'Half dead to get your disability': Understanding the Impoverishing Effects of Federal Disability Insurance Programs in Rural America

Abstract

To examine how the distinct challenges of disabled beneficiaries living in rural areas may be aided or aggravated by federal disability policy, this thesis draws upon in-depth interviews from two of the most disability-saturated counties in the United States: Clay County, Kentucky and Humphreys County, Mississippi. My research suggests that the process of applying for disability insurance and the process of staying on disability are both detrimental to the health and wellbeing of individuals living in rural areas. Specifically, I argue that the rules and administrative practices baked into federal disability policy are inherently impoverishing for rural Americans. Based on my analysis of 50 immersive qualitative interviews, I identified four mechanisms responsible for making the disability insurance system so difficult to navigate for rural Americans: an arduous application process that depletes resources and limits work prospects; the need to hire lawyers while navigating said application; the limited types of work available for disabled people; and the stigma attached to being on disability, even by those on disability themselves. By investigating the parameters and implementation of disability insurance programs through the lens of real lived experiences, I propose that these mechanisms provide one possible avenue to understand why disability tends to be a permanent, rather than transitory, status in the United States today. In so doing, this analysis not only contributes to prior scholarship on domestic disability insurance programs, but also draws upon firsthand accounts from disabled rural Americans to formulate policy recommendations that can better support the economic and health prospects of disabled Americans in rural areas.