The difference is greatest in the 20-29 age group, where nearly every other person with SoL contributions has only a grade school education compared with one in every ten in the corresponding ages among the total population.

Work

Establishment in the labor market is significantly lower for the study group than for the total population. The share established in the labor market amounts to approximately ten percent. The corresponding number for the total population aged 20-64 is approximately 80 percent.

It is still an open question whether weak establishment in the labor market corresponds to the absence of a capacity to work in the group, or to what extent it is an expression of a segregated labor market where not everyone has an equal opportunity to find employment. It is possible that many people with daily activities could manage paid work if they had the opportunity.

Leisure

The study group does not participate in cultural life and public entertainment, as well as exercise and outdoor life, to the same extent in comparison with the rest of the population.

They do not go away on vacation to the same extent as others, either. People with SoL contributions are less active within the leisure activities investigated than those with LSS contributions; they also go away on vacation to a lesser extent.

A significant part of the low leisure and cultural exercise can be thought to depend on the financial situation in combination with the lack of accessibility. The lack of users’ influence over the contributions given is also probably an explanation.

Health

The use of medicine for depression, anxiety, insomnia, schizophrenia or psychosis (psychopharmalogical drugs) is three times as common among people with developmental impairments, autism, or autism-like conditions than among the population.

One of every five people in the study group take medicines for schizophrenia and psychoses (neuroleptics). The corresponding portion in the total population is one percent. The National Board of Health and Welfare finds it noteworthy that so many in the study group take neuroleptics.

Outdated preparations for psychoses and schizophrenia entail higher risks for side effects and epileptic attacks than more modern preparations. The outdated preparations are more common in the study group than both among people who have been treated for schizophrenia and in the total population. This indicates that the lists of medicine for the study group are revised far too infrequently.

Anti-anxiety medications should only be taken as an exception by people with developmental impairments. 10 percent of the study group, however, take these medicines continuously. This entails certain risks for the study group, for example addiction, increased aggressiveness, and even heightened anxiety.

Contact

Karin Flyckt
075-273 30 00

See also

Disability