Chapter 6 - Conclusion

This report sets out to examine how adults were restricted from participating in various life areas. In the LOS, adults are said to experience a participation restriction in a life area if they reported at least one barrier for that area.

The analysis focused on four groups of adults defined by whether they had impairment(s) in the two waves of the LOS. The groups are described as: adults with impairment at both waves, offset adults, onset-acquired adults and adults without impairment at both waves. Changes between waves were examined in terms of participation restriction experienced by the four groups in the eight life areas1. Following this, we looked at the barriers reported by these groups in the areas of work, education and training, and transport ²; and whether these barriers were reported at both waves, or at only one of the waves. In addition to highlighting the specific barriers adults were reporting in these areas, these analyses also served as examples of how longitudinal analysis could be carried out using LOS data.

Notes for 6.1 What was this report about?

1. These analyses included all adults aged 16 and over

2. These analyses focused on working age (16 to 64) adults

1. Most adults were restricted from participating in at least one life area, regardless of whether they had impairment(s) or not

Most adults experienced a participation restriction in at least one of the eight life areas at both waves of the survey – with transport and leisure being the two areas where most adults experienced a restriction. Only a very small percentage of adults did not have a participation restriction in any of the eight life areas in both waves.

However, if we look at each life area individually, with the exception of transport and leisure, most adults did not experience a participation restriction at either wave.

2. Having impairment(s) was associated to being restricted from participating in areas of life

Our findings showed an association between having impairment(s) and experiencing a participation restriction.

When looking at all life areas together, adults with impairment at both waves were restricted in more life areas, compared to those without impairment at both waves. Offset adults, who no longer had impairment(s) at Wave Two, tended to experience fewer participation restrictions at Wave Two. The opposite was true for onset-acquired adults. These adults, who had acquired impairment(s) at Wave Two, were likely to experience more participation restrictions at Wave Two.

The impairment(s) or a disability may also become a barrier which restricted adults from participating in some life areas. For example, ‘a health condition, illness or impairment’ was the most often reported barrier for adults with impairment at both waves in the life area of work. It was also a common barrier reported at Wave One only by offset adults, and reported at Wave Two only by onset-acquired adults.

3. Most commonly-reported barriers related to costs, lack of time, and family responsibilities

Most barriers reported fell into common themes relating to cost (‘financial reasons/lack of money/can’t afford to’), lack of time (‘too busy/not enough time’), and family or caring responsibilities. Generally, cost-related barriers were the main barriers reported to education and training, and transport, whereas ‘family responsibilities’ was the main barrier reported to work.

As mentioned in section two, unlike other groups, adults with impairment at both waves tended to report impairment-based barriers in addition to the main barriers listed above. Indeed, impairment-based barriers seemed to be more relevant for adults with impairment at both waves than other barriers that commonly affected other groups, such as ‘family responsibilities’ in work, ‘too busy/not enough time’ in education and training, and ‘transport unavailable’ in some modes of transport.

In contrast, impairment-based barriers seemed to matter less for offset and onset-acquired adults, who were more likely to report barriers relating to cost, time and family responsibilities. In this sense, the barriers reported by offset and onset-acquired adults were generally more similar to those reported by adults without impairment at both waves.

4. Barriers may change over time

Barriers tended to be reported at only one of the waves, rather than consistently at both waves. This suggests that barriers and restriction were likely to be influenced by changes in people’s situation and circumstances.

However, there were some exceptions. For example, most adults who were economically inactive at both waves tended to report ‘family responsibilities’ at both waves as their reason for not working or seeking work.

5. External factors may influence the types of barriers reported

External factors that affect society as a whole may underlie some of the barriers reported for certain life areas. For example, ‘lack of job opportunities’ was a common barrier reported for work. The UK economy experienced a downturn in 2008/09, resulting in higher unemployment in the UK labour market (compared with pre-downturn figures). Adults in the LOS reported ‘lack of job opportunities’ as a barrier limiting the type and amount of paid work they could do. This may be a reflection of a shortage of jobs that were suitable or available for the workforce during this post-downturn period.

The economic climate in the UK between 2009 and 2012 might also be behind the reporting of financial reasons/cost as a common barrier in education and training, and transport¹.

Cost as a barrier to using motor vehicles might be associated more directly to the rising cost of fuel and car insurance. This barrier to using motor vehicles was reported more often at Wave Two only than at Wave One only, and was consistent with the way fuel and car insurance prices increased² over the period covered by the two waves of the survey.

In modes of public transport, ‘transport unavailable’ was also a commonly reported barrier, affecting most groups regardless of their impairment status.

6. Modified hours and tax credits were most commonly reported by people as measures which helped, or would help them to work

This report also examined enablers, or measures which have helped, or would enable people to work. Most adults did not report any enablers, but when reported, measures such as modified hours and tax credits were the most common responses. These measures could be seen as a means to ease family/caring responsibilities. It is important to bear in mind that different reasons may lie behind these reported enablers. ‘Modified or reduced hours’ might have been reported by adults with impairment at both waves to ease the barrier posed by their impairment, as well as a means to manage family/caring responsibilities.

Notes for 6.2 What were the Main Findings?

1. For changes in household income see the Households Below Average Income 2013 report.

2. Data source: Consumer Price Indices, January 2014 time series, Office for National Statistics.

Being restricted to participating fully in various areas of life is a common experience shared by nearly all adults in Great Britain.

This report provided evidence of an association between having impairment(s) and being restricted from participating in areas of life. Having impairment(s) seemed to increase the extent of restriction experienced, and also created impairment-based barriers. All adults, regardless of impairment status, were affected by similar barriers relating to cost, not having enough time, having family/caring responsibilities and services not being available. However, an impairment-based barrier was often more relevant for adults with impairment at both waves.

This report also highlighted the dynamic nature of barriers. Most barriers were reported at either Wave One only or Wave Two only, rather than consistently at both waves. In the LOS Wave Two Report Part I, we demonstrated the dynamic nature of impairments, with people moving in and out of impairment over time. Similarly, in this report, we showed the extent of change in people’s experiences of barriers to participation. It is clear that being able to participate fully in areas of life is affected by individuals’ circumstances (responsibilities to the family, not having enough time, having impairments), as well as societal factors relating to the economy (rising costs, lack of job opportunities) and unavailability of services (in public transport).

It is important to bear in mind that the groups included in our longitudinal analyses consisted of a diverse group of adults with respect to the types and severity of impairments they reported. As such, a simple picture of the relationship between impairment and restriction to participation is unlikely to emerge. Nonetheless, this report demonstrated one method of examining changes in restriction and barriers reported, and how they could be considered in parallel with changes or stability in impairment status over time.

Wave Three of the LOS will be completed in September 2014. The Wave Three questionnaire includes new questions exploring the reasons for impairment onset and offset, as well as questions on enablers – the reasons why barriers are no longer reported, after being reported in the previous wave. Responses to these questions, along with an additional wave of data, will further enhance our understanding of the relationship between impairment and restriction to participation.