Disability

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Government policies and support

United Kingdom

Under the Disability Discrimination Act (1995, extended in 2005), it is unlawful for organisations to discriminate (treat a disabled person less favourably, for reasons related to the person's disability, without justification) in employment; access to goods, facilities, services; managing, buying or renting land or property; education. Businesses must make "reasonable adjustments" to their policies or practices, or physical aspects of their premises, to avoid indirect discrimination.[2]

A number of financial and care support services are available, including Incapacity Benefit and Disability Living Allowance[3].

United States

Discrimination in employment

The US Rehabilitation Act of 1973 requires all organizations that receive government funding to provide accessiblity programs and services. A more recent law, the 1990 Americans with Disabilities Act (ADA), which came in to effect in 1992, prohibits private employers, state and local governments and employment agencies and labor unions from discriminating against qualified individuals with disabilities in job application procedures, hiring, firing, advancement, compensation, job training, or in the terms, conditions and privileges of employment. This includes organizations like retail businesses, movie theaters, and restaurants. They must make "reasonable accommodation" to people with different needs. Protection is extended to anyone with (A) a physical or mental impairment that substantially limits one or more of the major life activities of an individual (B) a record of such an impairment or (C) being regarded as having such an impairment. The second and third critiera are seen as ensuring protection from unjust discrimination based on a perception of risk, just because someone has a record of impairment or appears to have a disability or illness (e.g. features which may be erroneously taken as signs of an illness).

African Americans and Disability

According to the 2000 U.S. Census, the African American community has the highest rate of disability at 24.3 percent. Although people have come to better understand and accept different types of disability, there still remains a stigma attached to the disabled community. African Americans with a disability are subject to not only this stigma but also to the additional forces of race discrimination. African American women who have a disibility face tremendous discrimination due to their condition, race, and gender. Doctor Eddie Glenn of Howard University describes this situation as the "triple jeopardy" syndrome.

Social administration

The US Social Security Administration defines disability in terms of inability to perform substantial gainful activity (SGA), by which it means “work paying minimum wage or better”. The agency pairs SGA with a "listing" of medical conditions that qualify individuals for benefits.

Education

Under the Individuals with Disabilities Education Act, special educational support is limited to children and youth falling in to one of a dozen disability categories (e.g., specific learning disability) and adds that, to be eligible, students must require both special education (modified instruction) and related services (supports such as speech and language pathology).

Demographics

Difficulties in measuring

The demography of disability is difficult. Counting persons with disabilities is far more challenging than is counting males. That is because disability is not just a status condition, entirely contained within the individual. Rather, it is an interaction between medical status (say, having low vision or being blind) and the environment.

Estimates worldwide

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. The World Health Organization, for example, estimates that there are as many as 600 million persons with disabilities. The United Nations estimate is 650 million. In the United States, for example, Americans with disabilities constitute the third-largest minority (after persons of Hispanic origin and African Americans); all three of those minority groups number in the 30-some millions in America. According to the U.S. Bureau of the Census, as of 2004, there were some 32 million adults (aged 18 or over) in the United States, plus another 5 million children and youth (under age 18). If one were to add impairments -- or limitations that fall short of being disabilities -- Census estimates put the figure at 51 million.

There is also widespread agreement among experts in the field that disability is more common in developing than in developed nations.

Disability insurance—nationalized and private

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

Costs of disability pensions are steadily growing in Western countries, mainly European 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, but two decades later had reached 2.6% of GDP.^[1]^[2] Several studies have reported a link between increased sickness absence and elevated risk of future disability pension.^[3] A study by Denmark researchers suggests that information on self-reported days of sickness absence can be used to effectively identify future potential groups for disability pension. [4] These studies may provide useful information for policy makers, case managing authorities, employers, and physicians responsible for interventions aiming at reducing the cost and work disability.

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

Adaptations

Assistive Technology (AT) 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.^[4] A more recent notable example is the wheelchair, dating from the 17th Century. The curb cut is a related structural innovation. Other modern examples are standing frames, text telephones, accessible keyboards, large print, Braille, & speech recognition Computer software. Individuals with disabilities 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. Assistive technology or interventions are sometimes controversial or rejected, for example in the controversy over cochlear implants for children. A number of symbols are in use to indicate whether certain accessibility adaptations have been made[5].

Accessible computing

As the personal computer has become more ubiquitous, various organisations have been founded which develop software and hardware which make a computer more accessible for people with disabilities. Some software and hardware, such as SmartboxAT's The Grid, and Freedom Scientific's JAWS has been specifically designed for people with disabilities; other pieces of software and hardware, such as Nuance's Dragon NaturallySpeaking, was not developed specifically for people with disabilities, but can be used to increase accessibility.

Further organisations, such as AbilityNet and U Can Do IT, have been established to provide assessment services which determine which assistive technologies would best assist an individual client, and also to train people with disabilities in how to use computer-based assistive technology.

Related Chapters

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Footnotes

↑ OECD. Transforming disability into ability: Policies to promote work and income security for disabled people. Paris: OECD Publication Offices. 2003
↑ Labriola M, Lund T. Self-reported sickness absence as a risk marker of future disability pension. Prospective findings from the DWECS/DREAM study 1990-2004. Int J Med Sci 2007; 4:153-158. http://www.medsci.org/v04p0153.htm
↑ Virtanen M, Kivimaki M, Vahtera J, Elovainio M, Sund R, Virtanen P, Ferrie JE. Sickness absence as a risk factor for job termination, unemployment, and disability pension among temporary and permanent employees. Occup Environ Med. 2006;63(3):212-7
↑ Disability Social History Project

References

Frank Bowe, Handicapping America:Barriers to disabled people, Harper & Row, 1978 ISBN 0-06-010422-8
Encyclopedia of disability, general ed. Gary L. Albrecht, Thousand Oaks, Calif. [u.a.] : SAGE Publ., 2005
David Johnstone, An Introduction to Disability Studies, 2001, 2nd edition, ISBN 1-85346-726-X
Michael Oliver, The Politics of Disablement, St. Martin's Press 1997, ISBN 0-333-43293-2
Tom Shakespeare, Genetic Politics: from Eugenics to Genome, with Anne Kerr , New Clarion Press, 1999, ISBN 1-873797-25-7
Kaushik, R.,1999, " Access Denied: Can we overcome disabling attitudes ," Museum International (UNESCO) , Vol. 51, No. 3, p. 48-52.
Disability Now
Glenn, Eddie. March 20, 1997. "African American Women with Disabilities: An Overview."

External Links

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[1] OECD. Transforming disability into ability: Policies to promote work and income security for disabled people. Paris: OECD Publication Offices. 2003

[2] Labriola M, Lund T. Self-reported sickness absence as a risk marker of future disability pension. Prospective findings from the DWECS/DREAM study 1990-2004. Int J Med Sci 2007; 4:153-158. http://www.medsci.org/v04p0153.htm

[3] Virtanen M, Kivimaki M, Vahtera J, Elovainio M, Sund R, Virtanen P, Ferrie JE. Sickness absence as a risk factor for job termination, unemployment, and disability pension among temporary and permanent employees. Occup Environ Med. 2006;63(3):212-7

[4] Disability Social History Project

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