Disability

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International Symbol of Access Handicapped Accessible sign.svg
International Symbol of Access

According to many definitions, a disability is an impairment that may be cognitive, developmental, intellectual, mental, physical, sensory, or some combination of these. Other definitions describe disability as the societal disadvantage arising from such impairments. Disability substantially affects a person's life activities and may be present from birth or occur during a person's lifetime. [1]

Developmental disability is a diverse group of chronic conditions that are due to mental or physical impairments that arise before adulthood. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, especially in "language, mobility, learning, self-help, and independent living". Developmental disabilities can be detected early on and persist throughout an individual's lifespan. Developmental disability that affects all areas of a child's development is sometimes referred to as global developmental delay.

Intellectual disability Generalized neurodevelopmental disorder

Intellectual disability (ID), also known as general learning disability and mental retardation (MR), is a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning. It is defined by an IQ under 70, in addition to deficits in two or more adaptive behaviors that affect everyday, general living.

A physical disability is a limitation on a person's physical functioning, mobility, dexterity or stamina. Other physical disabilities include impairments which limit other facets of daily living, such as respiratory disorders, blindness, epilepsy and sleep disorders.

Contents

Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives.

World Health Organization, Disabilities [2]

Disability is a contested concept, with different meanings in different communities. [3] It may be used to refer to physical or mental attributes that some institutions, particularly medicine, view as needing to be fixed (the medical model). It may refer to limitations imposed on people by the constraints of an ableist society (the social model). Or the term may serve to refer to the identity of disabled people. Physiological functional capacity (PFC) is a related term that describes an individual's performance level. It gauges one's ability to perform the physical tasks of daily life and the ease with which these tasks are performed. PFC declines with advancing age to result in frailty, cognitive disorders or physical disorders, all of which may lead to labeling individuals as disabled. [1] [4]

The medical model of disability, or medical model, arose from the biomedical perception of disability. This model links a disability diagnosis to an individual's physical body. The model supposes that this disability may reduce the individual's quality of life and the aim is, with medical intervention, this disability will be diminished or corrected.

Ableism is discrimination and social prejudice against people with disabilities or who are perceived to have disabilities. Ableism characterizes persons as defined by their disabilities and as inferior to the non-disabled. On this basis, people are assigned or denied certain perceived abilities, skills, or character orientations.

The social model of disability is a reaction to the dominant medical model of disability which in itself is a functional analysis of the body as machine to be fixed in order to conform with normative values. The social model of disability identifies systemic barriers, negative attitudes and exclusion by society that mean society is the main contributory factor in disabling people. While physical, sensory, intellectual, or psychological variations may cause individual functional limitation or impairments, these do not have to lead to disability unless society fails to take account of and include people regardless of their individual differences. The origins of the approach can be traced to the 1960s; the specific term emerged from the United Kingdom in the 1980s.

The discussion over disability's definition arose out of disability activism in the United States and the United Kingdom in the 1970s, which challenged how the medical concept of disability dominated perception and discourse about disabilities. Debates about proper terminology and their implied politics continue in disability communities and the academic field of disability studies. In some countries, the law requires that disabilities are documented by a healthcare provider in order to assess qualifications for disability benefits.[ citation needed ]

Disability rights movement social movement to secure equal opportunities and equal rights for all people with disabilities

The disability rights movement is a global social movement to secure equal opportunities and equal rights for all people with disabilities.

Disability studies is an academic discipline that examines the meaning, nature, and consequences of disability. Initially the field focused on the division between "impairment" and "disability", where impairment was an impairment of an individual's mind or body, while disability was considered a social construct. This premise gave rise to two distinct models of disability: the social and medical models of disability. In 1999 the social model was universally accepted as the model preferred by the field. However, in recent years, the division between the social and medical models has been challenged. Additionally there has been an increased focus on interdisciplinary research. For example, recent investigations suggest using "cross-sectional markers of stratification" may help provide new insights on the non-random distribution of risk factors capable of acerbating disablement processes.

Disability benefits are funds provided from public or private sources to a person who is ill or who has a disability.

Types

For the purposes of the Americans with Disabilities Act of 1990, the Equal Employment Opportunity Commission regulations provide a list of conditions that should easily be concluded to be disabilities: deafness, blindness, an intellectual disability (formerly termed mental retardation), partially or completely missing limbs or mobility impairments requiring the use of a wheelchair, autism, cancer, cerebral palsy, diabetes, epilepsy, HIV/AIDS, multiple sclerosis, muscular dystrophy, major depressive disorder, bipolar disorder, post-traumatic stress disorder, obsessive compulsive disorder, and schizophrenia. [5]

Americans with Disabilities Act of 1990 American law

The Americans with Disabilities Act of 1990 is a civil rights law that prohibits discrimination based on disability. It affords similar protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964, which made discrimination based on race, religion, sex, national origin, and other characteristics illegal. In addition, unlike the Civil Rights Act, the ADA also requires covered employers to provide reasonable accommodations to employees with disabilities, and imposes accessibility requirements on public accommodations.

Equal Employment Opportunity Commission

The U.S. Equal Employment Opportunity Commission (EEOC) is a federal agency that administers and enforces civil rights laws against workplace discrimination. The EEOC investigates discrimination complaints based on an individual's race, children, national origin, religion, sex, age, disability, sexual orientation, gender identity, genetic information, and retaliation for reporting, participating in, and/or opposing a discriminatory practice.

Amputation removal of a body extremity by trauma, prolonged constriction, or surgery

Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems. A special case is that of congenital amputation, a congenital disorder, where fetal limbs have been cut off by constrictive bands. In some countries, amputation of the hands, feet or other body parts is or was used as a form of punishment for people who committed crimes. Amputation has also been used as a tactic in war and acts of terrorism; it may also occur as a war injury. In some cultures and religions, minor amputations or mutilations are considered a ritual accomplishment.

History

Contemporary understandings of disability derive from concepts that arose during the West's scientific Enlightenment; prior to the Enlightenment, physical differences were viewed through a different lens.

Age of Enlightenment European cultural movement of the 18th century

The Age of Enlightenment was an intellectual and philosophical movement that dominated the world of ideas in Europe during the 18th century, the "Century of Philosophy".

During the Middle Ages, madness and other conditions were thought to be caused by demons. They were also thought to be part of the natural order, especially during and in the fallout of the Plague, which wrought impairments throughout the general population. [6] In the early modern period there was a shift to seeking biological causes for physical and mental differences, as well as heightened interest in demarcating categories: for example, Ambroise Pare, in the sixteenth century, wrote of "monsters", "prodigies", and "the maimed". [7] The European Enlightenment's emphases on knowledge derived from reason and on the value of natural science to human progress helped spawn the birth of institutions and associated knowledge systems that observed and categorized human beings; among these, the ones significant to the development of today's concepts of disability were asylums, clinics, and, prisons. [6]

Middle Ages Period of European history from the 5th to the 15th century

In the history of Europe, the Middle Ages lasted from the 5th to the 15th century. It began with the fall of the Western Roman Empire and merged into the Renaissance and the Age of Discovery. The Middle Ages is the middle period of the three traditional divisions of Western history: classical antiquity, the medieval period, and the modern period. The medieval period is itself subdivided into the Early, High, and Late Middle Ages.

Black Death Pandemic in Eurasia in the 1300s

The Black Death, also known as the Great Plague or the Plague, or less commonly the Black Plague, was one of the most devastating pandemics in human history, resulting in the deaths of an estimated 75 to 200 million people in Eurasia and peaking in Europe from 1347 to 1351. The bacterium Yersinia pestis, which results in several forms of plague, is believed to have been the cause. The Black Death was the first major European outbreak of plague, and the second plague pandemic. The plague created a number of religious, social and economic upheavals which had profound effects on the course of European history.

The early modern period of modern history follows the late Middle Ages of the post-classical era. Although the chronological limits of the period are open to debate, the timeframe spans the period after the late portion of the post-classical age, known as the Middle Ages, through the beginning of the Age of Revolutions and is variously demarcated by historians as beginning with the Fall of Constantinople in 1453, with the Renaissance period in Europe, the Muslim conquests in the Indian subcontinent, and with the Age of Discovery, and ending around the French Revolution in 1789.

Contemporary concepts of disability are rooted in eighteenth- and nineteenth-century developments. Foremost among these was the development of clinical medical discourse, which made the human body visible as a thing to be manipulated, studied, and transformed. These worked in tandem with scientific discourses that sought to classify and categorize and, in so doing, became methods of normalization. [8]

The concept of the "norm" developed in this time period, and is signaled in the work of the Belgian statistician, sociologist, mathematician, and astronomer Adolphe Quetelet, who wrote in the 1830s of l'homme moyen – the average man. Quetelet postulated that one could take the sum of all people's attributes in a given population (such as their height or weight) and find their average, and that this figure should serve as a norm toward which all should aspire.

This idea of a statistical norm threads through the rapid take up of statistics gathering by Britain, United States, and the Western European states during this time period, and it is tied to the rise of eugenics. Disability, as well as other concepts including: abnormal, non-normal, and normalcy came from this. [9] The circulation of these concepts is evident in the popularity of the freak show, where showmen profited from exhibiting people who deviated from those norms. [10]

With the rise of eugenics in the latter part of the nineteenth century, such deviations were viewed as dangerous to the health of entire populations. With disability viewed as part of a person's biological make-up and thus their genetic inheritance, scientists turned their attention to notions of weeding such "deviations" out of the gene pool. Various metrics for assessing a person's genetic fitness, which were then used to deport, sterilize, or institutionalize those deemed unfit. At the end of the Second World War, with the example of Nazi eugenics, eugenics faded from public discourse, and increasingly disability cohered into a set of attributes that medicine could attend to – whether through augmentation, rehabilitation, or treatment. In both contemporary and modern history, disability was often viewed as a by-product of incest between first-degree relatives or second-degree relatives. [11]

In the early 1970s, disability activists began to challenge how society treated disabled people and the medical approach to disability. Due to this work, physical barriers to access were identified. These conditions functionally disabled them, and what is now known as the social model of disability emerged. Coined by Mike Oliver in 1983, this phrase distinguishes between the medical model of disability – under which an impairment needs to be fixed – and the social model of disability – under which the society that limits a person needs to be fixed. [12]

Sociology

Museum of disABILITY History, Buffalo, New York. Museum of disABILITY History Buffalo NY.jpg
Museum of disABILITY History, Buffalo, New York.

Terminology

Handicap has been disparaged as a result of false folk etymology that says it is a reference to begging. It is actually derived from an old game, Hand-i'-cap, in which two players trade possessions and a third, neutral person judges the difference of value between the possessions. [13] The concept of a neutral person evening up the odds was extended to handicap racing in the mid-18th century. In handicap racing, horses carry different weights based on the umpire's estimation of what would make them run equally. The use of the term to describe a person with a disability – by extension from handicap racing, a person carrying a heavier burden than normal – appeared in the early 20th century. [14]

People-first language

People-first language is one way to talk about disability that some people prefer. Many others prefer identity-first language. Using people-first language is said to put the person before the disability, so those individuals who prefer people-first language, prefer to be called, "a person with a disability". This style is reflected in major legislation on disability rights, including the Americans with Disabilities Act and the UN Convention on the Rights of Persons with Disabilities.

For people-first guidelines, check out, "Cerebral Palsy: A Guide for Care" at the University of Delaware: [15]

"The American Psychological Association style guide states that, when identifying a person with a disability, the person's name or pronoun should come first, and descriptions of the disability should be used so that the disability is identified, but is not modifying the person. Acceptable examples included "a woman with Down syndrome" or "a man who has schizophrenia". It also states that a person's adaptive equipment should be described functionally as something that assists a person, not as something that limits a person, for example, "a woman who uses a wheelchair" rather than "a woman in/confined to a wheelchair".

A similar kind of "people-first" terminology is also used in the UK, but more often in the form "people with impairments" (such as "people with visual impairments"). However, in the UK, identity-first language is generally preferred over people-first language.

The use of “people-first” terminology has given rise to the use of the acronym PWD to refer to person(s) (or people) with disabilities (or disability). [16] [17] [18] However other individuals and groups prefer identity-first language to emphasize how a disability can impact people's identities. Which style of language used varies between different countries, groups and individuals.

Identity-first language

In contrast to people-first language, identity-first language describes the person as "disabled". Some people prefer this and argue that this fits the social model even better than does people-first language, as it emphasizes that the person is disabled not by their body, but by a world that does not accommodate them. [19]

This is especially true in the UK, where it is argued under the social model that while someone's impairment (for example, having a spinal cord injury) is an individual property, "disability" is something created by external societal factors such as a lack of accessibility. [20] This distinction between the individual property of impairment and the social property of disability is central to the social model. The term "disabled people" as a political construction is also widely used by international organisations of disabled people, such as Disabled Peoples' International (DPI).

Using identity-first language also parallels how people talk about other aspects of identity and diversity. For example: [21]

“In the autism community, many self-advocates and their allies prefer terminology such as ‘Autistic,’ ‘Autistic person,’ or ‘Autistic individual’ because we understand autism as an inherent part of an individual’s identity — the same way one refers to ‘Muslims,’ ‘African-Americans,’ ‘Lesbian/Gay/Bisexual/Transgender/Queer,’ ‘Chinese,’ ‘gifted,’ ‘athletic,’ or ‘Jewish.’”

Similarly, the Deaf community rejects people-first language in favor of identity-first language. [22]

Aging

To a certain degree, physical impairments and changing mental states are almost ubiquitously experienced by people as they age. Aging populations are often stigmatized for having a high prevalence of disability. Kathleen Woodward, writing in Key Words for Disability Studies, explains the phenomenon as follows:

Aging is invoked rhetorically – at times ominously – as a pressing reason why disability should be of crucial interest to all of us (we are all getting older, we will all be disabled eventually), thereby inadvertently reinforcing the damaging and dominant stereotype of aging as solely an experience of decline and deterioration. But little attention has been given to the imbrication of aging and disability. [23]

Employment

Studies have illustrated a correlation between disability and poverty. Notably, jobs offered to disabled people are scarce. In the developed world there are programs in place that aid intellectually disabled (ID) people to acquire skills they need in the workforce. [24] Such programs include sheltered workshops and adult day care programs. Sheltered programs consist of daytime activities such as, gardening, manufacturing, and assembling. These activities facilitate routine-oriented tasks that in turn allow intellectually disabled people to gain experience before entering the workforce. Similarly, adult day care programs also include day time activities. However, these activities are based in an educational environment where intellectually disabled are able to engage in educational, physical, and communication based tasks. This educational based environment helps facilitate communication, memory, and general living skills. In addition, adult day care programs arrange opportunities for their students to engage in community activities. Such opportunities are arranged by scheduling field trips to public places (e.g. Disneyland, Zoo, and Movie Theater). Despite, both programs providing essential skills for intellectually disabled prior to entering the workforce researchers have found that intellectually disabled people prefer to be involved with community-integrated employment. [24] Community-integrated employment are job opportunities offered to intellectually disabled people at minimum wage or a higher rate depending on the position. Community-integrated employment comes in a variety of occupations ranging from customer service, clerical, janitorial, hospitality and manufacturing positions. Within their daily tasks community-integrated employees work alongside employees who do not have disabilities, but who are able to assist them with training. All three options allow intellectually disabled people to develop and exercise social skills that are vital to everyday life. However, it is not guaranteed that community-integrated employees receive the same treatment as employees that do not have ID. According to Lindstrom, Hirano, McCarthy, and Alverson, community-integrated employees are less likely to receive raises. In addition, studies conducted in 2013 illustrated only 26% of employees with ID retained full-time status. [25]

Furthermore, many with disabilities, intellectual and (or) psychical, finding a stable workforce poses many challenges. According to a study conducted by JARID (Journal of Applied Research and Intellectual Disability, indicates that although finding a job may be difficult for an intellectually disabled individual, stabilizing a job is even harder. [26] This is largely due to two main factors: production skills and effective social skills. This idea is supported by Chadsey-Rusch, who claims that securing employment for the intellectually disabled, requires adequate production skills and effective social skills. [26] However, other underlying factors for job loss include, structural factors and the integration between worker and workplace. As stated by Kilsby, limited structural factors can effect a multitude of factors in a job. Factors such as a restricted number of hours an intellectually disabled person is allowed to work. This in return, according to Fabian, Wistow, and Schneider leads to a lack of opportunity to develop relationships with coworkers and a chance to better integrate within the workplace. Nevertheless, those who are unable to stabilize a job often are left discouraged. According to the same study conducted by JARED, many who had participated, found that they had made smaller incomes when compared to their co-workers, had an excess of time throughout their days, because they did not have work. They also had feelings of hopelessness and failure. According to the NOD ( National Organization On Disability), not only do the (ID) face constant discouragement, but many live below the poverty line, because they are unable to find or stabilize employment and (or) because of employee restricting factors placed on ID workers. [25] This then causes the (ID) the incapacity to provide for themselves basic necessities one needs. Items such as, food, medical care, transportation, and housing.

Poverty

The Cripples, Pieter Bruegel, 1568 Pieter Bruegel d. A. 024.jpg
The Cripples , Pieter Bruegel, 1568

There is a global correlation between disability and poverty, produced by a variety of factors. Disability and poverty may form a vicious circle, in which physical barriers and stigma of disability make it more difficult to get income, which in turn diminishes access to health care and other necessities for a healthy life. [27] The World report on disability indicates that half of all disabled people cannot afford health care, compared to a third of abled people. [28] In countries without public services for adults with disabilities, their families may be impoverished. [29]

Disasters

There is limited research knowledge, but many anecdotal reports, on what happens when disasters impact disabled people. [30] [31] Individuals with disabilities are greatly affected by disasters. [30] [32] Those with physical disabilities can be at risk when evacuating if assistance is not available. Individuals with cognitive impairments may struggle with understanding instructions that must be followed in the event a disaster occurs. [32] [33] [34] All of these factors can increase the degree of variation of risk in disaster situations with disabled individuals. [35]

Research studies have consistently found discrimination against individuals with disabilities during all phases of a disaster cycle. [30] The most common limitation is that people cannot physically access buildings or transportation, as well as access disaster-related services. [30] The exclusion of these individuals is caused in part by the lack of disability-related training provided to emergency planners and disaster relief personnel. [36]

Theory

The International Classification of Functioning, Disability and Health (ICF), produced by the World Health Organization, distinguishes between body functions (physiological or psychological, such as vision) and body structures (anatomical parts, such as the eye and related structures). Impairment in bodily structure or function is defined as involving an anomaly, defect, loss or other significant deviation from certain generally accepted population standards, which may fluctuate over time. Activity is defined as the execution of a task or action. The ICF lists 9 broad domains of functioning which can be affected:

In concert with disability scholars, the introduction to the ICF states that a variety of conceptual models have been proposed to understand and explain disability and functioning, which it seeks to integrate. These models include the following:

Medical model

The medical model views disability as a problem of the person, directly caused by disease, trauma, or other health conditions which therefore requires sustained medical care in the form of individual treatment by professionals. In the medical model, management of the disability is aimed at a "cure", or the individual's adjustment and behavioral change that would lead to an "almost-cure" or effective cure. In the medical model, medical care is viewed as the main issue, and at the political level, the principal response is that of modifying or reforming healthcare policy. [37] [38]

Social model

The social model of disability sees "disability" as a socially created problem and a matter of the full integration of individuals into society. In this model, disability is not an attribute of an individual, but rather a complex collection of conditions, created by the social environment. The management of the problem requires social action and it is the collective responsibility of society to create a society in which limitations for disabled people are minimal. Disability is both cultural and ideological in creation. According to the social model, equal access for someone with an impairment/disability is a human rights concern. [39] [38] The social model of disability has come under criticism. While recognizing the importance played by the social model in stressing the responsibility of society, scholars, including Tom Shakespeare, point out the limits of the model, and urge the need for a new model that will overcome the "medical vs. social" dichotomy. [40] The limitations of this model mean that often the vital services and information persons with disabilities face are simply not available, often due to limited economic returns in supporting them. [41]

Some say medical humanities is a fruitful field where the gap between the medical and the social model of disability might be bridged. [42]

Social construction

The social construction of disability is the idea that disability is constructed by social expectations and institutions rather than biological differences. Highlighting the ways society and institutions construct disability is one of the main focuses of this idea. [43] In the same way that race and gender are not biologically fixed, neither is disability.

Around the early 1970s, sociologists, notably Eliot Friedson, began to argue that labeling theory and social deviance could be applied to disability studies. This led to the creation of the social construction of disability theory. The social construction of disability is the idea that disability is constructed as the social response to a deviance from the norm. The medical industry is the creator of the ill and disabled social role. Medical professionals and institutions, who wield expertise over health, have the ability to define health and physical and mental norms. When an individual has a feature that creates an impairment, restriction, or limitation from reaching the social definition of health, the individual is labeled as disabled. Under this idea, disability is not defined by the physical features of the body but by a deviance from the social convention of health. [44]

Social construction of disability would argue that the medical model of disability's view that a disability is an impairment, restriction, or limitation is wrong. Instead what is seen as a disability is just a difference in the individual from what is considered "normal" in society. [45]

Other models

Identity

In contexts where their differences are visible, persons with disabilities often face stigma. People frequently react to disabled presence with fear, pity, patronization, intrusive gazes, revulsion, or disregard. These reactions can, and often do, exclude persons with disabilities from accessing social spaces along with the benefits and resources these spaces provide. [59] Disabled writer/researcher Jenny Morris describes how stigma functions to marginalize persons with disabilities: [60]

“Going out in public so often takes courage. How many of us find that we can't dredge up the strength to do it day after day, week after week, year after year, a lifetime of rejection and revulsion? It is not only physical limitations that restrict us to our homes and those whom we know. It is the knowledge that each entry into the public world will be dominated by stares, by condescension, by pity and by hostility.”

Additionally, facing stigma can cause harm to psycho-emotional well-being of the person being stigmatized. One of the ways in which the psycho-emotional health of persons with disabilities is adversely affected is through the internalization of the oppression they experience, which can lead to feeling that they are weak, crazy, worthless, or any number of other negative attributes that may be associated with their conditions. Internalization of oppression damages the self-esteem of the person affected and shapes their behaviors in ways that are compliant with nondisabled dominance. [59] Ableist ideas are frequently internalized when disabled people are pressured by the people and institutions around them to hide and downplay their disabled difference, or, "pass". According to writer Simi Linton, the act of passing takes a deep emotional toll by causing disabled individuals to experience loss of community, anxiety and self-doubt. [61] The media play a significant role in creating and reinforcing stigma associated with disability. Media portrayals of disability usually cast disabled presence as necessarily marginal within society at large. These portrayals simultaneously reflect and influence the popular perception of disabled difference.

Tropes

There are distinct tactics that the media frequently employ in representing disabled presence. These common ways of framing disability are heavily criticized for being dehumanizing and failing to place importance on the perspectives of persons with disabilities.

Inspiration porn

Inspiration porn refers to portrayals of persons with disabilities in which they are presented as being inspiring simply because the person has a disability. These portrayals are criticized because they are created with the intent of making non-disabled viewers feel better about themselves in comparison to the individual portrayed. Rather than recognizing the humanity of persons with disabilities, inspiration porn turns them into objects of inspiration for a non-disabled audience. [62]

Supercrip

The supercrip trope refers to instances when media reports on or portray a disabled person who has made a noteworthy achievement; but center on their disability rather than what they actually did. They are portrayed as awe-inspiring for being exceptional compared to others with the same or similar conditions. This trope is widely used in reporting on disabled athletes as well as in portrayals of autistic savants. [63] [64]

Many disabled people denounce these representations as reducing people to their condition rather than viewing them as full people. Furthermore, supercrip portrayals are criticized for creating the unrealistic expectation that disability should be accompanied by some type of special talent, genius, or insight.

Disabled villain

Characters in fiction that bear physical or mental markers of difference from perceived societal norms are frequently positioned as villains within a text. Lindsey Row-Heyveld notes, for instance, “that villainous pirates are scraggly, wizened, and inevitably kitted out with a peg leg, eye patch, or hook hand whereas heroic pirates look like Johnny Depp's Jack Sparrow.” [65] Disabled people's visible differences from the abled majority are meant to evoke fear in audiences that can perpetuate the mindset of disabled people being a threat to individual or public interests and well-being.

Self advocacy

Some disabled people have attempted to resist marginalisation through the use of the social model in opposition to the medical model; with the aim of shifting criticism away from their bodies and impairments and towards the social institutions that oppress them relative to their abled peers. Disability activism that demands many grievances be addressed, such as lack of accessibility, poor representation in media, general disrespect, and lack of recognition, originates from a social model framework.

Embracing disability as a positive identity by becoming involved in disabled communities and participating in disabled culture can be an effective way to combat internalised prejudice; and can challenge dominant narratives about disability. [66]

Intersections

The experiences that disabled people have navigating social institutions vary greatly as a function of what other social categories they may belong to. The categories that intersect with disability to create unique experiences of ableism include, but aren't limited to, race and gender. The United Nations Convention on the Rights of Persons with Disabilities differentiates two kinds of disability intersection, race disability intersection and gender disability intersection. [67]

Race

Disabled people who are also racial minorities generally have less access to support and are more vulnerable to violent discrimination. For example, in the United States people of color who are mentally ill are more frequently victims of police brutality than their white counterparts. Camille A. Nelson, writing for the Berkeley Journal of Criminal Law, notes that for “people who are negatively racialized, that is people who are perceived as being non-white, and for whom mental illness is either known or assumed, interaction with police is precarious and potentially dangerous.” [68]

Gender

The marginalization of disabled people can leave persons with disabilities unable to actualize what society expects of gendered existence. This lack of recognition for their gender identity can leave persons with disabilities with feelings of inadequacy. Thomas J. Gerschick of Illinois State University describes why this denial of gendered identity occurs: [69]

Bodies operate socially as canvases on which gender is displayed and kinesthetically as the mechanisms by which it is physically enacted. Thus, the bodies of disabled people make them vulnerable to being denied recognition as women and men.

To the extent that women and men with disabilities are gendered, the interactions of these two identities lead to different experiences. Disabled women face a sort of “double stigmatization” in which their membership to both of these marginalized categories simultaneously exacerbates the negative stereotypes associated with each as they are ascribed to them. According to The UN Woman Watch, "Persistence of certain cultural, legal and institutional barriers makes women and girls with disabilities the victims of two-fold discrimination: as women and as persons with disabilities." [70] As Rosemarie Garland-Thomson puts it, “Women with disabilities, even more intensely than women in general, have been cast in the collective cultural imagination as inferior, lacking, excessive, incapable, unfit, and useless.” [71]

Assistive technology

Assistive Technology is a generic term for devices and modifications (for a person or within a society) that help overcome or remove a disability. The first recorded example of the use of a prosthesis dates to at least 1800 BC. [72] The wheelchair dates from the 17th century. [73] The curb cut is a related structural innovation. Other examples are standing frames, text telephones, accessible keyboards, large print, Braille, & speech recognition software. Disabled people often develop personal or community adaptations, such as strategies to suppress tics in public (for example in Tourette's syndrome), or sign language in deaf communities.

As the personal computer has become more ubiquitous, various organizations have formed to develop software and hardware to make computers more accessible for disabled people. Some software and hardware, such as Voice Finger, Freedom Scientific's JAWS , the Free and Open Source alternative Orca etc. have been specifically designed for disabled people while other software and hardware, such as Nuance's Dragon NaturallySpeaking, were not developed specifically for disabled people, but can be used to increase accessibility. [74] The LOMAK keyboard was designed in New Zealand specifically for persons with disabilities. [75] The World Wide Web consortium recognised a need for International Standards for Web Accessibility for persons with disabilities and created the Web Accessibility Initiative (WAI). [76] As at Dec 2012 the standard is WCAG 2.0 (WCAG = Web Content Accessibility Guidelines). [77]

Adapted sports

Wheelchair basketball match between South Africa and Iran at the 2008 Summer Paralympics Wheelchair basketball at the 2008 Summer Paralympics.jpg
Wheelchair basketball match between South Africa and Iran at the 2008 Summer Paralympics

The Paralympic Games (meaning "alongside the Olympics") are held after the (Summer and Winter) Olympics. The Paralympic Games include athletes with a wide range of physical disabilities. In member countries, organizations exist to organize competition in the Paralympic sports on levels ranging from recreational to elite (for example, Disabled Sports USA and BlazeSports America in the United States).

The Paralympics developed from a rehabilitation programme for British war veterans with spinal injuries. In 1948, Sir Ludwig Guttman, a neurologist working with World War II veterans with spinal injuries at Stoke Mandeville Hospital in Aylesbury in the UK, began using sport as part of the rehabilitation programmes of his patients.

In 2006, the Extremity Games were formed for physically disabled people, specifically limb loss or limb difference, to be able to compete in extreme sports. [78]

Rights and government policies

Rights movement

The disability rights movement aims to secure equal opportunities and equal rights for disabled people. The specific goals and demands of the movement are accessibility and safety in transportation, architecture, and the physical environment; equal opportunities in independent living, employment, education, and housing; and freedom from abuse, neglect, and violations of patients' rights. [79] Effective civil rights legislation is sought to secure these opportunities and rights. [79] [80] [81]

The early disability rights movement was dominated by the medical model of disability, where emphasis was placed on curing or treating disabled people so that they would adhere to the social norm, but starting in the 1960s, rights groups began shifting to the social model of disability, where disability is interpreted as an issue of discrimination, thereby paving the way for rights groups to achieve equality through legal means. [82]

Policies and actions

Convention on the Rights of Persons with Disabilities

On December 13, 2006, the United Nations formally agreed on the Convention on the Rights of Persons with Disabilities, the first human rights treaty of the 21st century, to protect and enhance the rights and opportunities of the world's estimated 650 million disabled people. [83] As of April 2011, 99 of the 147 signatories had ratified the Convention. [84] Countries that sign the convention are required to adopt national laws, and remove old ones, so that persons with disabilities will, for example, have equal rights to education, employment, and cultural life; to the right to own and inherit property; to not be discriminated against in marriage, etc.; and to not be unwilling subjects in medical experiments. UN officials, including the High Commissioner for Human Rights, have characterized the bill as representing a paradigm shift in attitudes toward a more rights-based view of disability in line with the social model. [83]

International Year of Disabled Persons

In 1976, the United Nations began planning for its International Year of Disabled Persons (1981), [85] later renamed the International Year of Disabled Persons. The UN Decade of Disabled Persons (1983–1993) featured a World Programme of Action Concerning Disabled Persons. In 1979, Frank Bowe was the only person with a disability representing any country in the planning of IYDP-1981. Today, many countries have named representatives who are themselves individuals with disabilities. The decade was closed in an address before the General Assembly by Robert Davila. Both Bowe and Davila are deaf. In 1984, UNESCO accepted sign language for use in education of deaf children and youth.

Policies in the United States

In the United States, the Department of Labor's 2014 rules for federal contractors, defined as companies that make more than $50,000/year from the federal government, required them to have as a goal that 7% of their workforce must be disabled people. [86] In schools, the ADA says that all classrooms must be wheelchair accessible. [87] The U.S. Architectural and Transportation Barriers Compliance Board, commonly known as the Access Board, created the Rehabilitation Act of 1973 to help offer guidelines for transportation and accessibility for the physically disabled. [88]

About 12.6% of the U.S. population are individuals who suffer from a mental or physical disability. Many are unemployed because of prejudiced assumptions that a person with disabilities is unable to complete tasks that are commonly required in the workforce. This became a major Human rights issue because of the discrimination that this group faced when trying to apply for jobs in the U.S. Many advocacy groups protested against such discrimination, asking the federal government to implement laws and policies that would help individuals with disabilities.

Rehabilitation Act of 1973

The Rehabilitation Act of 1973 was enacted with the purpose of protecting individuals with disabilities from prejudicial treatment by government funded programs, employers, and agencies. The Rehabilitation Act of 1973 has not only helped protect U.S. citizens from being discriminated against but it has also created confidence amongst individuals to feel more comfortable with their disability. There are many sections within The Rehabilitation Act of 1973, that contains detailed information about what is covered in this policy.

Section 501
An employer must hire an individual who meets the qualifications of a job description despite any preexisting disabilities.
Section 503
Requires contractors or subcontractors, who receive more than $10,000 from the government to hire people with disabilities and to accommodate them with the needs that they need to achieve in the work force.
Section 504
States that receive federal money may not discriminate against any person with disabilities who qualifies for a program or job.

On June 22, 1999 the United States Supreme Court issued a ruling in Olmstead vs. L. C. that said unjustified segregation of persons with disabilities constitutes discrimination in violation of title II of the Americans with Disabilities Act. This has been interpreted as meaning people with disabilities must be given all opportunity by government to stay in their own homes as opposed to assisted living, nursing homes or worse, institutions for the disabled. It's been interpreted as meaning government must make all reasonable efforts to allow people with disabilities to be included in their respective communities and enjoy family and friends, work if possible, get married, own homes and interact with nondisabled people. This is why the United States has so many community based services today for the disabled including but not limited to home health aides, personal care attendants and other programs to keep people with disabilities in their own homes and communities.

The Americans with Disabilities Act of 1990

The federal government enacted The Americans with Disabilities Act of 1990, which was created to allow equal opportunity for jobs, access to private and government funded facilities, and transportation for disabled people. This act was created with the purpose to ensure that employers would not discriminate against any individual despite their disability. In 1990, data was gathered to show the percentage of disabled people who worked in the U.S. Out of the 13% who filled out the survey, only 53% percent of individuals with disabilities worked while 90% of this group population did not, the government wanted to change this, they wanted Americans with disabilities to have the same opportunities as those who did not have a disability. The ADA not only required corporations to hire disabled people but that they also accommodate them and their needs.

Title I
Employment
An employer must give a qualified individual with disabilities the same opportunities as any other employee despite their disability. The employer must offer equal work privileges to someone who has a disability including but not limited to pay, work hours, training, etc. The employer must also create accommodations suitable for the person and their physical or mental disabilities.
Title II
State and Local Government Activities
Requires that the government give disabled people the same opportunities involving work, programs, building access, and services. Title II also requires that buildings create easy access for disabled people and provide communicators who will be able to help those with hearing or speaking impairments. Public spaces are however not required to create accommodations that would in turn alter their services as long as the services proved that they did all they could to prevent discrimination against disabled people.
Title II
Transportation
Public transportation should be customized so that disabled people may have easy access to public transit. Paratransit is a service that provides transportation to people who are unable to get from one destination to another due to their mental or physical disability.
Title II
Public Accommodations
Public accommodations require that private businesses create accommodations that will allow disabled people easy access to buildings. Private businesses may not discriminate against disabled people and must provide accommodations that are reasonable, alterations may be made so that a person with disabilities can have equal access to facilities that are provided, communicators for the hearing impaired, devices for the visually impaired, and wheelchair access. Facilities must regulate with the ADA, when regulating the buildings infrastructure so it meets the ADA regulations.
Title IV
Telecommunication Relay Services
Requires telephone companies to have TRS seven days a week, twenty four hours a day. It requires telephone companies to create accommodations for deaf/hard of hearing people by providing a third party that will be able to assistant both parties in communicating with one another.

Policies in the United Kingdom

In the UK, the Department for Work and Pension is a government department responsible for promoting disability awareness and among its aims is to increase the understanding of disability and removal of barriers for disabled people in the workplace. According to a news report, a people survey conducted in the UK shows a 23% increase in reported discrimination and harassment in the workplace at The Department for Work and Pension. The survey shows the number of reports for discrimination due to disability was in majority compared to discrimination due to gender, ethnicity or age. DWP received criticism for the survey results. As a department responsible for tackling discrimination at work, the DWP results may indicate room for improvement from within. A DWP spokesperson said the survey results do not necessarily indicate an increase in the number of reports, but rather reflecting the outcomes of efforts to encourage people to come forward. [89]

Policies in Japan

Policies in Sweden

Political issues

A 28-year-old Iraqi woman who lost both of her legs during the Iraq War in 2005 USMC-00772.jpg
A 28-year-old Iraqi woman who lost both of her legs during the Iraq War in 2005

Political rights, social inclusion and citizenship have come to the fore in developed and some developing countries. The debate has moved beyond a concern about the perceived cost of maintaining dependent disabled people to finding effective ways to ensure that disabled people can participate in and contribute to society in all spheres of life.

In developing nations, where the vast bulk of the estimated 650 million disabled people reside, a great deal of work is needed to address concerns ranging from accessibility and education to self-empowerment, self-supporting employment, and beyond. [90]

In the past few years, disability rights activists have focused on obtaining full citizenship for the disabled.

There are obstacles in some countries in getting full employment; public perception of disabled people may vary.

Abuse

Disability abuse happens when a person is abused physically, financially, verbally or mentally due to the person having a disability. As many disabilities are not visible (for example, asthma, learning disabilities) some abusers cannot rationalize the non-physical disability with a need for understanding, support, and so on. [91]

As the prevalence of disability and the cost of supporting disability increases with medical advancement and longevity in general, this aspect of society becomes of greater political importance. How political parties treat their disabled constituents may become a measure of a political party's understanding of disability, particularly in the social model of disability. [92]

Insurance

Disability benefit, or disability pension, is a major kind of disability insurance that is provided by government agencies to people who are temporarily or permanently unable to work due to a disability. In the U.S., disability benefit is provided in the category of Supplemental Security Income. In Canada, it is within the Canada Pension Plan. In other countries, disability benefit may be provided under social security systems.

Costs of disability pensions are steadily growing in Western countries, mainly in Europe and the United States. It was reported that, in the UK, expenditure on disability pensions accounted for 0.9% of gross domestic product (GDP) in 1980; two decades later it had reached 2.6% of GDP. [91] [93] Several studies have reported a link between increased absence from work due to sickness and elevated risk of future disability pension. [94]

A study by researchers in Denmark suggests that information on self-reported days of absence due to sickness can be used to effectively identify future potential groups for disability pension. [93] These studies may provide useful information for policy makers, case managing authorities, employers, and physicians.

In Switzerland, social policies in the field of disability have been significantly reshaped over the last two decades by reducing the number of allowances awarded and by increasing the recourse to vocational rehabilitation measures. Drawing on interviews conducted with individuals who have been involved in programmes set up by Swiss disability insurance, a study highlights their uncertainties and concerns relating to their place in society, as well as their reactions to disability insurance’s interventions. [95]

Private, for-profit disability insurance plays a role in providing incomes to disabled people, but the nationalized programs are the safety net that catch most claimants.

Demographics

Estimates of worldwide and country-wide numbers of individuals with disabilities are problematic. The varying approaches taken to defining disability notwithstanding, demographers agree that the world population of individuals with disabilities is very large. For example, in 2012, the World Health Organization estimated a world population of 6.5 billion people. Of those, nearly 650 million people, or 10%, were estimated to be moderately or severely disabled. [96] In 2018 the International Labour Organization estimated that about a billion people, one seventh of the world population, had disabilities, 80% of them in developing countries, and 80% of working age. Excluding disabled people from the workforce was reckoned to cost up to 7% of gross domestic product. [97]

Afghanistan

After years of war in Afghanistan, there are more than 1 million disabled people. [98] Afghanistan has one of the highest incidences of disabled people in the world. [99] An estimated 80,000 Afghans are missing limbs, usually from landmine explosions. [100]

Australia

More than 4 million people in Australia have some form of disability as of 2018. Approximately 18.6% of females and 18.0% of males are said to be affected. 50.7% of Australians aged 65 and over have disability, as opposed to 12.5% aged under 65. [101]

United States

According to the U.S. Census Bureau, as of 2010, there were some 56.7 million disabled people, or 19% (by comparison, African Americans are the largest racial minority in the U.S., but only constitute 12.6% of the U.S. population). [102]

Disabled individuals make up one of the most inclusive minority groups in the United States. [103] According to the 2014 Disability status report of the Cornell University Yang Tan Institute the prevalence rate of individuals with disabilities in the United States was 12.6% in that year. As of 2014 ambulatory disability had the highest prevalence (7.1%) in the United States. By contrast, visual disability had the lowest prevalence (2.3%). Additionally, 3.6% of people in the United States were reported to have had an auditory disability in the same year. [104]

5.8% of individuals ages 16–20 reported having any disability, physical and/ or cognitive. Adults 21 to 64 had a prevalence of 10.8% with over half of these (5.5%) being ambulatory disabilities. Ambulatory disability prevalence raised to 15.8% in adults 65–74 years of age. Adults 75 years and older comprised the highest prevalence with any disability at 50.3%.

Female individuals across all ages reported a total 0.4% higher prevalence rate than males who reported 12.4%.

In the U.S. 17.9% of Native American peoples reported having a disability while 4.5% reporting were of Asian descent, these were the two opposing poles of the prevalence rate within race as of 2014. [104]

Although there are acts that have been imposed in order to prevent the discrimination of individuals with disabilities in the workplace, there is still an employment gap that can be seen between those with and without disabilities. In regards to employment, the institute's status report accounts that 34.6% of people with any disability reported being employed. By comparison; 77.6% of individuals, who did not report having a disability, reported having a full-time job in 2014. [104]

For those employed full-time, individuals with disabilities on average earned $5,100 less than employees without a disability who were also employed full-time. Those affected the most by these differences were intellectually disabled people. [104] As of 2008, there were 2.9 million disabled veterans in the United States, an increase of 25 percent over 2001. [105]

Europe

Nearly 8 million European men were permanently disabled in World War I. [106] About 150,000 Vietnam veterans came home wounded, and at least 21,000 were permanently disabled. [107]

Developing nations

There is widespread agreement among experts[ who? ] in the field, that disability is more common in developing than in developed nations. The connection between disability and poverty is thought to be part of a "vicious cycle" in which these constructs are mutually reinforcing. [108]

See also

Related Research Articles

Accessibility The design of products or services for people with temporary or permanent impairments

Accessibility is the design of products, devices, services, or environments for people with disabilities. The concept of accessible design and practice of accessible development ensures both "direct access" and "indirect access" meaning compatibility with a person's assistive technology.

Rehabilitation Act of 1973 United States law

The Rehabilitation Act of 1973,, is a federal law, codified as 29 U.S.C. § 701 et seq. The principal sponsor of the bill was Rep. John Brademas [IN-3]. The Rehabilitation Act of 1973 replaces the Vocational Rehabilitation Act of 1973, to extend and revise the authorization of grants to States for vocational rehabilitation services, with special emphasis on services to those with the most severe disabilities, to expand special Federal responsibilities and research and training programs with respect to individuals with disabilities, to establish special responsibilities in the Secretary of Health, Education, and Welfare for coordination of all programs with respect to individuals with disabilities within the Department of Health, Education, and Welfare, and for other purposes.

Inclusion (disability rights) including people with and without disabilities, people of different backgrounds

Inclusion is a term used by people with disabilities and other disability rights advocates for the idea that all people should take action to freely accommodate people with a physical, mental, cognitive, and or developmental disability. For example, providing ramps and accessible toilets in meeting facilities or providing additional intervention and resources in the education system are known as 'universal design' or efforts towards the goal of inclusion. The education system has a more specific definition for disability. An individual who exhibits challenges that substantially limits one or more major life activities is disabled. The interpretation of what is considered a major life activity has been recently expanded to include all barriers to reading, writing, concentrating, and thinking. For example, individuals with Attention deficit hyperactivity disorder, are now included as a disability in the education system. This allows educational resources to be used for a wider population of individuals with barriers to learning.

Convention on the Rights of Persons with Disabilities international human rights treaty of the United Nations intended to protect the rights and dignity of persons with disabilities

The Convention on the Rights of Persons with Disabilities is an international human rights treaty of the United Nations intended to protect the rights and dignity of people with disabilities. Parties to the Convention are required to promote, protect, and ensure the full enjoyment of human rights by people with disabilities and ensure that they enjoy full equality under the law. The Convention has served as the major catalyst in the global movement from viewing people with disabilities as objects of charity, medical treatment and social protection towards viewing them as full and equal members of society, with human rights. It is also the only UN human rights instrument with an explicit sustainable development dimension. The Convention was the first human rights treaty of the twenty-first century.

The world's poor are significantly more likely to have or incur a disability within their lifetime compared to more financially privileged populations. The rate of disability within impoverished nations is notably higher than that found in more developed countries. Though no one explanation entirely accounts for this connection, recently there has been a substantial amount of research illustrating the cycle by which poverty and disability are mutually reinforcing. Physical, cognitive, mental, emotional, sensory, or developmental impairments independently or in tandem with one another may increase one's likelihood of becoming impoverished, while living in poverty may increase one's potential of having or acquiring special needs in some capacity.

Disability in China is common, and according to the United Nations, approximately 83 million people in China are estimated to have a disability.

Disability is an issue that directly affects a significant proportion of the population of the United Kingdom. Section6(1) of the Equality Act 2010 defines disability as:

"A person has a disability for the purposes of the Act if he or she has a physical or mental impairment and the impairment has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities."

According to Abilities United, over 16% of Americans are considered to have either a physical, developmental, or learning disability. The barriers that 33.7 million persons with disabilities face within the American electoral process include access to polling information, physical access to polls, current and future laws that deal with the topic, and the moral implications regarding the varying levels of both physical and cognitive disabilities and the act of voting.

Disability rights are not specifically addressed by legislation in New Zealand. Instead, disability rights are addressed through human rights legislation. Human rights in New Zealand are protected by the New Zealand Bill of Rights Act 1990 and the Human Rights Act 1993. New Zealand also signed and ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2008.

Peruvians with disabilities constitute 5.2% of the population. 52.1% of disabled people are women. 40.5% of disabled Peruvians have a primary or better education. 76.8% are not economically active they have an unemployment rate of 12.1%. Of those Peruvians with disabilities who do work, 58.3% are self-employed.

Disability in Singapore

Disability in Singapore describes the different aspects of life affecting people with disabilities in Singapore. Singapore does not have a formal definition of disability, but has been making changes in regards to the visibility of people with disability and also with increasing accessibility of all areas of the country. Early in the country's history, human rights issues for people with disabilities took second place to the need to secure independence and building the economy. Singapore signed on to the Convention on the Rights of Persons with Disabilities (UNCRPD) in 2013 and coordinates the Enabling Masterplan with both government and non governmental organisations.

As of 2007, there are almost one million people with various levels of physical and mental disabilities in Taiwan. Taiwan adopted a universal healthcare system in 1995 to properly support patient care and provide more transparent access to its people, including those who identify as disabled.Taiwan is a nation that has grown tremendously to support those that are disabled. This includes having a socialized form of medical care that is run by the executive branch of government known as “Yuan”. Overall this universal scheme includes the law, public facilities, and educational aspect of healthcare. Taiwan also has different aspects of healthcare to effectively support those that are disadvantaged or disabled, this included subsidies, loans, plans, service guarantee and specific care for medically vulnerable populations. Taiwan's healthcare development and dedication to support its people plays an important role in its transformation of benefits for the disabled.

Geography of disability is a branch of Human Geography focusing on the disabled or impairs and their experience. Disability refers to individuals with physical and intellectual impairments. The difference between the disability and impairment is that disability is the restriction of the ability caused by the actual decrement of functioning, aka impairment, of the individual. The Geography of disability studies the experience of disabled people and examines the relationship between the disability and space, ranging from the accessibility, mobility and the landscape, in terms of socio-economic, environmental and political perspectives. Hawkesworth, a scholar refers the Geography of disability as “a set of discursive and performative practice”, which intersects more with in the social and cultural aspects, instead of solely on the physical impairment.

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