The first ever World Report on Disability, produced jointly by the World Health Organisation and the World Bank, suggests that more than a billion people in the world today experience disability. The proportion of disabled people has risen from 10% in the 1970s to 15% of the world population today indicating an increase in the prevalence of disability.
Disability and socio-economic barriers
The report documents that “people with disabilities have generally poorer health, lower education achievements, fewer economic opportunities and higher rates of poverty than people without disabilities”, conditions that are not necessarily associated with or intrinsic to disability, but are instead a result of lack of adequate services, barriers faced in accessing services such as transport, healthcare, education etc and negative attitudes. In the words of Tom Shakespeare, one of the authors of the report, “Disabled people do not need to be poor and excluded; they do not need to be segregated. They do not need to be second class citizens.”
Low income and developing countries have higher numbers of disabled people and are more prone to face barriers in accessing healthcare, education, adequate income etc. Overall, women, older people and poor households experience disability more commonly. These vulnerable groups therefore feel a disproportionate effect of disability.
Discrimination in healthcare
The report suggests that disabled people face systemic discrimination in accessing healthcare even in the developed world. Statistically speaking, the disabled have three times higher risks of being refused necessary medical care than the non-disabled.That hardly comes as a surprise after the recent shocking Panorama exposé of abuse of people with autism and learning disabilities by care workers in a care home in the UK.
Shift in understanding of disability
On a more positive note, the report recognises that there has been a paradigm shift in the way disability is conceptualised referring to the move to social rather than medical models of disability (for more on social and medical models of disability, read a previous blog post by Nicki Martin). But disability is still not adequately perceived as a condition with varying experiences of varying degrees and is often typecast as a mobility impairment. There is a need to move away from the exclusive ‘wheelchair imagery’ of disability to discourage stereotyping of disabled people and their experiences. It’s also important to recognise that all of us will be permanently or temporarily disabled at some point in our lives and therefore, disabled people are not and should not be seen as ‘others’ or ‘outcastes’.
Though progress has been made, there is still much to do. Beginning with engagement with disabled people, the state needs to ensure that adequate funding is provided to ensure equal access to services for all. What also needs to be recognised is that disabled people do not require ‘special’ services, they need provisions to access mainstream services and programmes; so the focus should be on inclusion rather than segregation.
Further, to create an inclusive society, it is of utmost impotance that public awareness regarding disability be raised. To this end, there have to be active initiatives for programmes involving disabled and non-disabled people. The report also recognises the need for more research on disability (please see LSE’s Disability Equality Research Network) to create a sophisticated understanding of disability that can inform disability policies and programmes.
In the UK, the Equality Act 2010, building up on the Disability Discrimination Act 2005, sets out an anticipatory duty on all public bodies to make reasonable adjustments for disabled people. Strong legislation needs to be accompanied by equally strong efforts to remove barriers that the disabled face in accessing everyday services.