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Disability policies and public views on work disability...

appears to relate to a modest upswing in reporting moderate/severe disabilities and, at
the same time, to a much higher rate of reporting no disability.
These findings have important policy implications. For example, when the medical
or vocational assessment procedures are changed, in addition to directly affecting
individuals’ medical and vocational qualifications for disability benefits, over time it
would also possibly affect how the general public assesses work disabilities medically
and vocationally, especially as time goes by and the policy changes gradually shape
the disability culture in the country.
More work-oriented disability policy will likely foster a culture of work in the wake
of health limitations. This culture could then quickly evolve over time: when few
workers with health impairments take up the work incentives in the disability policy,
information is scarce and participation rises slowly. As information accumulates, the
effect of employment among the health impaired individuals becomes less uncertain
and the participation rate increases.
Here we focused on how longstanding policies and institutions may influence
cultural beliefs, rather than the reverse relationship. Culture and institutions are
likely interrelated in a complex way. A country shares specific cultural values, such
as attitude towards work, sense of solidarity, and preference for redistribution, which
may lead to the emergence of particular disability institutions. Then, in turn, certain
disability institutions will lead to the survival of certain cultural values and affect
the social norms towards work disability. Individuals acquire information about the
institutions through social learning, including learning about the policies and assessing
the policy results over time.
Given the two-way relationship between policy and beliefs, the effects that we
estimate from disability policies to disability perceptions are likely an upper bound
of the policy effects. We are not able to analyze the co-evolution of disability policies
and disability vignette ratings. For institutions to transform cultural values, it could
take a very long time. The main disability institutions in the countries under study here
have remained mostly unchanged. Hence, it is plausible to think that the social norms
about work disability in those countries have gradually come into being under the
influence of the consistent disability institutions in the country. In the future, as data
become available on the evolution of both institutions and cultural values, we hope that
researchers will revisit these questions to more fully understand the complementarities
between disability culture and disability institutions and the dynamic effects of
disability reform on disability culture.
5 Conclusions

In this paper, we provide a comparative analysis of disability policy in the U.S. and
seven European countries and using an anchoring vignette approach, we investigate
whether different views held by the general public regarding what constitutes a
work disability are related to cross-country differences in disability policies. We find
evidence consistent with the correlation between disability policy generosity and
public perceptions about work limitations. A closer look at the correlations reveal that
the way people classify disability does not correlate with each policy dimension in the
same fashion. The most influential policy dimensions in affecting disability reporting
are policy coverage, medical assessment, and vocational assessment. Specifically,
more extensive policy coverage and more lenient vocational assessments in a country
are linked to its residents rating more vignettes cases as relatively severe disabilities,
while a country’s more lenient medical evaluations are associated with its citizens
classifying more vignettes characters as not disabled at all. Our study has demonstrated
an important pathway through which a country’s disability policy interacts with its
general public, an effect that we should keep in mind while designing and reforming
disability programs.

Conflict of Interest
No conflict of interest was reported by all authors.

60 International Journal of Population Studies 2017, Volume 3, Issue 1