Disability and discrimination in Ireland: evidence from the QNHS Equality modules

This report has been conducted by the Economic and Social Research Institute (ESRI) under a joint programme of research with the Irish Human Rights and Equality Commission. The Research Programme on Human Rights and Equality investigates issues relating to equality and discrimination among the ten equality grounds set out in Irish legislation. Using data from the 2004, 2010 and 2014 Equality modules of the Quarterly National Household Survey this report focuses on disability and discrimination in Ireland.


IHREC/ESRI RESEARCH PROGRAMME ON HUMAN RIGHTS AND EQUALITY
This is the fourth report in a joint IHREC/ESRI programme of research investigating issues relating to equality and discrimination among the ten equality groups set out in Irish legislation. The first report, entitled Who Experiences Discrimination in Ireland, was published in November 2017. This research investigated the determinants of the experience of discrimination in Ireland, using the QNHS Equality module, which is the same dataset used in the current project. The second publication, Attitudes to Diversity in Ireland, was released in March 2018 and used European Social Survey data to probe attitudes to immigrants and minority racial/ethnic groups among the Irish born population. The third report in the series was entitled Discrimination and Inequality in Housing in Ireland and was published in June 2018. It used a variety of high-quality sources of information to evaluate housing discrimination and outcomes across a range of equality groups.

EXECUTIVE SUMMARY
This report provides a detailed account of the experience of discrimination for people with disabilities in Ireland. Using the Equality module of the Quarterly National Household Survey (QNHS), this report examines the extent to which people with disabilities experience higher rates of discrimination across a range of life settings or domains compared to people without disabilities. These domains include both public and private settings such as education and training, access to healthcare, access to housing, the provision of goods, facilities or services, shops, pubs, restaurants and banks and other financial services.
The report is organised around four main research questions: • Do people with disabilities experience discrimination more frequently than people without disabilities and does it have a greater impact on them?
• Do people with disabilities experience discrimination to a greater extent in some domains than others? Are any such differences related to other characteristics (such as gender, age and education)?
• Are people with specific disabilities more likely to experience discrimination than others?
• Has the experience of discrimination among people with disabilities changed over time?

KEY FINDINGS
This report shows that between 2004 and 2014, between 10 and 12 per cent of the population reported a disability. The findings also show that people with disabilities have a distinct socio-demographic profile compared to the general population. In particular, they are more likely to be over the age of 65 compared to those without disabilities.
Focussing on discrimination, the findings clearly show that people with disabilities experience higher rates of discrimination than people without disabilities. On average, 15 per cent of people with disabilities experience discrimination compared to 11 per cent of x | Disability and discrimination in Ireland: evidence from the QNHS Equality modules those without a disability. People with disabilities are not only more likely to experience discrimination more frequently; when they do, it has a more serious effect on their lives.
Pooling the data from 2010 and 2014 together, we find that people with disabilities experience discrimination 'more regularly' than people without disabilities. The data also reveal that people with disabilities were more likely to say that the discrimination had a 'serious' or 'very serious' effect on their well-being. For instance, in 2014, 18 per cent of people with disabilities who reported experiencing discrimination said it had a 'very serious' effect on them, compared to 10 per cent of those without a disability.
We also examine the extent to which people with disabilities experience discrimination to a greater extent in some domains than others. Descriptive analysis shows that discrimination for people with disabilities is mostly experienced in the health services followed by the private sector (e.g. financial institutions, shops, pubs and restaurants). This is likely to be due to the fact that people with disabilities interact with health services on a much more frequent basis than those without disabilities. Unlike the rest of the population, reports of discrimination among people with disabilities in the workplace, or while looking for work, make up a small portion of the total reports of discrimination -fewer than one-in-four. This is because they are less likely to be economically active, which necessarily diminishes the chance that they will experience work-related discrimination.
This report employs multivariate techniques which allow us to further investigate whether the relationship between disability and discrimination holds when other socio-demographic characteristics are taken into account. We model the relationship between disability and discrimination in three broad domains; in the labour market, in accessing public services and in accessing private services.
Our findings show that when people with disabilities are looking for work, or in the workplace, the odds of experiencing work-related discrimination was twice as high compared to those without disabilities. This pattern holds even when we take account of differences in terms of age, sex, family and marital status and employment status. The findings do show, however, that those with higher levels of education are more likely to report discrimination. This may be due to higher educated groups having a greater awareness of their legal rights.
Executive Summary | xi Focussing on discrimination in the public services (such as education, health, transport), the findings also show that people with disabilities were three times more likely to experience discrimination compared to those without disabilities.
Controlling for socio-demographic characteristics, the findings show that discrimination in private services (such as pubs, shops, restaurants, financial institutions or housing) was also significantly more likely for people with disabilities compared to those without disabilities with the odds 65 per cent higher overall.
In Chapter 4, we investigate whether the impact of disability on the experience of discrimination in 'any' domain varies according to the specific type of disability considered.
We focus on six different disabilities: blindness, deafness, physical disability, learning/intellectual disability, psychological/emotional conditions, and other disabilities/chronic illnesses. We find that the experience of discrimination varies by disability type, with blindness having the greatest risk of discrimination, followed by psychological/emotional conditions.
Finally, we study whether the risk of discrimination for people affected by each type of disability varies over time. Overall, the probability of experiencing discrimination fell from 24 per cent in 2004 to 17 per cent in 2010 for people with any type of disability. With the exception of people who are blind or deaf, individuals with each type of disability had a reduction in the experience of discrimination from 2004 and 2014. By contrast, discrimination risks for people without disabilities remained stable over the period examined.

Disability, discrimination and disadvantage
The link between disability and poverty has been well documented, with evidence showing that people with disabilities are more likely to be in poverty and outside the labour force.
The report suggests that policy should not just rely on social security or social welfare to address this issue, but that responsibility also lies in education and employment policy. The retention of people with disabilities in school is directly linked to their later life chances xii | Disability and discrimination in Ireland: evidence from the QNHS Equality modules including their access to the labour market or further education. The full implementation of the Education for Persons with Special Educational Needs (EPSEN) Act (2004) is essential in order to improve the engagement, retention and progress of students with special educational needs and disabilities. Given the over-representation of students with special educational needs in DEIS schools, programmes that aim to improve school engagement and retention such as the School Completion Programme and the Home School Community Liaison Scheme are important in targeting this group of students and providing them with the guidance and supports necessary during their transition from school.

Discrimination in accessing public services
The findings point to the need for greater awareness, amongst policymakers and service providers, of discrimination against people with disabilities in accessing public services, particularly healthcare. It is important, however, to gain a clear understanding of what aspect of accessing health services is giving rise to discrimination against people with disabilities. For other public services, the report highlights the need for implementation of the Public Sector Equality and Human Rights Duty (Government of Ireland, 2014) in eliminating discrimination against employees, customers and service users with disabilities in their interaction with all public sector bodies.

Access to employment for people with disabilities
The labour market participation of people with disabilities remains far lower than participation rates in the general population, even when controlling for age and other personal characteristics. As most disabilities develop during people's working lives, retention in the workplace should be a policy priority. There have been a number of recent policy initiatives to increase the recruitment opportunities for people with disabilities such as increasing the public service employment target from 3 per cent to 6 per cent by 2024.  (Russell et al., 2008;McGinnity et al., 2012;McGinnity et al., 2017). It also draws on research specifically on the position of people with disabilities in the Irish labour market, which includes the experience of discrimination . Using data from the Equality modules of the Quarterly National Household Survey in 2004, 2010 and 2014, this report addresses several research questions pertaining to the link between disability and discrimination. It evaluates the prevalence, severity and frequency of discrimination over time and across several domains of public life. More detailed analysis considers the effect of different kinds of disability and the extent to which differences in socio-demographic characteristics on these relationships explain the patterns found.

RELEVANT LEGISLATION AND POLICY
There has a been global shift in thinking about disability in recent decades, from a deficitbased medical view of people with disabilities, which sees the disability as something inherent in the person, to a more inclusive bio-psychosocial model where disability is understood as emerging from an interaction between personal capacities and facilitators or barriers in the environment (WHO, 2001). This section outlines a range of legislation and policy relevant to discrimination against people with disabilities by focussing on primary legislation in Ireland, European Union law and international law, followed by a number of international and national policies.

Primary legislation
The Employment Equality Acts 1998and the Equal Status Acts 2000 Under the Employment Equality Acts 1998-2015 and the Equal Status Acts 2000-2015, discrimination in Ireland is defined as the treatment of a person in a less favourable way than another person is, has been, or would be treated in a comparable situation on any of the following ten grounds: gender; marital status; family status; age; race; religion; disability; sexual orientation; membership of the Traveller community; or receipt of housing assistance or social welfare (accommodation only). 1 The legislation identifies two types of discrimination. Direct discrimination is where a person is treated less favourably than another in similar circumstances based on one of the ten grounds above. Indirect discrimination refers to practices or policies, which seem fair at first sight but which in effect, either intentionally or unintentionally, result in discrimination. This definition can apply to complaints about discrimination in a range of social settings that can include employment, vocational training, the provision of goods, facilities or services, education and premises. Discrimination occurs when, for a reason related to a person's membership of an equality group, they are treated less favourably than other people to whom the reason does not or would not apply, and this treatment cannot be justified.

The Irish Human Rights and Equality Commission Act 2014
The Irish Human Rights and Equality Commission (IHREC) is Ireland's national human rights and equality institution. It is an independent public body established in 2014 by the Irish Human Rights and Equality Commission Act (2014). Under this Act, all Irish public bodies have responsibility to promote equality, prevent discrimination and protect the human rights of their employees, customers, service users and everyone affected by their policies and plans (Government of Ireland, 2014). Section 42 of the Act is the Public Sector Equality The Equality (Miscellaneous Provisions) Act 2015, which came into effect from January 2016, introduced an additional ground which prohibits discrimination in the provision of accommodation on the basis of a potential renter being in receipt of housing assistance payments. and Human Rights Duty which places 'a positive duty on public sector bodies to have regard to the need to eliminate discrimination, promote equality, and protect human rights, in their daily work' (IHREC, 2017). Three core steps are to be taken by public bodies in order to implement the Duty: • assess human rights and equality issues as part of their strategic plans; • identify policies that can address the issue identified; • report developments and achievements in addressing the issues identified.
The Disability Act (2005) The • the provision of an assessment system which could identify the health, personal and social service needs of the person with a disability. This also involves the drawing up of service statements which outline the services required; • safeguards against the use of genetic testing by an employer, insurance or mortgage broker. People are therefore not required to provide genetic data for employment, insurance policies, health insurance, occupational or other retirement annuities or mortgages; • the establishment of a Centre for Excellence in Universal Design. This was established by the National Disability Authority (NDA) in 2007 and aims to develop and promote universal access for all people; • an obligation on public bodies to provide access to public buildings. There is specific reference to heritage sites, where all people with disabilities are able to visit Heritage Sites with ease and dignity; • an obligation on public bodies to be proactive in employing people with disabilities; • the provision of disability-specific services and improving access to mainstream public services; and • the creation of sectoral plans. Part of the Act required that six Government departments prepare sectoral plans to ensure that access for people with disabilities will become an integral part of service planning and provision. These plans were published in 2006 and set out how each department would deliver specific services. 2 The Education Act (1998)

and the Education for Persons with Special Educational Needs (EPSEN) Act (2004)
Specific legislation for children and young people with special educational needs and disabilities were also introduced which sought to change from a system of segregated educational provision for these students towards a more inclusive model of special education delivered in mainstream schools (Griffin and Shevlin, 2011 The Act followed the publication of a key policy report by the Special Education Review Committee (SERC) in 1993 which was the first review of special education provision in Ireland.
Introduction | 5 preamble specifically states its objective to 'Give practical effect to the constitutional rights of children, including children who have a disability' (Education Act, 1998, Part I, Section 6 (a)). Schools were now required to use resources to identify and provide for the educational needs of students with special educational needs or disabilities (DES, 2007).  (Government of Ireland, 2004).
This definition is far more detailed than the definition provided in the Education Act (1998) and much broader than the definition of disability in the Disability Act (2005) (UN, 2006).
Under international law, Ireland must abide by legal obligations created by UNCRPD. Its general principles include: • respect for inherent dignity, individual autonomy including the freedom to make one's own choices, and independence of persons; • non-discrimination; • full and effective participation and inclusion in society; • respect for difference and acceptance of persons with disabilities as part of human diversity and humanity; • equality of opportunity; • accessibility; • equality between men and women; • respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities. • equality and non-discrimination; • awareness raising; • accessibility; • equal recognition before the law; • freedom from exploitation, violence and abuse (COE, 2017).
The strategy is intended to operate across five cross-cutting themes which include; participation, co-operation and co-ordination, universal design and reasonable accommodation, gender equality perspective, multiple discrimination, and education and training. The priority areas outlined above and the cross-cutting themes are anchored in the UNCRPD which reinforces the emphasis on the implementation of existing human rights standards (COE, 2017).

The Comprehensive Employment Strategy for People with Disabilities 2015-2024
Recent policy in Ireland has begun to take a proactive approach to ensure the inclusion and participation of people with disabilities, especially in the area of employment. The Comprehensive Employment Strategy (CES) for People with Disabilities 2015-2024 (Government of Ireland, 2015), is a ten-year strategy aimed at ensuring that people with disabilities, who are able to work and want to work, are supported and enabled to do so.
The CES sets out six strategic priority areas: • building skills, capacity and independence; • providing bridges and supports into work; • making work pay; • promoting job retention and re-entry to work; • providing co-ordinated and seamless support; • engaging employers.
The CES forms part of the objective to increase the statutory target of 3 per cent of employees with disabilities in the public sector towards 6 per cent by 2024. The stated aim of the strategy is to reduce the numbers of people with disabilities entering unemployment either when they leave school, or if they develop a disability in adult life. An Implementation Group was established to monitor its implementation and, in 2017, two years after its Introduction | 9 introduction, it reported an increase in the number of people with disabilities employed in public sector bodies. Over the same time period, however, the employment rate for people with disabilities increased (CSO, 2017a). These changes may, therefore, reflect the ageing of the public sector workforce rather than the result of recruitment initiatives, though it is difficult to separate the effect of policy changes from general economic trends without further research.
Focussing on a range of government departments and agencies, the review highlights specific initiatives that have been introduced since the strategy was introduced that include: • the launch of a €16 million Ability Programme (2018-2021) to improve the employability of people with disabilities aged 15-29; • increased funding in transport; • the launch of the National Plan for Equity of Access to Higher Education (2015-2019) to widen access to third level for people with disabilities; • the introduction of a new resource allocation model for students in mainstream schools to create a more equitable resource allocation system, enhance educational opportunities and improve retention for students with special educational needs and disabilities in the future (NDA, 2017a).
These initiatives have not yet been formally evaluated so continued monitoring will be needed to assess their impact in the future.
Following on from the CES, an expert group under the auspices of the then Department of • joined-up services; • education; • employment; • health and well-being; • person-centred disability services; • housing; • transport and access to places (Department of Justice and Equality, 2017).
One of the aims of the NDIS is to make Departments and agencies work more closely together to deliver on the themes outlined above. The four-year plan outlines the actions to be taken, the government department responsible and the timeframe for delivering on the action. The NDIS is required to produce an annual report on its implementation; however, further research is needed to assess its impact to date on specific outcomes for people with disabilities.
For people in receipt of Disability Allowance, if the employment is considered to be of a rehabilitative nature, there is an earnings disregard available (see  for more detail).

OVERVIEW OF THE LITERATURE
In the following section, we provide a brief review of the Irish and international literature on discrimination against people with disabilities. This involves an analysis of a range of empirical research, policy reports and documents and theoretical studies on disability and discrimination to provide context for the study.
Negative attitudes to people with disabilities can lead to discrimination in all spheres of life including education, employment and health (Barr and Bracchitta, 2015;Special Eurobarometer 437, 2015;Hannon, 2007). Increasingly, research highlights the experience of discrimination faced by people with disabilities in accessing public and private services and more so in entering and remaining in employment. Some studies focus on specific disability types, particularly psychosocial disabilities/mental health problems, and people's experience of discrimination. One systematic review of the literature found that people with mental health problems were treated differently or less favourably to others across different domains (such as employment) (Sharac et al., 2010). The review cites a New Zealand study which examined discrimination as experienced by people with mental health problems. This mixed methods study found that respondents (i.e. those with mental health problems) reported discrimination in every area of their lives. Discrimination was highest from family and friends, followed by discrimination in the workplace and in accessing mental health services (Peterson et al., 2007). Other research also highlights how the direction of causality in the relationship between self-reported discrimination and mental health is complex. It argues that the experience of discrimination may be a cause, as well as an effect, of poor mental health (Kessler et al., 1999;Grotti et al., 2018;Yang et al., 2016).

Discrimination in health domains
It is perhaps not surprising that healthcare features in the literature on discrimination experienced by people with disabilities given the greater interaction they have with health systems as a result of acquiring disabilities or impairments over the life course (Sakellariou and Rotarou, 2017;Australian Government, 2015). One UK study shows how people with disabilities have poorer access to healthcare compared to people without disabilities.
Reasons for lack of access were related to transport issues, long waiting lists and overall costs (Sakellariou and Rotarou, 2017; Lee et al., 2014). Other research focuses on both 12 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules direct and indirect discrimination in accessing healthcare for people with different types of disabilities. In one qualitative study of people with intellectual disabilities (and their carers), Ali et al. (2013) found that half of the participants felt the patient had been treated unfairly by the health services. They identified communication problems, negative staff attitudes and failure to make reasonable adjustments for people with intellectual disabilities (Ali et al., 2013).

Discrimination in education
Research in education settings shows that, compared to their peers, students with disabilities are more likely to face barriers in education, are more likely to report disliking school and are at risk of poorer academic outcomes (Humphrey et al., 2012;McCoy et al., 2012). Findings also show that parents and teachers of children with disabilities have lower expectations compared to children without disabilities (Banks et al., 2016;Shandra et al., 2009). Low expectations have clear long-term implications for accessing further and higher education and entry into the labour market for people with disabilities. For those that do progress to further or higher education, issues exist around transition planning and retention (Smith, 2006). Studies also show that discrimination on entry to higher education can vary by disability type. In one field experiment by Deuchert et al. (2017), students with dyslexia and depression were treated less favourably by the university compared to students with physical disabilities and those without a disability (Deuchert et al., 2017).
In Ireland, much of the policy focus has been on inclusive education and removing the barriers for people with disabilities entering higher education and remaining in university (Mooney et al., 2017). In recent years, the number of students with disabilities in further and higher education has grown, leading to a substantial increase in numbers seeking disability services, disability funding and reasonable accommodations (HEA 2017; AHEAD, 2016). On entry to higher education, students with disabilities can benefit from affirmative action through schemes such as the Disability Access Route to Education (DARE). DARE prioritises places in higher education for school leavers with disabilities, although research by Byrne et al. (2013) points to a lack of consistency in the implementation of DARE across Introduction | 13 Higher Education Institutions (HEIs) and queries the effectiveness of the scheme in increasing participation for people with disabilities (Byrne et al., 2013).

Discrimination related to housing
More recently, a number of studies have sought to examine whether some groups experience discrimination in accessing housing (Turner et al., 2005). Using field experiments, this research highlights discrimination in accessing housing is most often the result of an individual's ethnicity or nationality (Andersson et al., 2012;Auspurg et al., 2017) or their disability (Verhaeghe et al., 2016;Aranda, 2015). One pilot study from the Chicago area suggests that those with disabilities are more likely than those from ethnic minority groups and those without a disability to be discriminated against in inspecting potential properties or getting information from landlords (Turner et al., 2005). Where people have physical disabilities, the findings for those searching for rental accommodation suggest discrimination both during the searching process, when communicating with landlords and when being shown accommodation (Aranda, 2015). In Ireland, recent research has highlighted the specific issue of discrimination for people with disabilities related to housing. The findings show that people with disabilities are more than twice as likely to report discrimination related to housing and over 1.6 times more likely to live in poor housing or neighbourhood conditions (e.g. leaking roof, damp walls, no central heating, crime/vandalism in the area, etc.).

Labour market discrimination
Much of the literature on discrimination against people with disabilities has, however, focussed on discrimination in the labour market based on disability status. Research on the experiences of people with disabilities in the labour market tends to focus on those either seeking work and their ability to enter the labour market or those who are working and their performance and outcomes in the labour market. People with disabilities are less likely to be in employment compared to those without disabilities and (once in the labour market) are more likely to be unemployed (Kraus et al., 2018;Watson et al., 2017). Discrimination is cited as a likely reason for these poorer employment outcomes among people with disabilities (Kaye, 2009). Studies show how the characteristics of employers, of people with disabilities, and employers' organisations influence attitudes towards people with 14 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules disabilities in the workplace (Vornholt et al., 2013). In one US study, Bendick et al. (2018) compared those with and without a disability applying for sales positions at clothing retailers. They found that people with disabilities were only 27 per cent as likely to receive a job offer or advance as far in the hiring process as their equally qualified counterparts without a disability (Bendick, 2018). They describe this as a 'no foot in the door' discrimination pattern which gives no opportunity for people with disabilities to explain or demonstrate their suitability for the job (Bendick, 2018). For those in employment, people with disabilities are more likely to be in low status jobs that are temporary or part-time or in low-skilled, low paid occupations. Snyder et al. (2010) examined the experiences of employees at a large US university that included 90 self-identified people with disabilities.
They found that employees with disabilities reported more 'overt and subtle' discrimination than their non-disabled colleagues (p.5). They also noted differences in the level of discrimination by type of disability, with those with non-physical disabilities reporting more negative experiences than those with physical disabilities (Snyder et al., 2010). This report seeks to build upon this literature to better understand what factors influence the likelihood of people with disabilities being discriminated against at different stages of the employment process.

Disability and discrimination: research from Ireland
In line with disability policy developments, there has been a major expansion of research on disability in Ireland over the last decade. Much of this work has focussed on attitudes to disability, the experiences of people with disabilities and the issue of disability and labour market and service-related discrimination. Attitudinal surveys show that attitudes to people with disabilities in Ireland have improved over time (NDA, 2017b;2006;. A number of studies have sought to deal with the issue of disability and labour market and servicerelated discrimination (Watson et al., 2017;Russell et al., 2008;McGinnity et al., 2012;NDA, 2017b;CSO, 2005 (over five times more likely to report problems of discrimination). For work-related discrimination they found that those with disabilities are 2.8 times more likely to report discrimination compared to those without a disability (Russell et al., 2008). Focussing specifically on people with disabilities in the Irish labour market, Watson et al.
(2012) used the QNHS Equality modules for 2004 and 2010. They showed that work-related discrimination was higher for people with disabilities compared to those without disabilities but highlighted a fall in this type of discrimination for people with disabilities during that time period, from 16 per cent to 10 per cent . The authors note the importance of context in these findings, as Ireland experienced a period of economic boom and extremely low rates of unemployment. Controlling for a range of factors, their analysis identifies certain groups who are at higher risk of work-related discrimination including single parents with disabilities, younger people with disabilities and those with learning or intellectual disabilities .
The impact of disability on employment, and particularly on earnings, has been the subject of much research which has sought to understand the 'earnings gap' between people with disabilities and those without (Gannon and Nolan, 2005). This discussion often takes place alongside debates around labour market activation measures for people with disabilities, the impact of disability benefits on earnings, and income support or wage subsidies for people with disabilities. Much of the policy in this area seeks to balance incentives to work with providing adequate social protection for people with disabilities (OECD, 2010). In Ireland, Nolan (2015) examined the issue of the earnings gap for people with disabilities in the Irish labour market. Controlling for a range of characteristics, he showed that people with a chronic illness or disability are more likely to have a lower hourly wage compared to those without a disability (Nolan, 2015).
16 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules

RESEARCH QUESTIONS
Given the intensive policy attention paid to this area in Ireland since 2005, it is timely to examine whether there has been an improvement in the circumstances of people with a disability over time. The report is organised around a number of broad research questions which evaluate the relationship between disability and the experience of discrimination in Ireland: • Do people with disabilities experience discrimination more frequently than people without disabilities and does it have a greater impact on them?
• Do people with disabilities experience discrimination to a greater extent in some domains than others? Are any such differences related to other characteristics (such as gender, age and education)?
• Are people with specific disabilities more likely to experience discrimination than others?
• Has the experience of discrimination among people with disabilities changed over time?

METHODOLOGY
This report relies on two related sources of data. First, it uses data from the Quarterly National Household Survey (QNHS), a large and nationally representative sample of the Irish population. While representative of the overall Irish population, it might not be representative of the population with disabilities given that people with the most severe forms of disability may be in residential care homes or unable to answer the questions in the manner in which they are asked, and thus outside the scope of the survey. Implications of this for our results are, on one hand, overestimation of the exposure to discrimination for people with disabilities and, on the other, possible underestimation of their experience of discrimination because we might expect people with the most severe disabilities to be most at risk of experiencing discrimination. Notwithstanding these possible limitations, the QNHS still remains the best source of information available. Indeed, this survey collects a wide range of individual and family information including labour market information and, most importantly for our purposes, information about the disability status and the specific type of

BOX 1.1 DEFINITION OF DISCRIMINATION IN EQUALITY MODULES
I am going to ask you some questions about your experiences of discrimination in Ireland. The focus of this section of the questionnaire is to collect data on discrimination as defined in Irish law. Under Irish law, discrimination takes place when one person or a group of persons is treated less favourably than others because of their gender, marital status, family status, age, disability, 'race' (skin colour or ethnic group), sexual orientation, religious belief, and/or membership of the Traveller Community. When the term discrimination is used in this questionnaire, it refers to this legal definition only.
If you believe you were treated less favourably than someone else but it was for another reason (such as your qualifications, being over an income limit or because you are further back in a queue for something), this is not considered discrimination under Irish law.
Respondents to the Equality module were first prompted by being provided with a definition of discrimination (see Box 1.1) which involves being treated less favourably on the For further details, see: www.cso.ie/en/qnhs/abouttheqnhs/whatistheqnhs. 6 18 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules basis of the nine grounds specified in Irish law. 7 Finally, the questions in the module specify a particular time period: they ask about discrimination experienced in the previous two years.
It is worth noting that the Equality module provides a subjective measure of discrimination.
It does not tell us whether individuals have experienced discrimination but rather whether individuals have reported to have experienced discrimination. Some groups might therefore over-and others under-report discrimination depending on characteristics such as gender and levels of education for example.
Providing the respondent with the definition of discrimination as reported in Box 1.1 should reduce the bias between discrimination experienced and discrimination reported; the discrepancy between the two is not eliminable completely. For a more detailed discussion of the Equality module and the measurement of discrimination see McGinnity et al. (2017).
The disability status and the type of disability that affects people is collected by directly asking them whether they have any long-lasting condition. Over time, the way this was asked has changed as Table 1.1 shows. First of all, the filter question has changed: while the 2004 round refers to long-lasting 'conditions', the following rounds (2010 and 2014) refer to 'conditions or difficulties'.
The tenth ground was added after the most recent Equality module was fielded.  There were also changes in how the response categories were worded. Blindness and deafness have been split in the recent waves and, in addition, the items refer to 'severe' category.
Whether these changes are more likely to increase or to decrease reported disability, however, is not entirely clear. If these changes will have an impact, it is more likely that this 20 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules impact will be visible for the detailed analysis of disability types rather than in the overall levels and trends.
Finally, in order to maximise the comparability over time, we have collapsed the items for the 2010-2014 rounds to correspond with the 2004 round. The labels of the classification of disability types that we use throughout the report are shown in the first column of Table   1.1.
Studying people with disability and distinguishing them according to the different types of disability implies that we have to deal with very small groups in some cases. Therefore, in order to have sufficiently large groups and thus have more robust estimates, in most of the analyses we pool the data across the three rounds. After the pooling, our analytical sample exceeds 56,000 individuals.

REPORT STRUCTURE
Chapter 2 of this report presents baseline data on the numbers and characteristics of people with disabilities in Ireland using the three waves of the QNHS Equality module. It examines the extent to which people with disabilities experience discrimination, and the severity and frequency of that discrimination. Chapter 3 investigates people's experience of discrimination in a range of different life settings or domains including work-related discrimination, discrimination in private services and discrimination in public services. In Chapter 4, we focus on whether people with some types of disability are at a greater risk of discrimination than others. Using the five disability categories shown in Table 1.1, Chapter 4 assesses the extent to which their experience of discrimination can be explained by other characteristics associated with having a disability or being discriminated against. Chapter 5 provides a summary of findings and outlines some policy issues arising from the data.
The experience of discrimination among people with disabilities | 21

CHAPTER 2
The experience of discrimination among people with disabilities This chapter uses data from the three waves of the QNHS Equality module to present descriptive statistics on disability and the experience of discrimination in Ireland. It gives a breakdown of the prevalence of different types of disability recorded in the data, as well the socio-demographic characteristics of people living with disabilities, highlighting where they are similar and different to the rest of the population. Turning to discrimination, the chapter investigates to what extent disability is associated with the domain, frequency and severity of the experience of discrimination.

Type of disability
According to the QNHS data, the proportion of people in Ireland with disabilities was were a decrease in the percentage of people answering 'yes' to 'physical disabilities that limit daily activities' and an increase in the percentage answering 'yes' to the 'other/chronic illness' category.
-- Source: QNHS (2004QNHS ( , 2010QNHS ( and 2014. The margins of error on these estimates range from less than 0.1 percentage points to 0.5 percentage points.

Socio-demographic characteristics
The socio-demographic characteristics of people with disabilities differ in a number of ways to the rest of the population (see Figure 2.2). These differences are important because when we attempt to examine the association between disability and discrimination in later chapters, we need to control for these other characteristics. One of the most notable characteristics is age, because the disabled population is significantly older than the nondisabled population. For instance, while 13 per cent of the non-disabled pooled sample was aged 65 or over, the equivalent proportion for people with disabilities was over 40 per cent.
Conversely, the youngest age category, 18-24, accounted for 13 per cent of people without a disability but only 3 per cent of people with disabilities. Finally, interesting patterns emerge regarding marital status and family type. On the family type variable, it appears that people with disabilities, at 41 per cent, were almost twice as likely to be unpartnered (and without children) as people without disabilities. On the marital status variable, however, they displayed a relatively low probability of being 'never married' (28.1 per cent compared to 38.9 per cent). The main reason for this difference is that widowed and divorced/separated individuals were included in the unpartnered category in the family status variable. People with disabilities were much more likely to be widowed or divorced, which once again may be explained by their age profile, or by relationship stress associated with their disability. No disability Disability Source: QNHS Equality module.

Note:
The margins of error on these estimates range from 0.4 to 0.5 percentage points for people without disabilities, and from 1.3 to 1.6 percentage points for people with disabilities.

Where do people with disabilities experience discrimination?
We next turn our attention to the nine domains in which people with and without disabilities report experiencing discrimination.

THE FREQUENCY AND SEVERITY OF DISCRIMINATION
Respondents in the 2010 and 2014 QNHS Equality modules who report experiencing discrimination were asked how often they had this experience. The distribution of these responses is shown in Table 2.1. In 2010, people with disabilities showed a similar distribution on this item to the rest of the population that experienced discrimination.
Approximately one-third say that they only experienced discrimination once, half reported it 'on a few occasions' and the remainder said it happened 'more regularly'. In 2014 there was a slight difference between the groups, because people with disabilities became more likely to say that discrimination occurred 'more regularly' (28 per cent) and less likely to say that it happened just once (23 per cent). While there were similar changes for people without disabilities, these were not as large. Pooling the two years, we find that the difference between people with and without disabilities is only statistically significant for people reporting discrimination 'more regularly'.

Notes:
Sample limited to those who had experienced discrimination in the previous two years. The margins of error on these estimates range from 1.9 to 2.6 percentage points for people without disabilities, and from 4.9 to 6 percentage points for people with disabilities.
QNHS Equality module respondents who report discrimination are also asked 'How serious was the effect of this discrimination on your life?' The experience of discrimination among people with disabilities | 29 statistically significant. However, additional tests revealed that the change over time was not statistically significant.

SUMMARY
This chapter presents summary statistics on disability and discrimination using data from the QNHS Equality module. The headline finding from the chapter is that although there has been a considerable reduction in the prevalence of discrimination among people with disabilities, in 2014 there remained a substantial 'discrimination gap' between those with and those without disabilities.
The data also show that between 10 per cent and 12 per cent of the population report having a disability. There have been some changes in the prevalence of certain kinds of disability over the three years of the Equality modules, though this may be due to changes in question wording between 2004 and 2010.
The socio-demographic characteristics of people with disabilities are significantly different to the rest of the population. Pooling the years together, 41 per cent of people with disabilities were aged over 65, compared to just 12 per cent of people without disabilities.
Perhaps partly as a result of their age profile, people with disabilities were also more likely to be widowed or divorced. The findings show that 19.6 per cent were widowed and 9.7 per cent were divorced compared to 5.4 per cent for each for people without disabilities. This chapter also highlights how people with disabilities were much less likely to be active in the labour market, and if they were active, were more likely to be unemployed. Over three-30 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules quarters of people with disabilities surveyed in the three Equality modules were inactive compared to less than one-third of people without disabilities.
Turning to discrimination, we find some evidence that disability is a significant factor in determining experience of discrimination. However, we cannot rule out that other factors which affect both disability and discrimination might be driving the relationship. This is because of the differences in the socio-demographic characteristics of people with and without disabilities. Chapters 3 and 4 turn to multivariate modelling to investigate this issue further.
We also find that the domain where discrimination is experienced varies by disability status.
While discrimination reported by people without disabilities is most likely to occur in the labour market, discrimination reported by people with disabilities is most likely to be in accessing health services. This is explained by lower rates of labour market participation, and higher rates of interaction with the health service among people with disabilities.
In addition to being more likely to experience discrimination, people with disabilities were more likely to report that the discrimination they experienced had 'serious' or 'very serious' effects on them compared to those with no disability. They were also more likely to report that the discrimination occurred more frequently than those with no disability. ). This will be affected by both the extent to which they are active in the domain (seeking work, seeking advancement or seeking services) and in the extent to which, once active in the domain, they experience discrimination. In this chapter, we focus more specifically on the risk of experiencing discrimination among those active in the domain. For instance, in the last chapter, we saw that people with a disability who experienced discrimination were less likely than those without a disability to report discrimination in the workplace. This was at least partly because people with disabilities were less likely to be in employment or seeking employment. When we focus on the risk of discrimination in this chapter, we base the analysis on those who are active in the domain.
We now group them into three categories -work-related discrimination, discrimination in public services, and discrimination in private services (see Table 3.1) -and model the association between each one and disability, taking account of a range of other characteristics. The work-related grouping captures discrimination in looking for work and in the workplace. This means that it could potentially apply to people who are both employed and unemployed (but seeking work), but not those who are outside of the labour force (students, carers, retirees etc.). The public services category includes discrimination in health, education, and transport, and respondents are given an option to report discrimination in 'other public services'. Private service discrimination is recorded in shops, pubs and restaurants, in financial institutions such as banks and insurance companies, and in housing.

THE RISK OF EXPERIENCING DISCRIMINATION BY DOMAIN
We first compare the risk of experiencing discrimination among people with and without disabilities across the entire sample (exposed and not exposed) in the three broad domains described above. Table 3.2 shows that with the exception of work-related discrimination in 2010, the risk of experiencing discrimination was higher for people with disabilities across all three domains, in all three years. 11 The largest gaps between the groups were in public services in 2004 (6.8 percentage points) and in 2014 (4.4 percentage points). Looking at change over time, we see that discrimination against people with disabilities fell significantly in all domains after 2004.
However, while the rate remained below 7.5 per cent in public and private services after 2010, there was a small (but statistically insignificant) increase in reports of work-related discrimination in 2014.
The difference between the groups on work-related discrimination in 2010 and 2014 is not statistically significant. All other between-group differences are significant at p < 0.05.

EXPOSURE TO DISCRIMINATION -AGGREGATED DOMAINS
Much of the variation in discrimination between people with and without a disability occurs because of differences in the kinds of interactions each group has in everyday life. As shown in Chapter 2, people with disabilities are generally older, are less likely to be active in the labour market, and have lower rates of educational attainment. This means that they have fewer interactions with employers and educational institutions and more interactions with the health service. People with disabilities therefore have lower chances of being discriminated against in the labour market and in education, and have higher chances of experiencing discrimination in the health service. We label this concept 'exposure to potential discrimination'. Figure 2.4 of the previous chapter demonstrates the effect of exposure quite clearly with the health service emerging as the most commonly cited domain of discrimination for people with disabilities.
While we cannot completely account for the amount of exposure to discrimination a respondent has, we can at least exclude those who report having no exposure at all by answering 'not applicable' to the questions on discrimination in specific domains. These are people who are not active (i.e. employed, seeking work or seeking services) in the domain.
The labour market domains (the workplace and looking for work) are the only ones with a well populated 'not applicable' category. This is expected, because nearly all respondents will have had some experience of using at least some public and private services. Table 3.3 shows the percentage of working-age respondents with and without a disability that are exposed to labour market discrimination in each year. The 'not exposed' row refers to people that answer 'not applicable' when asked about work-related discrimination. In ------34 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules most cases, a respondent would answer 'not applicable' because they had not been in employment or looking for work in the two years preceding the survey. All other respondents are deemed to be exposed. It is clear that exposure to work-related discrimination, at between 51.7 per cent and 57.1 per cent is much lower among people with disabilities than people without disabilities (between 81.3 per cent and 83.1 per cent).  the 'not applicable' group and recording their answer as 'no discrimination'). The second row excludes the group responding 'not applicable' (because they are not active in the work-related domain and not exposed to potential discrimination in this area). We find that the values increase for both groups, but that the increase is much greater among people with disabilities, meaning that the discrimination gap grows. In fact, when we restrict the cross tabulation to exposed respondents, the risk of experiencing workplace discrimination is almost twice as high for people with disabilities in 2014. Even with this correction, the prevalence of work-related discrimination may be understated, because people with disabilities might self-select into less discriminatory workplaces, or may choose to work fewer hours -or, indeed, drop out of the labour market entirely -to avoid potential discrimination.

Work-related discrimination
The following section uses multivariate statistical analysis to evaluate the effect of disability on the experience of discrimination in the three broad areas of public life -work-related discrimination, discrimination in access to private services, and discrimination in access to public services -while accounting for the effect of socio-demographic characteristics. 12 The analysis is conducted using a nested models approach. This involves adding blocks of characteristics at a time, which allows us to interpret the extent to which individual characteristics alter the association between disability and discrimination.
Beginning with the analysis of work-related discrimination, the sample is restricted to the working age population (aged 18-64) who are active in the labour market (either at work or seeking work). To help to overcome the problem of small sample size among people with disabilities who are exposed to this form of discrimination (see Chapter 1), we pool the data from the three rounds of the survey, and include a series of dummy variables for each year to account for change over time. The results of a series of models on discrimination in any of these three domains are presented in Appendix Model 1, the odds of work-related discrimination among people with disabilities are 1.97 times higher than the odds of this type of discrimination among those without a disability. Source: Own calculation based on the Equality module (2004, 2010 and 2014). Note: Individuals aged 18-64 and exposed to work-related domains. * p<0.05, ** p<0.01, *** p<0.001.
Being disabled has a strong and statistically significant effect across all models.
Furthermore, the effect is likely an underestimate because, as shown above, people with disabilities have lower levels of exposure to discrimination in this area. Some of those with a disability may have become discouraged from looking for work and may have opted out of the labour market because of prior experience of discrimination, or because they expect to The models also show that work-related discrimination increased by over 20 per cent in 2014 relative to 2004, and that this change is not due to changes in the other variables in the models. Women are 16 per cent more at risk of experiencing work-related discrimination, and educational attainment is positively associated with the experience of discrimination. Previous research in Ireland has also found that despite their advantage in the labour market, more educated people are more likely to report discrimination (Russell et al., 2010;McGinnity et al., 2006;Bond et al. 2010). This may be because Relative to the 'never married' group, and after controlling for age and gender, married people and widow(er)s are less likely to experience work-related discrimination than those who have never married. Divorced and separated people, by contrast, show a 33 per cent higher risk of experiencing discrimination relative to the reference category. Model 3 also shows that people with children, especially lone parents, are more likely to experience work-related discrimination than couples without children.

Discrimination in public services
The analysis of discrimination in access to public services is presented in Table 3.6 in a similar way to work-related discrimination. However, additional variables have been added to the third model to account for the effect of principal economic status (employed, unemployed and inactive). This can be done here because, unlike for work-related discrimination, economic status is not part of the identification of those exposed to discrimination. Also, the analysis has been extended to the entire adult population, rather 38 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules than just people of working age, because service-related discrimination is relevant at all ages.
The results show that having a disability has a much stronger association with discrimination in this arena than in the area of work, with odds ratios exceeding three in all three models.
Note that this does not refer to the level of discrimination experienced by people with a disability in any absolute sense, but to the gap between people with and without a disability. In fact, as we saw in Table 3.2, the risk of discrimination against people with disabilities is quite similar in the work arena, and in the public and the private services domains. Instead, it shows that it is in accessing public services that large discrimination gaps between people with and without disabilities can be found. Controlling for the effect of age in the second model increases the odds ratio substantially (because older people are less at risk than the reference group of young adults). The odds ratio for disability is reduced to 3.06 with the addition of other controls in Model 3. Separate analysis (not shown) revealed that this reduction is almost entirely driven by the inclusion of principal economic status in the model. This occurs because employed people are at lower risk of discrimination than the unemployed and the economically inactive. In other words, the relationship between disability and discrimination is stronger for those not in employment. There is very little evidence that the rate of discrimination in public services changed over time, with only one statistically significant coefficient -for 2010 in Model 3 -suggesting a slight reduction. As in work-related discrimination, these models reveal that women are more at risk (with odds that are 13 per cent higher than for men). As before, age has a negative relationship with discrimination, but it is mainly driven by people aged over 65 40 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules having a lower risk. Like in the first set of models, lone parents and couples with children are significantly more at risk than couples without children.

Discrimination in private services
The models of discrimination in private services are presented in an identical fashion to discrimination in public services, with three nested models and the full adult population considered (Table 3.7).
Once again, the effect of disability is strong and statistically significant across all of the models presented below. As in the analysis of discrimination when using public services, the size of the effect of disability is sensitive to the inclusion of control variables. When the year of the survey is the only control, people with disabilities have 1.65 times the odds of experiencing discrimination compared to people without disabilities. The effect of age is controlled in Model 2, revealing that age is negatively associated with discrimination in private services. The odds of experiencing private service discrimination among people aged over 65 are only 18 per cent that of people aged 18-24. Because people with disabilities are relatively concentrated in the older age groups, the negative effect of age reduces the positive effect of disability on discrimination in Model 1. Controlling for the effect of age in Model 2 therefore causes the odds ratio for disability to rise to 2.44. In other words, this analysis shows that if it wasn't for disabled people being older on average, they would be even more at risk of experiencing discrimination in accessing private services. 13 These results are consistent with the findings of recent Irish research using the Equality modules, which showed that people with disabilities were over twice as likely as people without disabilities to experience discrimination in access to housing   largest impact on the disability odds ratio is principal economic status, suggesting that disabled people are more likely to experience discrimination in private services in part because they are more likely to be unemployed or inactive. The finding that part of the discrimination experienced by disabled people results from their labour market situation means that addressing disabled people's access to employment may help to reduce their exposure to discrimination in the private services domain. We also see that private service discrimination was significantly and robustly less prevalent in 2010 and 2014 than in 2004, contrasting with the pattern in workplace discrimination.
The effect of educational attainment on private service discrimination is comparable to its effect in the other two domains. Those with third-level honours degrees (or equivalent) are 25 per cent more likely than early school leavers to report discrimination.
The patterns with respect to marital and family status are similar to the patterns observed for work-related discrimination, where risks were higher for divorced/separated people, lone parents and couples with children (though the latter isn't statistically significant here); and the least at risk are widow(er)s and married people.

SUMMARY
In this chapter, we examined the association between discrimination and disability in three broad domains, controlling for socio-demographic characteristics and the year of the survey.
Work-related discrimination includes discrimination in looking for work or in the workplace and this was examined for those aged 18 to 64 who were exposed to this kind of discrimination (i.e. who were active in the labour market in that they had been at work or had been looking for work in the previous two years). The odds of experiencing discrimination were about twice as high for people with disabilities compared to those without disabilities. Controlling for socio-demographic characteristics (such as age, gender, marital status and family status) made little difference to this overall pattern. The findings do show, however, that educational attainment is positively associated with the experience of discrimination.
Discrimination in public services covered the domains of education, health, transport and other public services. This was where we found the largest gap between people with and without disabilities, with the odds of discrimination being about three times higher among those with disabilities. Controlling for socio-demographic characteristics did little to account for this gap. Being older tended to reduce the likelihood of experiencing discrimination when accessing public services (especially for those over age 65); but being outside the labour force, which is more common among people with disabilities, caused the odds ratios to increase. This latter finding may well be due to people outside the labour market being Disability and discrimination in different domains | 43 more dependent on public services meaning that they might face more potential situations in which discrimination can occur.
Discrimination in private services included discrimination experienced in shops/pubs/ restaurants, in financial institutions and in housing. People with disabilities are also significantly more likely to experience discrimination in private services than those without disabilities, with odds of discrimination that are about 65 per cent higher overall. Again, controlling for socio-demographic characteristics does not reduce the size of this gap; rather, the gap would be larger were it not for the fact that people with disabilities tend to be older -a trait which usually reduces an individual's experience of discrimination.
The overall pattern of results is confirmed by the additional analysis run with 'any discrimination' as the dependent variable (see Appendix Table A3.1). Here we see that people with disabilities are between 1.6 and 2.2 times as likely to experience discrimination as people without a disability. The odds ratio is sensitive to the inclusion of age as a control variable, but changes little when additional socio-demographic controls are added.
Discrimination for people with different types of disability | 45

CHAPTER 4 Discrimination for people with different types of disability
This chapter has two aims. The first is to investigate whether the link between disability and discrimination shown in Chapter 3 varies by type of disability. The QNHS Equality module distinguishes between disability types in term of sensory, physical, psychological or emotional conditions and intellectual disabilities. As in Chapter 3, this chapter investigates whether the effects of disability on discrimination hold when controlling for relevant sociodemographic and economic characteristics. The second aim of the chapter is to examine whether these associations have changed or remained constant over time.
Recent research on Ireland has shown that people with disabilities tend to be disadvantaged in many respects. For example, people with disabilities are overrepresented among homeless people and are more likely to experience bad housing conditions , are more at risk of poverty and deprivation (Watson et al., 2018), and they also are more likely to be discriminated against in a series of domains as shown by McGinnity et al.
(2017) and in line with Chapters 2 and 3 of this report.
However, while most previous research has considered people with disabilities as a homogeneous group, the present chapter adds to the existing research by studying how discrimination is associated with different types of disability. While Watson et al. (2012) have already shown the variability in the experience of discrimination between people with different types of disability, this study extends their research up to more recent dates, namely up to 2014.

DISCRIMINATION AND DISABILITY TYPES: DESCRIPTIVES
In this section we address the question of whether some types of disability are associated with a greater risk of discrimination. To this end, we consider the risk of experiencing discrimination in any domain (including the labour market, private services, and public services).
46 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules As discussed in Chapter 1, the way the QNHS collects information about the different types of disability has changed over time. Most importantly, while the 2010 and 2014 waves distinguish between blindness and deafness, the 2004 wave merges these two disability types together. In order to conduct a more in-depth analysis of the experience of discrimination of people with different types of disability and to take into account possible heterogeneity in the experience of discrimination of blind and deaf people, in this chapter we focus on the most recent waves, namely 2010 and 2014. In these two waves, the same question wording was used to capture disability types. shares ranging from about 0.5 to 0.9 per cent characterise other types of disability: blindness, deafness, learning or intellectual disabilities, and psychological or emotional conditions. The residual category, which also includes pain, breathing and chronic illnesses, accounts for 7.4 per cent of the sample. Note that the sum of the percentages with each type of disability is larger than the percentage with any type of disability. This is because the same individual may have more than one type of disability. Source: Own calculation based on the QNHS Equality module (2010 and 2014); population aged 18 and over. Margin of error for the proportion of people with disability rages between 0.08 percentage points for people with learning or intellectual disabilities and 0.35 percentage points for people with any type of disability.
Discrimination for people with different types of disability | 47 The second column of Table 4.1 reports the percentage of people who experienced discrimination; while the third column reports the margin of error of that percentage, showing that the uncertainty around our estimates increases while the size of the groups decreases. The experience of discrimination across people with different types of disability varies substantially, but in almost all cases is higher compared with people without disability. Indeed, while 11.3 per cent of people without disability experience discrimination, on average (see Figure 2.3), 15 per cent of people with disabilities experience discrimination. The most likely to report discrimination are people with blindness or serious vision impairment (22.5 per cent), followed by people with psychological or emotional problems (19.1 per cent). On the other hand, the lowest levels of discrimination are experienced by people with deafness or a serious hearing impairment (8.2 per cent), a value that is even lower than for people without disability. The experience of discrimination among people with other types of disability ranges between 13 and 15.5 per cent. However, we have to interpret these differences between groups with caution given that the margin of error for some groups is rather wide. If we focus on people affected by blindness or a serious visual impairment, for example, the 'true' percentage of people experiencing discrimination falls, with the 95 per cent of confidence, within the interval 17 (22-5) and 27 (22+5) per cent. Therefore, the value of 22 that we observe for them cannot be considered statistically different from the value of 19 observed for people with psychological or emotional conditions (ranging between 15 and 23).

BOX 4.1 AGE, DISABILITY AND DISCRIMINATION
Age has consistently been an important variable in mediating the relationship between disability and discrimination in the models thus far. While we can confidently assert that disability is associated with an increased risk of reporting an experience of discrimination, we have shown that the size of this effect increases substantially when age is taken into account in the models. The diagram shows why this is the case.
We know that people with disabilities are overrepresented among older people (positive association), and we also know that older people are less likely to experience discrimination (negative association). From this it follows that when measuring discrimination for people with disabilities, we are measuring discrimination for a group that tends to experience low discrimination levels given their older age.

Age
Experie11ce of Discrimi11a ti on la11y domai n) 48 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules Therefore, while the disability status per se increases discrimination, the age profile of people with disabilities decreased discrimination. In each set of models in Chapter 3 and 4, the first column (Model 1) mixes these two opposite forces, which leads to an underestimation of the effect of disability. On the contrary, Model 2 takes into account the age composition of people with disabilities and provides estimates of the effect of disability, net of the effect of age.

DISCRIMINATION AND TYPE OF DISABILITY: MODELLING
The next step is to investigate if, and to what extent, the higher risk of discrimination experienced by people with particular types of disability is explained by other characteristics that may be associated with both type of disability and discrimination. We do that using regression models which allow us to study the impact of disability type on discrimination while controlling for other relevant characteristics.
Model 1 in people who do not have those disabilities to experience discrimination. A lower but positive and significant effect can be observed for people with other types of disability. On the contrary, deaf people are just over half as likely as non-deaf people to experience discrimination. People with conditions that limit physical activities and with intellectual disabilities do not present substantial and statistically significant effects.
Model 2 adds a control for age. As in many of the models presented in Chapter 3, age is an important mediating characteristic for the relationship between disability and discrimination. Indeed, once age is taken into account, the observed pattern and the size of the disability impact change: many of the effects of the disability types strengthen. The types of disability differ in their relationship with age. For instance, the prevalence of deafness or hearing impairments, physical disability and sensory disability and most problems with pain and breathing (in the 'other' category) increase sharply with age, while intellectual/learning disabilities are concentrated in the earlier part of adulthood and psychological/emotional disability is more evenly spread across the adult years .
When we control for age, the impact of visual impairment on discrimination increases strongly. The effect size of having 'other' types of disability also increases, as well as the effect of having physical disabilities, which also becomes statistically significant. On the other hand, the effect of deafness decreases and becomes not statistically significant: controlling for age, deaf people experience the same likelihood of being discriminated against as non-disabled people.
Overall, we have observed that the penalty of disability increases for all those types of disability that are more common among older people, namely blindness, deafness, physical conditions, and 'other' types of disability. This is explained by the fact that, all else equal, older people are less likely to experience discrimination (see Box 4.1 for a more detailed discussion of the relationship between age, disability and discrimination). For these reasons, not controlling for age would lead to an underestimation of the association between discrimination and these types of disability. 50 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules In Model 3, we also control for other socio-demographic characteristics including sex, education, employment status, and marital and family status. Unlike the inclusion of age, Discrimination for people with different types of disability | 51 adding these characteristics to the model does not substantially affect the association between discrimination and type of disability.
Concerning the direct effect of all the control variables included in the model, their effects on discrimination in any domain are in line with results shown in Chapter 3 regarding domain-specific discrimination. In other words, the experience of any type of discrimination falls with age, is higher for females and for those with higher levels of education, for lone parents, people who are divorced/separated and (as we say in the case of discrimination in the services domains) those not at work.

EXPERIENCE OF DISCRIMINATION OVER TIME FOR PEOPLE WITH DISABILITIES
Our next step is to investigate whether the experience of discrimination has changed over time for people with various types of disability. Unlike in Section 4.1, here we focus on the entire time span available in the QNHS, namely from 2004 to 2014. This is important because in this decade Ireland experienced an economic cycle of boom, bust and early recovery, which may have impacted also on people's experience of discrimination. As discussed above, extending the observational window comes at the cost of less detail in distinguishing between types of disability -blindness and deafness are merged together. In addition, it is worth remembering that other questions have changed wording over time, possibly influencing the choice of 'physical disability' or 'other' disabilities (see Table 1.1 in Chapter 1).
We model discrimination trends over time by interacting each type of disability with the survey year. In order to facilitate the interpretation of the results, we present predicted probabilities of experiencing discrimination by year (Figure 4.1). Predicted probabilities are estimated controlling for all the other characteristics included in the model. They represent the 'pure' differences by disability type, after isolating them from any differences that might be linked to other characteristics such as age, gender or level of education.  Table A4.2a and Table A4.2b respectively.
The first graph on the top left of Figure 4.1 shows the trend for people with any type of disability and without disability. In terms of levels, we can observe substantial and statistically significant differences between the two groups (see Table A4.  Table A4.2a). For people without disability, we can see a very flat trend over the entire period: the experience of discrimination of people without any disability has not changed substantially over the decade that we observe.  Other Source: Own calculation based on the Equality module (2004, 2010 and 2014).

Note:
Predictions for each type of disability based on the Model in Table A4.1 in the Appendix that includes the interaction between survey year and types of disability. Blindness and deafness have been aggregated because not identifiable separately for 2004. Predictions for people with no disability and any disability estimated on a separate model with the same set of control variables (available from the authors).
A fairly flat trend also characterises people with blindness or deafness impairments (and none of these changes are statistically significant). However, more substantial changes can be observed for people with other types of disability. All of these groups, in fact, experience Overall, considering trends over time in the experience of discrimination, we have shown that while discrimination risks have not changed for people without disabilities, people with disabilities experienced decreasing risks of discrimination over the examined decade.

SUMMARY
This chapter uses QHNS data and the Equality module data for the years 2010 and 2014 to examine the experience of discrimination and the labour market outcomes of people affected by different types of disability.
On average, 15 per cent of people with a disability and 11.3 per cent of people without a disability experience discrimination. The experience of discrimination, however, varies substantially across people with different types of disability -and it is in almost all cases higher compared with people who do not have any disability. People with blindness or serious visual impairment and psychological/emotional disabilities are the most likely to experience discrimination.
As in Chapter 3, we find that age is an important mediating characteristic in the relationship between disability and discrimination. Indeed, once age is taken into account, the experience of discrimination intensifies for many types of disability. Conversely, the other controls (gender, marital and family status, education) do not substantially affect the association between disability and discrimination.
Over time, the experience of discrimination does not change for people without disability.
However, it declines for almost all types of disability, especially physical disability, learning/ intellectual disability and psychological/emotional disability.  . In this chapter, we provide a summary of the key findings and highlight the main implications for policy. The report is organised around four main research questions: • Do people with disabilities experience discrimination more frequently than people without disabilities and does it have a greater impact on them?
• Do people with disabilities experience discrimination to a greater extent in some domains than others? Are any such differences related to other characteristics (such as gender, age and education)?
• Are people with specific disabilities more likely to experience discrimination than others?
• Has the experience of discrimination among people with disabilities changed over time?
After a brief overview of the characteristics of people with disabilities, this chapter brings together the results of the analysis to address these questions and to outline the main implications for policy.

Characteristics of people with disabilities
The findings reported in Chapter 2 show that between 10 and 12 per cent of the population reported a disability in the period from 2004 to 2014. People with disabilities are also shown to have a distinctive socio-demographic profile. In particular, they are older compared to 56 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules those without disabilities, with 41 per cent of them over the age of 65 compared to just 12 per cent of other adults.

Do people with disabilities experience discrimination more frequently than people without disabilities and does it have a greater impact on them?
The findings show that, overall, people with disabilities experience higher rates of discrimination than people without disabilities. On average, 15 per cent of people with disabilities experience discrimination compared to 11 per cent of those without a disability.
Respondents in the survey were also asked how often they experienced discrimination and how severe the impact of this discrimination was. The findings here show that people with disabilities report experiencing discrimination 'more regularly' than the rest of the population. Focussing on the severity of the impact of discrimination, the report finds that people with disabilities are more likely to suffer adverse effects of being discriminated against. In 2014, for example, 18 per cent of people with disabilities who experienced discrimination reported it having a 'very serious' effect on them, compared to 10 per cent of those without disabilities.

5.2.3
Do people with disabilities experience discrimination to a greater extent in some domains than others? Are any such differences related to other characteristics (such as gender, age and education)?
Using the three waves of the data (2004, 2010 and 2014), we examine where people with disabilities are most likely to report discrimination. The findings show that discrimination for people with disabilities is mostly experienced in the health services followed by the private sector (e.g. financial institutions, shops, pubs and restaurants). We note that this concentration of reports of discrimination in the health sector is most likely due to people with disabilities requiring more health services due to a higher incidence of health problems, perhaps related to their disability. On the contrary, fewer than one-in-four reports of discrimination among people with disabilities relate to the workplace. This is because they are more likely to be inactive in the labour market which obviously reduces their likelihood of experiencing this type of discrimination. Comparing levels of discrimination in the three different domains, the largest gap between people with and without disabilities is found when people are accessing public services such as health, education and transport. Chapter 3 shows how people with disabilities accessing public services are between 3 and 3.5 times more likely to experience discrimination than people without disabilities.
The influence of having a disability on the likelihood of being discriminated against in private services is also evident in the research findings. People with disabilities are significantly more likely to experience discrimination than those without disabilities in pubs, shops, restaurants, financial institutions or housing (up to two times more likely).
Interestingly, the findings highlight that for all three domains, controlling for age in the models strengthens the association between disability and the experience of discrimination.
This can be explained by the fact that people with disabilities are overrepresented in older age groups which are characterised by relatively low discrimination risks.

5.2.4
Are people with specific disabilities more likely to experience discrimination than others?
In Chapter 4, we examine whether people with some types of disability are more likely to experience discrimination compared to those with other disabilities in any domain. As mentioned in Chapter 2, almost 12 per cent of survey respondents reported having some 58 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules form of disability. This group is made up of people who report their disability as 'Other, including chronic illness' (6.2 per cent), those with conditions that 'limit basic physical activities' (5 per cent), people who are blind or deaf or those with severe vision or hearing impairments (1.3 per cent), and people with a 'psychological or emotional condition' and a 'learning and intellectual disability' (both 1 per cent). The findings show that discrimination varies by the type of disability and that discrimination is particularly prevalent for people who are blind followed by those with a 'psychological or emotional condition'. As before, controlling for age appears to strengthen the relationship between discrimination and these types of disabilities.

Has the experience of discrimination among people with disabilities changed over time?
Chapter 4 also examines the extent to which discrimination against people with different disabilities has changed over time. The findings show that between 2004 and 2014, discrimination declined for almost all types of disability, especially physical disability, learning/intellectual disability and psychological/emotional conditions. Net of sociodemographic factors, the overall probability of experiencing discrimination fell from 24 per cent in 2004 to 17 per cent in 2010 for people with any type of disability.

POLICY IMPLICATIONS
The findings in this report highlight the experience of discrimination for people with disabilities in Ireland. The results show that people with disabilities continue to experience more discrimination than people without disabilities. There are a number of specific policy issues arising out of the findings of this report:

Addressing the link between disability, discrimination and disadvantage
Previous research has shown that disability increases the risk of poverty as people with disabilities have a lower rate of participation in the labour market than those without disabilities . Although anti-poverty policy is often seen as the remit of the Department of Employment Affairs and Social Protection, policy areas such as education and employment must also be used in order to address the issue.
The reasons for low labour market participation for people with disabilities may, in part, be due to negative school experiences and outcomes among this group of students (McCoy and Banks 2012;Mc Guckin et al., 2013). The stigma associated with the label of a disability has been shown to influence teacher and parent educational expectations of children and young people (Banks et al., 2016;Shandra et al., 2009). This has clear long-term implications for whether a young person with a disability enters further or higher education or the labour market. Furthermore, this may lead to young people with disabilities being stereotyped into lower qualifications and lower paid employment (Humphrey et al., 2012;Cosgrove et al., 2014;EHRC, 2017). For those whose disability emerges during their school years, facilitating retention in education is paramount to improving later life chances by enhancing initial labour market entry . Within this context, it is essential that the EPSEN Act (2004) is fully implemented so that students with special educational needs and disabilities can get access to assessments and be provided with the necessary resources to allow them to engage with school and improve their retention at second-level. Given the policy emphasis on inclusive education, retention for students with disabilities should be under the remit of the School Completion Programme and the Home School Community Liaison Scheme. These supports operate through the DEIS programme (Delivering Equality of Opportunity in Schools) which aims to address the educational needs of children living in 60 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules disadvantaged communities. Given the over-representation of children with special educational needs in DEIS schools these programmes should place greater emphasis on the retention of students with special educational needs and disabilities. Identifying the reasons for early school leaving among this group of students would be important in order to target policy more effectively. At third level, the promotion of incentives such as the DARE (Disability Access Route to Education) scheme are also important in increasing the numbers of young people with special educational needs and disabilities transitioning to higher education. The funding and support for university based access programmes is also important in improving both entry and retention of students with disabilities. Access programmes can provide information and guidance to students with disabilities and can act as a point of contact within the university setting. Other initiatives aimed at promoting the inclusion of people with disabilities in education and broader society should also be supported and expanded. The Trinity Centre for People with Intellectual Disabilities (TCPID), for example, provides higher education programmes at Level 5 of the NFQ for people with intellectual disabilities.

Discrimination in accessing public services
Focussing on where people with disabilities experience discrimination, this report shows that people with disabilities most commonly experience discrimination when accessing public services. Although the rate of discrimination among those at work or seeking work may be higher, because so many people with disabilities rely on public services, most of the discrimination they experience is in the context of accessing these services, particularly health services. As a result, from the perspective of the quality of life of people with disabilities, tackling discrimination in access to public services needs to be a priority. The implementation of the Public Sector Equality and Human Rights Duty (Government of Ireland, 2014) is therefore essential in eliminating discrimination in these areas. More detailed investigation than was possible with these data would be needed in order to identify where the discrimination was experienced. In the context of health services, for instance, what part of the health services was in question (e.g. primary, specialised or acute care)? Also, it would be important to know in what part of the process of accessing services the discrimination is encountered (e.g. in obtaining an appointment, in gaining physical access to services, time spent on the waiting list, quality of care and aftercare).

Summary and conclusions | 61
Understanding discrimination in the private sector The results suggest that areas of the private sector such as financial institutions, housing and the labour market require closer attention for identifying discriminatory practices. In light of the findings of this report and Grotti et al. (2018), access to housing for people with disabilities should be a policy priority. People with disabilities are specifically mentioned in the Rebuilding Ireland report which seeks to address some of the issues around access and suitability of accommodation (Government of Ireland, 2016). This report highlights the need to improve access to social housing for people with disabilities and to provide grants for modifications to homes to improve access or other supports/devices (p.47).

Work-related discrimination
Turning to accessing the labour market, for those whose disability emerges during their working life (a much larger group), ensuring retention in employment needs to be emphasised in policy. To this end, working with employers (as noted in the Comprehensive Employment Strategy for People with Disabilities) is a key element. To the extent that discrimination -or the fear of discrimination -discourages people with disabilities from seeking work or remaining in employment after the onset of disability, the Irish Human Rights and Equality Commission and its partner Department, the Department of Justice and Equality, have roles in ensuring that both employers and people with disabilities are familiar with the legal protection of the rights of people with disabilities. Not all people with disabilities will be able to work. In order to protect this group from poverty, reasonable accommodations, income supplementation and free or subsidised access to services will continue to be important.

Improving access to employment for people with disabilities
Participation in the labour market remains far lower than participation rates in the general population. These findings are in line with previous research which has highlighted how people with disabilities have a greater risk of being outside the labour market . In recent years there have been a number of policy initiatives to increase recruitment opportunities for people with disabilities both in Ireland and internationally (Government of Ireland, 2015;UN, 2006). This has meant an increase in the public service 62 | Disability and discrimination in Ireland: evidence from the QNHS Equality modules employment target from 3 per cent to 6 per cent by 2024 with special public service competitions for people with disabilities.
However, a case can be made for increasing the emphasis on strategies to keep employed people with disabilities in their jobs.  found that most disabilities (70 per cent) are acquired in later life, where the difficulty lies around retaining people in employment or retraining them for more suitable employment . They argue the need for employers and policymakers to facilitate greater flexibility in the workplace for people with disabilities, provide information on requirements and suggest the need for some form of supplemental income to bridge the gap between the required level of income and what they are able to earn . The publication of the

Comprehensive Employment Strategy for People with Disabilities 2015-2024 highlights how
Ireland's current incentives to 'make work pay' for people with disabilities is in line with policies internationally. The report, however, shows the potential disincentives to taking up employment for some people with disabilities such as the potential loss of their Medical Card. This is particularly important as people with disabilities tend to have greater health needs than the general population so it is a significant support to them (WRC Social and Economic Consultants, 2007).

Improving educational outcomes for people with disabilities
Alongside the development of policy for people with disabilities, there have been major changes in educational policy for children and young people with special educational needs and disabilities. As discussed in Chapter 1, the EPSEN Act (2004) represents a commitment by government to the effective inclusion of children and young people with special educational needs in mainstream education settings. Since its introduction, the profile and characteristics of students attending mainstream schools has altered dramatically with more and more students with a broad range of special educational needs and disabilities attending school alongside their peers without such needs (Banks et al., 2011). The establishment of the NCSE at this time represented a shift in policy towards more effectively supporting and resourcing students with special educational needs in an inclusive way.
Following its introduction, a large body of research (commissioned by the NCSE and the NDA) was undertaken to better understand the progress, experiences and outcomes of this group of students (Rose et al., 2015;Banks and McCoy, 2011;McCoy et al., 2014;Scanlon et al., 2015). In light of this policy change, however, there remains limited understanding of the outcomes of students with special educational needs and disabilities, the barriers to them accessing further or higher education or employment (with the exception of McGuckin et al., 2013;Scanlon et al., 2015). Longitudinal data, such as the Growing Up in Ireland study, could provide much needed insights into the experiences of students with special educational needs and disabilities at the ages of 13 and 17 as they prepare for the transition to further or higher education, training or employment. Further research could identify the barriers to successful transitions and, where successful transitions occur, the factors influencing student engagement and retention.

Employment for people with disabilities
Another avenue worthy of exploration in future research is to develop the understanding of what people with disabilities would require in order for them to be able to work. Research based on the National Disability Survey pointed to the importance of flexible working hours and modified job tasks (Watson and Nolan, 2011). Wage subsidies also have a role to play, to the extent that earnings capacity is reduced as a result of disability.
The area of employment is particularly important for a number of reasons. First, employment is crucial for the full participation of individuals in society and for their personal fulfilment. Second, disability is strongly associated with poverty and, given that paid employment is the main channel for moving people out of poverty, bringing disabled people to the labour market would at the same time bring them out of poverty.
The integration of people with disabilities into the labour market will thus profit from understanding the range of occupations undertaken by people with disabilities, what their typical working arrangements are, and in which sectors are they more likely to be employed or excluded from, perhaps because of a low availability of part-time or flexible working arrangements.
A critical issue which also emerges from the Department of Employment Affairs and Social Protection's 'Make Work Pay' report is the need for early intervention, namely the retention  Source: Own calculation based on the Equality module (2004, 2010 and 2014).

Note:
This model corresponds to Model 3 in Table 4.2 plus the interaction between types of disability and year of the survey.