The call to include disability in Diversity, Equity, and Inclusion (DEI) initiatives isn’t new, but unfortunately, not much has changed. According to the U.S. Department of Labor, disability is a facet of diversity and should be included in DEI efforts.

Ninety percent of companies are enthusiastic about enhancing diversity, but disability is considered in only 4 percent of those initiatives.

How can your organization more actively include employers with disabilities and chronic health conditions?

Educate Yourself on Disability and Chronic Health Concerns

When most of us think of disability, we think about someone in a wheelchair, or perhaps a visually impaired person who uses a white cane. While these are accurate examples of disabled people, most people with work-affecting chronic conditions do not use an assistive device or display any obvious signs of discomfort most of the time.

This is known as invisible illness – and I understand this deeply, as my illnesses are all usually invisible. They include fibromyalgia and chronic pain resulting from a series of car accidents. Unless I say something or am in so much pain that I lose focus, no one can tell that I’m disabled unless I let them know.

Here are some statistics you should know to increase your awareness about invisible illnesses:

• 10 percent of Americans have invisible disabilities.
• 96 percent of people living with a chronic medical condition have one or more conditions that are invisible.
• 25 percent of those with chronic medical conditions are affected in a way that limits their mobility.

Check out my linked sources – I found all of this info on Google, and you can, too.

Use Terms of Preference Regarding Identity

Some disabled people prefer the term “disabled person.” Others prefer people-first language, such as “person with a disability.” If someone is openly disabled, listen to how the identify themselves or ask them for their preference so you know how to properly refer to them.

Generally, “handicapped” is considered an outdated if not offensive term. Please do not use it.

Please note that I am primarily but not exclusively using “disabled person” as that’s how I identify, but others may wish to be referred to as a “person with a disability.” 

Provide Necessary Accommodations

More widely understood is the concept of accommodations: that is, employers should provide people with disabilities or work-affecting health conditions with equipment to support their ability to work. Accommodations often looks like an ergonomic chair, but they may include ramp accessibility, proximity to the bathroom (for employees with Irritable Bowel Syndrome, or IBS), or flexibility so that employees can communicate with their doctors during work hours.

Most able-bodied people do not understand that if you have medical concerns, keeping up with medical appointments is essentially a part-time job. Since most medical offices are only open during the workday, patients typically need to take daytime appointments or make phone calls at that time.

Consider Pay Equity and Disability

According to the U.S. Census Bureau, disabled workers in certain professions have income on par with able-bodied employees. However, they say:

“Overall, workers with a disability earn less than workers who do not have a disability.”

While this sort of pay gap may not seem like a big deal, it can be, especially when considering an intersectional identity. A woman of color, for example, still typically faces a significant pay gap due to unfair bias against her race and gender, as well as societal barriers caused by patriarchy and white supremacy. If she has a disability, that creates even more of an inequity in pay.

Know That Some Are Still on the Diagnosis Journey

Depending on the disability or chronic illness, getting a disability can take a long time. For me, it took over a decade between lack of healthcare access, evolving symptoms, and bias in medical practice. One study demonstrated that women with stomach pain had to wait longer than men for treatment – 33 percent longer.

This also makes for a more lengthy diagnosis, and considering that women receive diagnosis on average four years later than men, it’s a real problem. Without having the correct medication (which is often held until a diagnosis), and with more sick days without the cover of disability, working women are in danger of losing their jobs when not diagnosed quickly. In addition to making 82 cents on the dollar compared to a man, a woman is more likely to lose time or work because of the length of time it takes to reach a diagnosis. It’s a vicious cycle: a pay gap also represents a lack of healthcare access in countries like the United States, where healthcare is often inaccessible and unaffordable.

Today.com ran a series called “Dismissed” all about this issue. Furthermore, studies indicate that women of color have even more bias against them when it comes to receiving adequate medical care. Women experience drug interactions twice as often as men because they’re underrepresented in clinical trials. In a study by Drs. Zucker and Prendergast, findings showed that in over 90 percent of cases, “women experienced stronger side effects than men and experienced adverse drug reactions at nearly twice the rate of men.”

For those hoping to access Affordable Care Act (“Obamacare”) insurance, there are still major access problems. While pre-existing conditions are covered (for example, if you have one or more diagnosis), there’s no rule in practice about how that affects the insurance rates. Navigating the healthcare marketplace was tough for me when I was uninsured and freelancing full-time – because I finally had a diagnosis, it would have cost about $700/month to access the care I needed. That was more than my car payment and as much as my rent at the time.

How does this affect DEI? People without diagnoses still have needs that may require flexibility from their employer. Creating an open and safe environment that won’t ditch them just because of documented health issues is important to inclusion (and employee retention). There’s also the race and gender component to it: people of marginalized races and genders are more heavily affected by delays in diagnoses.

Always Include People With Temporary Disabilities

Most of us will be affected by a temporary disability in our lifetime. Think about a kid falling out of a tree and breaking their arm; a person who has recently given birth with or without complications; or someone with a temporary, painful back strain because they moved a lot of furniture over the weekend.

Most employees will experience temporary disabilities, and they should also receive any necessary accommodations.

Be Mindful of Menstruation and Miscarriage

Getting a period is a normal part of life for most people assigned female at birth (AFAB). We’re taught by our feminist mothers that haven’t a period doesn’t mean we are less capable of doing what we normally do. While this lesson is helpful, it’s not always accurate.

Normal symptoms of menstruation such as cramps and fatigue can affect someone ‘s ability to work. For people like me with Polycystic Overlain Syndrome (PCOS), menstruating is often debilitating. Without the help of hormonal birth control, I’d be unable to work about 25 percent of the time and I am extremely fortunate that an accessible, commonly proscribed medication helps me (assuming birth control is not banned in the future as a continuation of a possible Roe v. Wade overturn). People with Endometriosis also typically experience difficult symptom during menstruation.

Additionally, miscarriages are surprisingly common. Up to 26 percent of pregnancies end in miscarriage. And what is the would-be parent to do? Since it’s considered verboten to talk about miscarriage in our society (similar to but more so than menstruation), people have to suffer alone. Plus, this doesn’t always affect only the person who miscarried – an expectant partner could experience serious mental health affects as well.

The societal change required here is openness. That won’t happen overnight, but if you create a safe enough environment for people to at least disclose this to human resources or feel comfortable providing a doctor’s note, it can help.

“She’s pissy today. Must be on her period.”

We’ve all heard this, possibly even at work.

More directly, you can discourage cisgender men from saying offensive or disparaging things to or about AFAB employees and their bodily functions.

Know This: Not Every Disabled Person Can Be Openly Disabled

Yesterday, a well-intention woman of color asked on LinkedIn:

“Why are all these cis straight white people on DEI panels?”

As a cis straight white person with a disability, I took some time to examine my defensiveness before responding. Defensiveness often occurs when a white person experiences discomfort at the presentation of a truth, especially if it makes them feel excluded.

After doing that work, I responded by agreeing that there are too many cis straight white people on panels, and marginalized voices should be prioritized. However, I explained that the comment was unintentionally hurtful to people with disabilities, and reminded the poster that while white women have privilege, we are also unfortunately still susceptible to severe disadvantages due to patriarchy. The comment ultimately contributed to the erasure of disabled persons in DEI considerations.

I was able to respond this way because I am openly disabled. I can be openly disabled because I have a respectful employer and leadership that appreciates my voice on our DEI Council and in our Women’s Employee Resource Group. I also have a desk job, and even without limitations suggested by my doctor, my hybrid job only requires me to go into the office twice weekly, which happens to work as an accommodation for me as well. I am not made to feel like I am violating any boundaries or endangering my employment by being disabled: in fact, I’m welcomed and appreciated.

I also felt comfortable in my previous (also mostly remote) role at a company that proudly declared it was owned by a disabled veteran. In both instances, I also had (have) understanding direct managers.

This was not always the case. I can’t imagine openly disclosing my car accident injuries and how the affect me while working as a barista at Starbucks, for example, because with a more physical job that involves mopping floors and lifting heavy coffee urns, my disabilities might have endangered my job. Even with disclosure, my coworkers might have felt that it was unfair that I “get out of’ having to do those particular tasks.

The best thing you can do for employees that are not sure whether to disclose their disability is to create an environment in which it may be safe for them to disclose if they choose. I chose to be open from day one in my current role, especially since I’m participating on a DEI Council. I feel that it’s important for the other council members to be aware of my disabilities so it doesn’t look like I’m that straight white cis person taking up more space than I should. (Additionally, I am mindful not to center my voice over voices of color and queer voices.)

Consider the Curb Cut Effect

If you create a safer environment for disabled people to disclose (if they choose to do so), you’re also creating a safer environment for others to express concerns related to issues like race and microaggressions, or identities such as a queer person feeling more comfortable being open about their sexuality.

The Curb Cut Effect describes how creating an accommodation for disabled people can help everyone. A cut curb is accessible for wheelchairs, but it could also help people with rolling suitcases and strollers or people on bikes.

While the curb cut is a physical accessibility example, it also applies to other accommodations. Did you know that fonts designed for people with reading comprehension difficulties can also benefit fast readers who can retain information as they read? Or that a website designed with an accessible user experience (UX) in mind can also be easier for a sighted person to navigate? Accessibility is important to promote the inclusion of disabled people, but it also benefits many more groups.

You can use examples of the Curb Cut Effect to demonstrate how an investment in a more accessible system will save time for everybody.

Use Inclusive Language

This one’s pretty easy. If you’re speaking about DEI matters, be sure to mention people with disabilities at least some of the time. If you’re talking about schedule flexibility, make sure to mention new parents so they don’t be guilty about taking advantage of the flexibility you offer.

The first step to inclusion is an invitation. What will you do to include disabled people at work and in your DEI initiatives? Please leave comments with more suggestions so we can all improve!