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Spatial Inequalities in Disabled Livelihoods: an Empirical Study of U.S

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Spatial Inequalities in Disabled Livelihoods: an Empirical Study of U.S Spatial Inequalities in Disabled Livelihoods: An Empirical Study of U.S. Counties DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Nicholas Britt Garcia, MS Graduate Program in the School of Environment and Natural Resources The Ohio State University 2019 Dissertation Committee: Professor Linda Lobao, Adviser Professor Jeff Sharp Professor Cathy Rakowski Copyright by Nicholas B. Garcia 2019 Abstract I consider contributions and limitations of traditional approaches to disability and inequality, noting a lack of quantitative empirical studies to address persistent poverty and underemployment since passage of the Americans with Disabilities Act (ADA). I find that the majority of literature is predicated upon assumptions of interpersonal discrimination and accessibility, without corresponding empirical study of how these factors influence the economic well-being of people with disabilities. Using newly-available county prevalence data from the American Community Survey (ACS), I present three studies to address areas of disability and inequality that have been neglected in sociological research. In the first, I address rising disability prevalence across U.S. counties and test prominent explanations involving health behaviors against place-based deprivation measures. Increasing disability prevalence is often attributed to rising obesity rates in the United States. Poverty and inequality, although commonly explored in studies of health disparities, have not been well- studied in their relationship to disability. I examine differences in disability prevalence across 2,964 U.S. counties to compare these competing explanations. I find that poverty is consistent in explaining the prevalence of overall disability and four subcategories of disability, while health behaviors are only significant when explaining some specific categories of disability. I further find that industrial composition of places plays an overlooked role in shaping disability i prevalence, presumably from occupational hazards associated with extractive industrial activities across counties. In the second, I address the increasing gap in disabled employment that has persisted since the implementation of the ADA. The ADA offered protections against discriminatory hiring and workplace accessibility, but did not address other place-based and individual determinants of disability employment. I examine how the socioeconomic composition of places and county-level indicators of mobility shape employment of people with disabilities, while also considering how each type of disability may have different employment prospects. I find that the socioeconomic composition of places and the types of disability most common in a county are significant in explaining employment differences across U.S. counties. Finally, I address the support received by people with disabilities from the government. Conventional explanations of disability welfare from Supplementary Supportive Income (SSI) describe increasing enrollment in government programs as a product of insufficient work incentives and fraudulent claims of disability. I compare self-reported disability rates of each county to SSI enrollment and find that differences in SSI coverage are related to two competing explanations. The first involves sociopolitical interests that shape flows of federal welfare dollars to districts based on racial and economic makeup of counties. The second involves the capacity of medical institutions and government to administer and process disability claims. Although conventional accounts of disability welfare assume economic self-interests as the driver of SSI enrollment, I find that economic interests fail to be significant in explaining SSI coverage. ii Taken together, these findings describe an account of inequality and disability that is connected to the places in which people with disabilities live. I find that poverty and industrial activities that contribute to disabilities in a county also shape employment outcomes of people with disabilities. Places with high poverty have higher disability prevalence and worse employment outcomes for people with disabilities. Programs offering economic support are also limited in areas of economic hardship, as high income areas with substantial medical and governmental resources have the most responsive government programs. Within the sociology of disability, inequality and disability is often explained in terms of stigma, discrimination, and marginalized social status. In my three empirical studies, I find that social and economic characteristics of counties play an overlooked role in explaining differences in employment and governmental support among people with disabilities. iii Para mi familia. iv Acknowledgments I did not do this alone. It's difficult to put a spotlight on how my academic career came together without acknowledging the very long and winding road that took me here. If I don't take the time to say my piece now, I'm afraid I'll always be too self-conscious to tell everyone how much they've done to get me here. (And if you think it's too long, I've got some bad news for you about the chapters that follow!) On the homefront, I'm fortunate to have had a pal, a coconspirator, a cheerleader, a coach, and a literal lifesaver in my wife Evie. I would not have gone back to school if not for her. Now we have our own family, and my hope to contribute to a better world for them has driven me to seek work that I can be proud of. I grew up in a household of teachers, and I was surrounded by ravenous readers and curious minds. I was lucky to have patient parents that supported me as I pursued learning for the sake of learning. They've given me unconditional support even if they were unclear on what exactly I studied for a living. I grew up with a brother that was both friend and foil, always appreciating expertise but never satisfied. How could I have made it to this point without coming home to people like these? I am humbled by the faculty at Ohio State that have helped to shape me into who I am today. I cannot express how deeply indebted I am to Linda Lobao. She is undoubtedly the most brilliant person I've ever met. This is not hyperbole. I've marveled at her ability to recall citations, draw from highly specialized literature outside of her own research, and still be incredibly in touch with world events. But more remarkable is the work that she's put in that has v made her so knowledgeable. She is passionate about her work, and her light was often on during the late nights I spent at Kottman Hall. It would be intimidating if it wasn't downright inspirational. I'm grateful for the direct guidance she's given me throughout the years. She's pushed me to produce work beyond anything I thought myself capable of. But her own work has fundamentally shaped how I view the work of sociologists, and I'm so damn thankful to have worked with her over these years. My experiences with our rural sociology faculty have been so rewarding, both in and out of the classroom. My first graduate teaching appointment was with Cathy Rakowski, and I am thankful for the experience. Cathy routinely asks sociologists, "Where are the people?!" when reading their work. She is a compassionate sociologist that cares deeply about the work we do in the world. But I found this compassion extends to her view of the classroom as well. Jeff Sharp has also been incredibly responsive in his role as director at our school. I've always appreciated the precision and focus of his scholarship, and I think SENR has benefitted greatly from his leadership. I am so thankful that Ohio State hired Kerry Ard during my graduate career. (I'm sure they're thankful, too!) Kerry has been so gracious with her time and energy. I've learned a lot about classroom instruction, job market preparation, career development- all from someone that wasn't my advisor. I've been very lucky. I've felt supported by the rural sociology faculty, and I've learned how rare that experience is. My peers within rural sociology have helped me immensely. Sometimes having a shoulder to lean on or having a laugh together. It helped to know we were all going through things together. It helped not to feel alone. I relied on the experiences of Dani, Joe, Rebecca, Vicki, Molly, and Cory to let me know what graduate life was like. It can be difficult to navigate vi conferences or to confront the job market. They gave me hope. As the program grew and I came out of my shell, I was heartened by the character and drive of new rural sociologists. I was surrounded by truly inspiring people that did meaningful work in the community. It's no surprise that Jazz and Caitlyn are doing great things in the world. I've truly been surrounded by superstars with great hearts. Soon Anne and Sarah will be joining their ranks, and I'm eager to see them as powerful forces of good in the world. I would have benefited from having their maturity, passion, and vision when I was younger. I know I'll be citing the work of Paige Kelly throughout my career. It's a bizarre feeling to meet someone and know that they will be a titan in their field. I've already laughed when she's referred to me as a mentor. I have learned so much from Paige over the years, and I truly think this dissertation would not have been possible without the countless hours she spent talking over research questions and literature, teaching me quantitative methods, and most importantly by just being a friend. These have not been easy years for the world, and it's been good to have a friend that's equally pissed off and devastated. I know I'll look back one day and marvel at having met a young Paige Kelly before she had her graduate degree.
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