By David Pettinicchio, Associate Professor of Sociology/Munk School of Global Affairs and Public Policy, University of Toronto – Mississauga. Image by Steve Buissinne from Pixabay.
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Across Europe, nearly one in four adults reports a disability. Behind that statistic is another, less visible reality: disability is a household experience.
When someone in a family has a disability, the economic consequences ripple outward shaping who works, who reduces their hours, who provides care, and how secure everyone feels about their financial future. Our new cross-national research in Sweden, Germany, Italy, and the United Kingdom published in European Societies shows that disability and caregiving are tightly bound to employment and economic insecurity in ways that policy still struggles to address.
The findings are both unsurprising and unsettling.
First, people with disabilities are significantly less likely to be employed full-time and more likely to be out of work. Despite decades of anti-discrimination laws and policies meant to encourage labour market participation, barriers persist. Some are structural barriers, like inaccessible workplaces, inflexible schedules, and hiring discrimination. Others are economic. For example, disability often comes with additional costs like health care, transportation, assistive devices, that can strain already limited incomes.
In our study, we find that when someone in a household has a disability, other members are far more likely to step into caregiving roles. And when caregiving is directed toward a disabled household member, employment suffers. Caregivers in these situations are substantially more likely to be working less or not working which also means they face reduced income.
In other words, disability reduces employment not only for individuals, but also for people in their household.
This dynamic helps explain why households that include a disabled member often face greater economic strain. Reduced earnings combine with higher disability-related costs, creating a “disability penalty.” Even when caregiving does not directly predict feelings of economic insecurity once employment is accounted for, the pathway is clear: caregiving shapes work, and work shapes financial security.
Employment emerges as a critical buffer. Caregivers who are able to remain employed particularly in full-time positions are less likely to report severe difficulty meeting expenses. But under what conditions can caregivers stay in the labour market?
Among the four countries we studied, Sweden stands out. Individuals with disabilities as well as those providing care to disabled household members are more likely to remain in full-time employment compared to their counterparts in Italy, Germany, or the UK. Sweden’s stronger public supports and services appears to make continued employment more feasible.
Italy presents a contrasting case. Italian respondents report higher levels of caregiving and greater difficulty meeting expenses. While Italy provides some cash allowances for caregivers, formal care services are less accessible and often insufficient. As a result, families shoulder more responsibility directly, often at the expense of paid work.
This means that policy design shapes not only objective economic outcomes, but also how secure people feel. Economic insecurity is not simply about income but also about vulnerability. It reflects whether households believe they can manage rising costs, unexpected expenses, or changes in employment. For families navigating disability and care, those risks are ever-present.
Importantly, our findings also challenge simplistic narratives. Not everyone who lives with a disabled family member leaves work. Not all caregiving leads to financial crisis. Education, dual-earner households, and supportive workplace policies can mitigate some of the risks. But these protections are unevenly distributed.
Too often, public debates frame disability policy and caregiver policy separately. Our research suggests this is a mistake. Disability and care are deeply intertwined within households. Policies that focus solely on integrating disabled people into employment without addressing caregiving demands overlook the broader family context. Likewise, caregiver supports that assume stable employment opportunities may fall short if workplaces remain inflexible or discriminatory.
If we take seriously the idea that “disability is a household affair,” then policy must follow suit.
That means investing in accessible, affordable formal care services so that families are not forced to choose between income and care. It means strengthening employment protections and flexible work arrangements for both disabled people and caregivers. And it means recognizing that austerity measures, whether in Sweden, Italy, the UK, or elsewhere, often shift costs from states onto families, deepening insecurity in the process.
As Europe grapples with ageing populations, rising living costs, and strained welfare systems, the intersection of disability, care, and work will only become more central. Economic security is about whether households can sustain care and employment simultaneously without being pushed to the brink.
Disability does not just shape individual lives. It reshapes family economies. The question is whether our policies will recognize it as a shared social responsibility.
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David Pettinicchio is Associate Professor of Sociology/Munk School of Global Affairs and Public Policy, University of Toronto – Mississauga
Image by Steve Buissinne from Pixabay.