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Discrimination against drug addicts

Discrimination against drug addicts is a form of discrimination against people who suffer from a drug addiction. In the process of stigmatization, drug addicts are stereotyped as having a particular set of undesirable traits, in turn causing other individuals to act in a fearful or prejudicial manner toward them. Drug use discrimination also leads to many users being secretive about drug use. As it relates to healthcare stigmatizing attitudes surrounding drug use can cause barriers to treatment uptake and engagement. In some of its manifestations, discrimination against drug addicts involves a violation of human rights.

People with substance use disorders are often depicted as human beings who are not capable of staying drug-free and are often addressed using derogatory terms. The reasoning for not helping patients seek the treatments needed are often due to the terms used to identify them, such as "crackhead" or "junkie". The name-calling and stigma place a sense of shame in people with substance use disorder for a disease that takes control of them physically and psychologically. Self-stigmatization is the shame experienced by persons labeled as addict. Their perception of insignificance originates from the biased and uninformed public stigma that excludes the addict from social acceptance. This social exclusion derives from the belief that addiction is a moral defect resulting in negative stereotypes. The negative stereotypes placed on those experiencing addiction is internalized into feelings of shame and guilt, and a motivating factor to continue self-destructive using behaviors.

Background

This section is an excerpt from Discrimination against drug addicts § Background.[edit]

Global Marijuana March, Paris.

Drug use discrimination is the unequal treatment people experience because of the drugs they use. People who use or have used illicit drugs may face discrimination in employment, welfare, housing, child custody, and travel, in addition to imprisonment, asset forfeiture, and in some cases forced labor, torture, and execution. Though often prejudicially stereotyped as deviants and misfits, most drug users are well-adjusted and productive members of society. Drug prohibitions may have been partly motivated by racism and other prejudice against minorities, and racial disparities have been found to exist in the enforcement and prosecution of drug laws. Discrimination due to illicit drug use was the most commonly reported type of discrimination among Blacks and Latinos in a 2003 study of minority drug users in New York City, double to triple that due to race. People who use legal drugs such as tobacco and prescription medications may also face discrimination.

Drug abusers often ‘choose’ the jail system because they have no healthy coping skills or social support; and resort to crime to survive while maintaining their addicted state. Once in jail, drug addicts sometimes can utilize the Drug Court Program, but only if their charges are drug-related. The first drug court program was started in 1989 in Florida. The purpose of the drug court program was to put the court's authority in motion to reduce the drug crime rate by offering rehabilitation to drug addicts. In 2015, up to 3,000 drug courts were available in the U.S. and merely 120,000 defendants were being worked with per year. The overall goal of the drug court program is to reduce the need for drugs and the crimes that accompany them. Statistics have led researchers to believe drug court may be an effective resolution to end drug addiction.

Individual Factors

Drugs (especially opioids and stimulants) can change the motivational patterns of a person and lead to desocialization and degradation of personality. Acquisition of the drugs sometimes involves black market activities, exposing users to social circles engaging in other criminal behavior. Certain types of criminal behavior can also put drug users at further risk of harm, or lead to additional stigmatization (sex work, drug dealing, theft, robbery, etc.).

Institutional Basis

Stigma by health care professionals stems from a belief that people with substance use disorder are not interested in their health as much as they are seeking drugs. This results in people with substance use disorders receiving unfair medical care. As well as hiding their underlying medical concerns and not receiving the medical and recovery care that is needed. Healthcare providers have effective tools such as medications for opioid and alcohol addiction that can help prevent many overdoses. These tools are not used widely in the United States healthcare system. The stigma that surrounds drug addicts is the main cause of why the healthcare system does not use these tools and medications. In the United States healthcare system there has not been much done to remove this stigmatism. Many healthcare providers do not view addiction as a disease and a mental illness.

The drugs Ritalin (methylphenidate) and Adderall (amphetamine) are stimulants often prescribed for ADHD. In colleges there has been an influx of this type of drug trafficked. These drugs stimulate your nervous system making you awake and attentive.Prescribing opioids to patients and related overdose has become a serious problem in the US.

Lack of objective information about drugs

An important role in the process of discrimination is played by the lack of objective information about drug addiction and drug addicts, caused by legislative barriers to scientific research, the displacement of such information by propaganda of various kinds.

Drug addiction has been categorized as a subcategory of mental illness. They are referred to as co-occurring disorders, which means if a person is dealing with an addiction, they may also struggle with a mental illness. Most individuals who suffer from drug dependency are nearly twice as likely to suffer from a mental illness as well. According to the Substance Abuse and Mental Health Services Administration, about 8.9 million adults who have an addiction also have a psychiatric disorder. When dealing with either a mental illness or a drug addiction some symptoms people will experience are being incapable of controlling their own impulses and mood swings.

When a person falls victim to drug addiction, they will undergo the five stages of addiction which are the first use, the continued use, tolerance, dependence, and addiction. The first use stage, is the stage where individuals experiment with drugs and alcohol. This is the stage where individuals may partake in drug use due to curiosity, peer pressure, emotional problems among other reasons. In the continued use stage, individuals know how the drug makes them feel and is likely to notice that they are not getting high as quickly as they use too. In the tolerance stage, the brain and the body have adjusted to the drug and it takes longer to get the effect an individual is seeking. Tolerance arrives after a period of continued use and is one of the first warning signs of addiction. In the dependence stage, the brain becomes accustomed to the drug and doesn't function well without it. Substance abusers become physically ill without the use of drugs and will begin to develop symptoms of withdrawal. In the addiction stage, individuals may struggle to discontinue use of drugs even if they do not enjoy it or if their behavior has caused problems within an individual's life.

With the increasing number of adults that suffer from an addiction, only a few will receive treatment due to the complexity of health care systems. Most health care systems do not have insurance coverage for addiction recovery and many health care providers have little to no training in treating addiction. Some doctors do not feel comfortable treating an addiction due to their lack of knowledge and training of the topic. The American Society of Addiction Medicine reports that there are only 3,000 board-certified addiction specialist physicians in the United States while there are nearly 2 million people experience opioid addiction. The limited presence and access to comprehensive care for addiction poses a barrier for recovery for many, particularly those hailing from lower socioeconomic backgrounds.

Drugs and HIV infection

Among injecting drug users, the incidence of HIV infection is higher than among other drug addicts, however punitive and discriminatory measures against drug addicts are not able to eliminate either the spread of drug addiction or HIV. Researchers say that around 90% of people that choose to inject drugs have missed prior opportunities for HIV testing that were provided.

Regional patterns

Across countries surveyed in the Stigma in Global Context Study, levels of recognition, acceptance of neurobiological causes of mental illness and substance use, and treatment endorsement were similarly high; however, a core of five prejudice items persisted. The researchers called this the “backbone of stigma”: issues of trust in intimate settings such as the family, potential contact with a vulnerable group such as children, the potential for self-harm, mental illness being antithetical to power or authority, and uneasiness about how to interact with people with mental illness (Pescosolido et al., 2013).

Africa

Africa has an estimated number 28 million substance users. This number is impacted by the rising availability of injection-based drugs such as heroin, cocaine, and methamphetamines. Socio-demographic factors are often primary determinants of the health status of drug users. These factors contribute to individual drug use behaviors such as the sharing of needles and the solicitation of sex in exchange for police protection or more drugs. Nutritional status, family support, stigma/discrimination, adherence to medication, and recovery from addiction are also impacted by these socio-demographic factors. Research shows that the majority of drug users transition from the use of non-injection substances to injection substances or use both simultaneously.

Kenya

In Kenya there is a link between injection-related discrimination, mental health, physical health, and the quality of life for those who inject drugs. The rates of discrimination are linked to higher levels of psychological distress and risk behaviors. Women in Kenya account for 10% of drug users. These women tend to experience the regular discrimination faced by drug users in addition to gender related discrimination. Levels of discrimination are often higher for those that are also HIV positive.

Tanzania

A study published in the Review of African Political Economy notes that commerce and political corruption in Tanzania have promulgated crack cocaine consumption and flash-blood practices, or blood sharing between substance users after recent injections, specifically among poor youth in urban centers.

Asia

India

Drug crimes are more likely to be prosecuted for individuals who have lower caste ancestry.

North America

Canada

In Vancouver Canada, there have been significant efforts in reducing opioid-related deaths. In an article published by the Canadian Medical Association Journal, it delves into the new efforts to create safe injection sites for people struggling with opioid addiction. Vancouver politicians have created these sites for people to safely use drugs that they are addicted to without the risk of infection or prosecution by the police. At safe injection sites, sterilized needles are provided to limit the reuse of needles that leads to the spread of HIV and other diseases.

United States

The Prison Policy Initiative cites that the criminalization of drug use in the United States can limit personal daily activities for those who may use substances, even if it is done in a safe, recreational manner.

Discrimination against people who use an illegal substance is very common in the workplace, a familiar example happens when employers give random drug test to see if the employee will pass it. However, according to the Rehabilitation Act of 1973, employers are supposed to ensure that alcoholics and other drug addicts get help and the accommodations that they need. The lack of job opportunities and treatment for drug addicts often results in relapses or in jail.

See also

• Cognitive liberty
• Drug liberalization
• Legalisation of marijuana

References

Category:Discrimination Category:Drug culture Category:Addiction

Disability in the United States

Americans with disabilities are a significant minority group in the United States, comprising of a fifth of the overall population and over half of Americans older than eighty. There is a complex history underlying the United States and its relationship with its disabled population, with great progress being made in the last century to improve the livelihood of disabled citizens through legislation providing protections and benefits. Most notably, the Americans with Disabilities Act is a comprehensive anti-discrimination policy that works to protect Americans with disabilities in public settings and the workplace. Despite great progress being made, disabled citizens today face ableism with respect to employment, education, and healthcare in addition to other facets of life as well.

Annual celebration of the Americans with Disabilities Act.

Definitions

Further information: Disability

According to the Social Security Advisory Board, when the federal government first began provisioning funds for state-run disability assistance programs, eligible individuals were defined as "totally and permanently disabled." In 1956, this definition was expanded by the Disability Insurance Program to describe disability as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or to be of long-continued and indefinite duration." Critics indicated that this language limited the concept of disability to an occupational scope, and more holistic definitions were adopted as time passed on. The modern consensus on disability within governmental, medical, sociological realms in the United States is that it includes impairments that either physically or mentally incapacitate individuals from engaging in significant life activities, as well individuals who are perceived as possessing such an impairment. Specific conditions that fall under this umbrella vary circumstantially, however it is broadly accepted that disability includes, but is not limited to the following:

• Autism
• Autoimmune conditions (ex. lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS)
• Blindness or poor vision
• Cancer
• Cardiovascular or heart disease
• Celiac disease
• Cerebral palsy
• Deaf or hard of hearing
• Depression or anxiety
• Diabetes
• Epilepsy
• Gastrointestinal disorders (ex. Crohn's Disease, IBS)
• Intellectual disability
• Missing limbs or partially missing limbs
• Nervous system conditions (ex. migraine headaches, MS, Parkinson’s disease)
• Psychiatric conditions (ex. bipolar disorder, major depressive disorder, PTSD, schizophrenia)

History

Further information: Timeline of disability rights in the United States

At a federal level, legislation pertaining to disability was limited in the 18th and 19th centuries, with notable laws at that time including an act for the relief of sick and disabled seamen, which was signed by John Adams in 1798. In the early 1900's Eugenic Sterilization Laws were passed in several states, permitting governments to conduct forced sterilization on individuals with mental disorders. The 1927 Supreme Court case Buck v Bell upheld the constitutionality of such legislation, with such laws being banned nearly half a century later with the 1978 Federal Sterilization Legislation, although loopholes have been exploited with such sterilizations continuing into modern times. The burgeoning of disability rights legislation in the 1900's came after World War I with congress' establishment of the Rehabilitation Programs, which provided education and healthcare support to recovering veterans. Significant progress came in the 1930's with the presidential election of Franklin D. Roosevelt, who was physically disabled himself, and his signage of the Social Security Act.

Progress towards disability justice came in hand with the civil rights movement in the latter half of the 20th century. In 1961 the American National Standards Institute published a document overviewing building accessibility limitations for physically disabled individuals, which supported the passage of the Architectural Barriers Act of 1968 and encouraged several states to adopt inclusive accessibility legislation in the '70s. Additionally in the 1960s, Medicaid and the Mental Retardation Facilities and Community Mental Health Centers Construction Act were passed, allocating funds towards healthcare and the developments of statewide councils, advocacy frameworks, and post-secondary education pathways for disabled citizens. In the 1970's major anti-discrimination legislation was enacted with the repeal of the last "Ugly law," which permitted law enforcement to incarcerate people for appearing disabled, as well as the 1973 Rehabilitation Act and Individuals with Disabilities Education Act (IDEA) which prevented institutions that received public funding from discriminating on disability status. The 1980s oversaw saw an additional movement towards accessibility with the passage of the Air Carrier Access Act, Fair Housing Amendments Act, and Technology-Related Assistance for Individuals with Disabilities Act and justice with the creation of the Civil Rights of Institutionalized Persons Act (CRIPA).

In 1990, the Americans with Disabilities Act (ADA) served as a landmark bill outlining more comprehensive protections and accommodations for the disabled community, with other legislation, introduced later that decade such as the Telecommunications Act and the Ticket to Work and Work Incentives Improvement Act (TWWIIA) expanding upon the ADA. The turn of the Millenium oversaw crucial Supreme Court cases such as Olmstead v. L.C. and Tennessee v. Lane which upheld federally outlined disability rights.

Demographics

According to the Disability Status: 2019 - Census 2019 Brief approximately 20% of Americans have one or more diagnosed psychological or physical disability:

Census 2000 counted 49.7 million people with some type of long lasting condition or disability. They represented 19.3 percent of the 257.2 million people who were aged 5 and older in the civilian non-institutionalized population -- or nearly one person in five..."

This percentage varies depending on how disabilities are defined. It may be helpful to note that disability in the United States is classified under different types of physical or mental impairments of which include one's ability to physically function, mental status, including decision skills and memory, the ability of sight, if they are self-sufficient, and finally, if they depend on any one to help them do tasks. According to Census Brief 97-5, "About 1 in 5 Americans have some kind of disability, and 1 in 10 have a severe disability. Not only does this statistic affect those who are disabled, but individuals with disabilities not only endure disadvantages, but so do their children or possibly grandchildren as they can potentially be left facing health care disadvantages as well as education."

The United States Census Bureau is legally charged with developing information on the type and prevalence of disability in the population. Statistics reveal the highest percentage of individuals with a disability reside in southern areas such as Texas, Florida, Mississippi, and anywhere along the southern cost. The states that include the fewest disabled individuals are western areas of which will include Wyoming, Colorado, and Utah. These disabled people are also protected not only under one law, but under three. These laws include the Americans with Disabilities Act, Individuals with Disabilities Education Act, and Section 504 of the Rehabilitation Act. The primary purpose of collecting ACS data on disability is to help the US Congress determine the allocation of federal funds and inform policies. It is also used to identify the characteristics of the disabled population of the United States. Determining the number and geographical location of people with disabilities is crucial for policies aimed at providing services like public transportation.

ACS does not directly measure disability There are other smaller survey studies that provide some insight on disability in the US. While studies like the National Health Interview Survey the Health and Retirement Study, the Behavioral Risk Factor Surveillance System, and the Health, Aging, and Body Composition (Health ABC) Study are used to infer valuable disability-related health characteristics in the US population. While responses to these items are commonly refer to as "disability", it could be argued the —it uses self- and proxy-reports to evaluate perceived ability to perform functional tasks. Existing publications have delineated details on the US population regarding disability by using information from the ACS. Publications have also outlined issues with disability data in the ACS. Research on disability continues to improve, and potential remedies are found for current methodological challenges. Because of the uniqueness, regarding federal funding and policy, researchers from various fields (e.g., sociology, epidemiology, and government) make wide use of ACS data to better understand disability in the US.

African Americans

According to the 2000 U.S. Census, the African American community has the highest rate of disability in the United States at 20.8 percent, slightly higher than the overall disability rate of 19.4%. Given these statistics, it can be suggested that African Americans with disabilities experience the most severe underemployment, unemployment, and under education compared to other disability groups. For instance, the 2015 American Community Survey indicates that African Americans who have disabilities live in poverty at a rate of 1.5 to 2 times greater than other racial groups in America.

Criminal Justice

Data obtained in the National Longitudinal Survey of Youth indicates that Black men with disabilities encounter the greatest cumulative probability of being arrested by age 28, in contrast to others with either different gender, disability, or race status. With respect to African American women re-entering society after serving time, a JHCPCU article identified disability, more specifically positive HIV/HCV status, as a major factor correlated with poor use of alternative, hospital, and emergency health care. Calls for civil rights and criminal justice reform with the Black Lives Matter movement have brought into public eye how Black individuals with disabilities disproportionately experience police violence. Instances cited as police brutality, such as the 2018 murder of Marcus-David Peters, a unarmed black man having a mental health crisis, have motivated legislation such as Virginia's Mental Health Awareness Response and Community Understanding Services (MARCUS) alert bill, which would necessitate that individual episodes be attended to by both police and mental health professionals.

Education

The lingering effects of segregation and separation of special education classrooms has been identified as potentially having a negative compound effect on the quality of education for African American students with disabilities. Educational pedagogy designed to "cross-pollinate" across race and disability coalitions have been suggested as way to combat exclusion that particularly impacts Black disabled children.

Employment

According to a study published in the Journal of Disability Policy, Black people with disabilities experience significantly higher unemployment and lower monthly wages compared to the overall disabled community and general population. A research paper in the Journal of Applied Rehabilitation Counseling reported that counseling professionals identified that disability status can limit employment prospects of Black and Latino offenders seeking work opportunities.

Healthcare

Disabled Black Americans face barriers to receiving comprehensive medical care to address their pre-existing health conditions. In studies published in the Journals of Applied Gerontology it was noted that elderly African American women face a greater likelihood of acquiring disability in comparison their white counterparts, and additionally are more likely to rely on medicaid for coverage. The same journal articles established a correlation between being uninsured or utilizing medicaid coverage with greater levels of disability. With respect to disabled youth, it was noted that Hispanic and Black children with disabilities are less likely to have received specialty care controlling for SES and insurance status, according to the journal PEDIATRICS.

Disparities

explain disability paradox

Discrimination in employment

Further information: Employment discrimination

The US Rehabilitation Act of 1973 requires all organizations that receive government funding to provide accessibility programs and services. A more recent law, the Americans with Disabilities Act of 1990 (ADA), which came into effect in 1992, prohibits private employers, state and local governments, 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 criteria 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). Employment protection laws make discrimination against qualified individuals with a disability illegal and may also require provision of reasonable accommodation. Reasonable accommodations includes changes in the physical environment like making facilities more accessible but also include increasing job flexibility like job restructuring, part-time or modified work schedules or reassignment to vacant position. Though many hold attitudes that are more enlightened and informed than past years, the word “disability” carries few positive connotations for most employers. Negative attitudes by employers toward potential employees with disabilities can lead to misunderstanding and discrimination.

Healthcare

Research reported in the Handbook of Disability Studies identified that the disability paradox is perpetuated in healthcare settings as practitioners have a greater tendency to award lower quality of life scores disabled individuals than a member of of the disabled population or general population would. Furthermore, physicians frequently go into consults with inflexible, skewed perceptions of their patient's disabilities. False practitioner confidence in this regard can harmfully impact disabled individuals seeking care as it increases the likelihood patients may distrust their physicians or conversely place excessive faith on their care provider. Limitations in healthcare access also impact disabled populations,

Poverty

Further information: Poverty in the United States

Investigations on the "poverty and disability nexus" have consistently shown poverty and disability are correlated for all race-ethnic groups within the United States. Financial stability of people with disabilities would decrease the dependence on governmental support programs. Studies have been done with the U.S. Census Bureau data to examine the high prevalence of disabilities among welfare recipients. Thirteen percent of families with children under the age of 18, who are also receiving welfare benefits, had at least one child with a disability. Families with income below twice the poverty line were 50% more likely to have a child with a disability than those families with higher incomes. Children with disabilities from families with annual household incomes of higher than $50,000 were more likely to attend higher education.

Research suggests higher education does impact employment and income opportunities for people with disabilities. It is also noted near equivocal employment opportunities and salaries for people with disabilities to their peers without disabilities. While only one-fifth of people in the United States have at least a four-year college degree, some studies note possessing a four-year degree is the difference between absolute job security and joblessness.

Services

Education

K-12

Before the Individuals with Disabilities Education Act was passed, children with disabilities were at-risk of not receiving a free, appropriate public education, but each act protecting the disabled individuals protects different criteria of which include differentiation in schools, the law by which schools must be up to date on the K-12 act, and equal service for the public who extend any services. For IDEA to apply, the child must first be determined to be able to benefit from public education. This benefit is not exclusively limited to school-aged children, but applies to children with disabilities from infancy.

Due to societal stigma of disability, children are sometimes treated like disabled children, and not included in activities in which other children were able to participate. However, These individuals with any type of disablement such as learning disabilities or physical disabilities, the Americans with Disabilities Act covers them. This act ensures no one is discriminated outside of their own home of which includes work, school, and anywhere in public. The places it does not cover will include sanctioned or private areas including one's home. Educators can hold students with disabilities to lower expectations, which impacts their future educational attainment. Although their future may be impaired the K-12 act is broad amongst education and the Section 504 of the Rehabilitation Act will help clarify. This act ensures individuals of whom attended schools, play on school sports teams, or attend any off or on campus events will be protected, unless that school is not funded by the government. These students must be given compromises that other students may not receive due to their impairments.

Under the Individuals with Disabilities Education Act, the school district must provide every disabled child with an Individualized Education Plan (IEP). The IEP is compiled by a team of school administrators and guardians, and may include a child advocate, counselors, occupational therapists, or other specialists. The Individuals with Disabilities Education act ensures all fees for schooling are discharged, but these children must be approved under IDEA and must be in a certain category of disabilities. This act allows for any student or child to be assessed and are provided extra incentives that may apply to their condition. The IEP also evaluates the goals for the child and determines what needs to be done in order for those goals to be met. Children with disabilities who do not have a parent or guardian advocating on their behalf are not as well served in the education system as their peers with parent or guardian advocates.

Transition preparation from K-12 education to post-secondary education or career was initially written into IDEA to begin at age 12, but in the existing law, transition preparation does not begin until age 16. While this law provides a maximum age at which to begin transition preparation, students with disabilities have been known to receive transition preparation at a younger age, as the states might mandate a younger age, or the IEP team might determine a younger age is appropriate to begin the transition preparation of the student. Some students with disabilities have noted not receiving any transition preparation at all. The transition services are to be designed to be results-oriented rather than outcome-oriented. This is to ensure the transition services are designed for the student's success. Students are intended to attend their transition planning meetings with the IEP, yet not all students do. Some do attend, yet generally not take a leadership role - only fourteen percent do. This places the students with a disability in a passive role instead of an agentic role in their own life plans. In a 2007 study of a higher education institution located in the Midwestern United States, it was found that one-third of students with disabilities felt their transition preparation was lacking. Many in this group were unaware of laws that pertained to disability and higher education. This leaves them without an understanding of their learning needs and unable to advocate for themselves.

Higher Education

Self-advocacy plays an important role in the success of students with disabilities in higher education. While examination of self-advocacy skills has been largely limited to the impact in academic settings, self-advocacy skills, or the lack thereof, do also impact non-academic situations. A 2004 study noted only 3 percent of students with disabilities had self-advocacy training. Students with disabilities who are confident about their disability identity and self-advocacy skills are more likely to disclose their disabilities and advocate for their needs when interacting with faculty and staff. Advocacy service is also provided to students as staff from different programs help instructors in college, understand the needs of the disabled who are attending their classes. So much so that when disable students need extra time to complete their course then some arrangements are made to cater such students. Students with disabilities who were embarrassed of their disability identity and did not understand their needs as learners looked to faculty and staff for solutions to accommodation needs. Education helps students with disabilities learn self-advocacy skills that affect their ability to advocate for their health, insurance, and other needs.

In spite of IDEA and Section 504 providing support for education of people with disabilities, the educational outcomes of people with disabilities vary significantly from the outcomes of people without disabilities. After high school, a 2005 study found students with disabilities enroll in postsecondary education, whether college, technical school, or vocational school, at a rate of 46% compared to the rate of 63% for students without disabilities. This rate is up 23% since 1990, when the Americans with Disabilities Act of 1990 was passed. Specifically to four-year degree granting higher education institutions, 27% of students with disabilities attend compared to 54% of students without disabilities. High school completion and postsecondary education enrollment vary per disability type.

Students with disabilities are responsible for advocating for their accommodations and needs as learners in higher education environments. Many higher education institutions have staff to work with students with disabilities on their accommodation requests. Higher education institutions do vary in process to obtain accommodations and accommodations provided. The staff members at the higher education institutions can recommend accommodations. The faculty members, however, may choose to vary or not implement the accommodations at all based upon concerns of weakening academic integrity of the course or risking the possibility of endless accommodation requests. When working with faculty members about accommodations, nearly half of the students with disabilities recalled receiving a negative response, while the other half felt their faculty members were accommodating.

For people with disabilities, having a four-year college degree provides significant employment and salary advantages.

Employment and minimum wage exemption

Disabled citizens in the United States receive Medicare insurance and social security benefits to varying degrees. For those that seek employment for therapeutic or economic reasons, the Fair Labor Standards Act of 1938 is applicable. This act was an attempt to facilitate the large number of disabled servicemen returning from the front lines "to the extent necessary to prevent curtailment of opportunities for employment". Section 14(c) provides the employers with a method of paying their disabled employees less than applicable federal minimum wage. The Secretary of Labor issues certificates that align wages with the employee's productivity.

At present there are 420,000 §14(c) employees being paid less than the minimum wage of $7.25 per hour. Administratively, the wage for the disabled was informally set at 75%. Those working in sheltered work centers have no minimum floor for their wage. The Fair Wages for Workers with Disabilities Act was proposed in 2013 to repeal §14(c) but was not passed.

Social Security Administration

The US Social Security Administration (SSA), defines disability in terms of an individual's inability to perform substantial gainful activity (SGA), by which it means “work paying minimum wage or better”. The agency pairs SGA with a list of medical conditions that qualify individuals for disability benefits. Individuals who are disabled will receive insurance and this ensures they will always be getting paid when they must take time off work or cannot work due to the severity of their illness. The SSDI and the SSI are both social security programs that will assist in payments.

The SSA makes available to disabled Americans two forms of disability benefits: Social Security Disability Insurance, (SSDI) and Supplemental Security Income (SSI). Briefly, the SSDI is a program that is useful in the sense that it is like welfare, but you must have been able to work enough hours throughout your life and you must have paid social security taxes in order to be approved. This benefit is most useful for those who do not have severe disabilities or illnesses because those who are immobile will not have been able to work. The good thing about this benefit is not only does it benefit the individual, but it will benefit their family members as well. To go more in depth, Social Security pays disability benefits to citizens who have worked long enough and have a medical condition that has prevented them from working or is expected to prevent them from working for at least 12 months or end in death. Looking at the SSI, the SSI insurance, or the Social Security Insurance program, is there to pay individual benefits who could not have worked or have little capital. However, for both of these insurances, the same approval is required by the individuals disability.

Some assistance ends if the beneficiary starts working. If that assistance (such as personal care or transportation) is necessary for work, it creates a welfare trap where it is not possible to work despite potentially being willing and able. Some programs do provide incentives to work.

Insurance

It is illegal for California insurers to refuse to provide car insurance to properly licensed drivers solely because they have a disability. It is also illegal for them to refuse to provide car insurance "on the basis that the owner of the motor vehicle to be insured is blind," but they are allowed to exclude coverage for injuries and damages incurred while a blind unlicensed owner is actually operating the vehicle (the law is apparently structured to allow blind people to buy and insure cars which their friends, family, and caretakers can drive for them).

See also

• List of disability organizations
• American Association of People with Disabilities
• United Cerebral Palsy, nonprofit supporting people with all disabilities

External links

• Census Bureau Data on Disability
• Unfit for Work: The startling rise of disability in America (2013)

Disability

A disability is any condition that makes it more difficult for a person to do certain activities or interact with the world around them. These conditions, or impairments, may be cognitive, developmental, intellectual, mental, physical, sensory, or a combination of multiple factors. Impairments causing disability may be present from birth or occur during a person's lifetime. The World Health Organization proposes the following definition of disabilities:

"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

Disability is a contested concept, with different meanings in different communities. The term disability may refer to physical or mental attributes that some institutions, particularly medicine, view as needing to be fixed (the medical model); it may also 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 measure of an individual's performance level that 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.

Terminology

Handicap

The term handicap derives from the medieval game Hand-in-cap, in which two players trade possessions and a third, neutral person judges the difference of value between the possessions. The concept of a neutral person evening up the odds was extended to handicap racing in the mid-18th century, where horses carry different weights based on the umpire's estimation of what would make them run equally. In the early 20th century the word gained the additional meaning of describing a disability, in the sense that a person with a handicap was carrying a heavier burden than normal.

Access

The ability to go places and do things. People with certain types of disabilities struggle to get equal access to some things in society. For example, a blind person cannot read printed paper voting ballots, and therefore does not have access to voting that requires paper ballots.

Accommodation

A change that improves access. For example, if voting ballots are available in Braille or on a text-to-speech machine, or if another person reads the ballot to the blind person and recorded the choices, then the blind person would have access to voting.

Causes

There are many different causes of disability that often affect basic activities of daily living, such as eating, dressing, transferring, and maintaining personal hygiene; or advanced activities of daily living such as shopping, food preparation, driving, or working.

For the purposes of the Americans with Disabilities Act of 1990, the US 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.

This is not an exhaustive list and many injuries and medical problems cause disability. Some causes of disability, such as injuries, may resolve over time and are considered temporary disabilities. An acquired disability is the result of impairments that occur suddenly or chronically during the lifespan, as opposed to being born with the impairment. Invisible disabilities may not be obviously noticeable.

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.

There is evidence of humans during prehistory that looked after people with disabilities. At the Windover Archeological Site, one of the skeletons that was found was a male about 15 years old, who had spina bifida. The condition meant that the boy, probably paralyzed below the waist, was taken care of in a Hunter-gatherer community.

Provision that enabled individuals with impaired mobility to access temples and healing sanctuaries were made in ancient Greece. Specifically, by 370 B.C., at the most important healing sanctuary in the wider area, the Sanctuary of Asclepius at Epidaurus, there were at least 11 permanent stone ramps that provided access to mobility-impaired visitors to nine different structures; evidence that people with disabilities were acknowledged and cared for, at least partly, in ancient Greece.

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. 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". 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.

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.

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 statistical norm threads through the rapid take-up of statistics gathering by Britain, the 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. 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.

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 as "deviations" out of the gene pool. Various metrics for assessing a person's genetic fitness, which was 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.

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.

Sociology

Museum of disABILITY History, Buffalo, New York

Main article: Disability studies

People-first language

Main article: 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:

"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). 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.

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. 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 organizations of disabled people, such as Disabled Peoples' International (DPI).

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

“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.

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.

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. 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 educationally 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. 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.

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. 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. 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 affect 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. 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

There is a global correlation between disability and poverty, produced by a variety of factors. Poverty and disability go hand in hand. The poverty rate for working-age people with disabilities is nearly two and a half times higher than that for people without disabilities. 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. In societies without state funded health and social services, living with a disability could require spending on medication and frequent health care visits, in-home personal assistance, and adaptive devices and clothing, along with the usual costs of living. The World report on disability indicates that half of all disabled people cannot afford health care, compared to a third of abled people. In countries without public services for adults with disabilities, their families may be impoverished.

Disasters

Main article: Disability and disasters

There is limited research knowledge, but many anecdotal reports, on what happens when disasters impact disabled people. Individuals with disabilities are greatly affected by disasters. 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. All of these factors can increase the degree of variation of risk in disaster situations with disabled individuals.

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

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:

• Learning and applying knowledge
• General tasks and demands
• Communication
• Basic physical mobility, Domestic life, and Self-care (for example, activities of daily living)
• Interpersonal interactions and relationships
• Community, social and civic life, including employment
• Other major life areas

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

Main article: Medical model of disability

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.

Social model

Main article: Social model of disability

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. 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. 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.

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

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. 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.

The 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.

Other models

• The spectrum model refers to the range of audibility, sensibility, and visibility under which people function. The model asserts that disability does not necessarily mean a reduced spectrum of operations. Rather, disability is often defined according to thresholds set on a continuum of disability.
• The moral model refers to the attitude that people are morally responsible for their own disability. For example, disability may be seen as a result of bad actions of parents if congenital, or as a result of practicing witchcraft if not. Echoes of this can be seen in the doctrine of karma in Indian religions. It also includes notions that a disability gives a person "special abilities to perceive, reflect, transcend, be spiritual".
• The expert/professional model has provided a traditional response to disability issues and can be seen as an offshoot of the medical model. Within its framework, professionals follow a process of identifying the impairment and its limitations (using the medical model), and taking the necessary action to improve the position of the disabled person. This has tended to produce a system in which an authoritarian, over-active service provider prescribes and acts for a passive client.
• The tragedy/charity model depicts disabled people as victims of circumstance who are deserving of pity. This, along with the medical model, are the models most used by non-disabled people to define and explain disability.
• The legitimacy model views disability as a value-based determination about which explanations for the atypical are legitimate for membership in the disability category. This viewpoint allows for multiple explanations and models to be considered as purposive and viable.
• The social adapted model states although a person's disability poses some limitations in an able-bodied society, often the surrounding society and environment are more limiting than the disability itself.
• The economic model defines disability in terms of reduced ability to work, the related loss of productivity and economic effects on the individual, employer and society in general.
• The empowering model (also, customer model) allows for the person with a disability and his/her family to decide the course of his/her treatment. This turns the professional into a service provider whose role is to offer guidance and carry out the client's decisions. This model "empowers" the individual to pursue his/her own goals.
• The market model of disability is minority rights and consumerist model of disability that recognizing disabled people and their stakeholders as representing a large group of consumers, employees, and voters. This model looks to personal identity to define disability and empowers people to chart their own destiny in everyday life, with a particular focus on economic empowerment. By this model, based on US Census data, there are 1.2 billion people in the world who consider themselves to have a disability. "This model states that due to the size of the demographic, companies and governments will serve the desires, pushed by demand as the message becomes prevalent in the cultural mainstream."
• The consumer model of disability is based upon the “rights-based" model and claims that disabled people should have equal rights and access to products, goods, and services offered by businesses. The consumer model extends the rights-based model by proposing that businesses, not only accommodate customers with disabilities under the requirements of legislation but that businesses actively seek, market to, welcome and fully engage disabled people in all aspects of business service activities. The model suggests that all business operations, for example, websites, policies, and procedures, mission statements, emergency plans, programs, and services, should integrate access and inclusion practices. Furthermore, these access and inclusion practices should be based on established customer service access and inclusion standards that embrace and support the active engagement of people of all abilities in business offerings. In this regard, specialized products and specialized services become important, such as auxiliary means, prostheses, special foods, domestic help, and assisted living.
• Different theories revolve around prejudice, stereotyping, discrimination, and stigma related to disability. One of the more popular ones, as put by Weiner, Perry, and Magnusson 's (1988) work with attribution theory, physical stigmas are perceived as to be uncontrollable and elicit pity and desire to help, whereas, mental-behavioral stigmas are considered to be controllable and therefore elicit anger and desire to neglect the individuals with disabilities.
• The ‘just world hypothesis’ talks about how a person is viewed as deserving the disability. And because it is the fault of that person, an observer does not feel obligated to feel bad for him or to help him.

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. Disabled writer/researcher Jenny Morris describes how stigma functions to marginalize persons with disabilities:

“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 the 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. 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. 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

Further information: Disability in the media

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.

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.

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.” 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 marginalization 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.

Intersections

The experiences that disabled people have to navigate social institutions vary greatly as a function of what other social categories they may belong to. The categories that intersect with a disability to create unique experiences of ableism include, but are not 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.

Race

Incidence of disability is reported to be greater among several minority communities across the globe, according to a systematic analysis of the Global Burden of Disease Study. Disabled people who are also racial minorities generally have less access to support and are more vulnerable to violent discrimination. A study in the journal Child Development indicated that minority disabled children are more likely to receive punitive discipline in low and and middle income countries. With respect to disability in the United States, Camille A. Nelson, writing for the Berkeley Journal of Criminal Law, notes the dual discrimination that racial minorities with disabilities experience from the criminal justice system, expressing 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."

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:

"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." 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.”

Assistive technology

Main article: 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. The wheelchair dates from the 17th century. 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. The LOMAK keyboard was designed in New Zealand specifically for persons with disabilities. The World Wide Web consortium recognized a need for International Standards for Web Accessibility for persons with disabilities and created the Web Accessibility Initiative (WAI). As at Dec 2012 the standard is WCAG 2.0 (WCAG = Web Content Accessibility Guidelines).

Adapted sports

Main article: Disabled sports

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 program 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 programs 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.

Rights and government policies

Main article: Ableism

Rights movement

Main article: Disability 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. Effective civil rights legislation is sought to secure these opportunities and rights.

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.

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. As of April 2011, 99 of the 147 signatories had ratified the Convention. 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.

International Year of Disabled Persons

In 1976, the United Nations began planning for its International Year of Disabled Persons (1981), 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 the 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. In schools, the ADA says that all classrooms must be wheelchair accessible. 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.

About 12.6% of the U.S. population are individuals who have 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 workforce.

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 opportunities by the government to stay in their own homes as opposed to assisted living, nursing homes or worse, institutions for the disabled. It has been interpreted as meaning the 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 required corporations to not only hire qualified disabled people but 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 building's 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 the 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.

Policies in Sweden

Main article: Disability policy in Sweden

Political issues

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.

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

Main article: Disability 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.

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.

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., the disability benefit is provided in the category of Supplemental Security Income. In Canada, it is within the Canada Pension Plan. In other countries, disability benefits 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. Several studies have reported a link between increased absence from work due to sickness and elevated risk of future disability pension.

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. These studies may provide useful information for policymakers, 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.

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. 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.

Developing nations

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.

See also

• Ableism
• Accessibility
• Assistive technology
• Disability abuse
• Disability hate crime
• Disadvantaged
• Frailty syndrome
• Physiological functional capacity

References

Sources

• DePoy, Elizabeth; Gilson, Stephen French (2004). Rethinking Disability: Principles for Professional and Social Change. Pacific Grove, CA: Brooks Cole. ISBN 978-0-534-54929-9.
• Donovan, Rich (March 1, 2012). "The Global Economics of Disability" (PDF). Return on Disability. Archived from the original (PDF) on September 13, 2012. Retrieved August 11, 2012.
• Ducy, Elizabeth McAdams; Stough, Laura M.; Clark, M. Carolyn (2012). Steinberg, Shirley R.; Cannella, Gaile S. (eds.). Choosing Agency in the Midst of Vulnerability: Using Critical Disability Theory to Examine a Disaster Narrative. New York: Peter Lang. ISBN 978-1-4331-0688-0. {{cite encyclopedia}}: |work= ignored (help)
• Nikora, Linda Waimari; Karapu, Rolinda; Hickey, Huhana; Te Awekotuku, Ngahuia (2004). "Disabled Maori and Disability Support Options" (PDF). Maori & Psychology Research Unit, University of Waikato. Retrieved August 11, 2012.
• Stough, Laura M. (2009). Neria, Yuval; Galea, Sandro; Norris, Fran H. (eds.). The Effects of Disaster on the Mental Health of Individuals With Disabilities. Cambridge University Press. ISBN 978-1-107-41282-8. {{cite encyclopedia}}: |work= ignored (help)
• Yeo, Rebecca (2005). "Disability, poverty, and the new development agenda" (PDF). Disability Knowledge and Research Programme. Retrieved June 19, 2013.

Further reading

• Albrecht, Gary L., ed. (2005). Encyclopedia of disability. Thousand Oaks, CA: SAGE Publications. ISBN 978-0-7619-2565-1.
• Arditi, A.; Rosenthal, B. (1998). Developing an objective definition of visual impairment. Vision '96: Proceedings of the International Low Vision Conference. Madrid. pp. 331–34.
• Bowe, Frank (1978). Handicapping America: Barriers to disabled people. New York: Harper & Row. ISBN 978-0-06-010422-1.
• Charlton, James I. (2004). Nothing about us without us : disability oppression and empowerment ([3. Dr] ed.). Berkeley: Univ. of California Press. ISBN 978-0-520-22481-0.
• Burch, Susan (July 2009). "(Extraordinary) Bodies of Knowledge: Recent Scholarship in American Disability History". OAH Magazine of History. 23 (3): 29–34. doi:10.1093/maghis/23.3.29. ISSN 0882-228X.
• Burkhauser, Richard V.; Schmeiser, Maximilian D.; Weathers II, Robert R. (Jan 2012). "The Importance of Anti-Discrimination and Workers' Compensation Laws on the Provision of Workplace Accommodations Following the Onset of a Disability". Industrial & Labor Relations Review. 65 (1): 161–180. doi:10.1177/001979391206500109. S2CID 154605646.
• Darling, Peter (Aug 2007). "Disabilities and the Workplace". Business NH Magazine. 24 (8).
• Glenn, Eddie (1995). African American Women with Disabilities: An Overview.
• Miles, Albert S (1994). "Brown v. Board of Education and the American with Disabilities Act: Vistas of equal educational opportunities for African Americans". Journal of Negro Education. 63 (3).
• Johnstone, David (2001). An Introduction to Disability Studies (2nd ed.). Fulton. ISBN 978-1-85346-726-4.
• Masala, Carmelo; Petretto, Donatella Rita (2008). Psicologia dell'Handicap e della Riabilitazione [The Psychology of Handicap and Rehabilitation] (in Italian). Rome: Kappa. ISBN 978-88-15-06226-0.
• Oliver, Michael (1997). The Politics of Disablement. London: St. Martin's Press. ISBN 978-0-333-43293-8.
• Pearson, Charlotte (2006). Direct Payments and Personalisation of Care. Edinburgh: Dunedin Academic Press. ISBN 978-1-903765-62-3.
• Shakespeare, Tom; with Anne Kerr (1999). Genetic Politics: from Eugenics to Genome. Cheltenham: New Clarion Press. ISBN 978-1-873797-25-9.
• Kaushik, R. (1999). "Access Denied: Can we overcome disabling attitudes". Museum International. 51 (3): 48–52. doi:10.1111/1468-0033.00217. ISSN 1468-0033.
• Lansing, Michael J. (January 2009). "'Salvaging the Man Power of America': Conservation, Manhood, and Disabled Veterans during World War I". Environmental History. 14: 32–57. doi:10.1093/envhis/14.1.32. ISSN 1084-5453.
• Longmore, Paul (July 2009). "Making Disability an Essential Part of American History". OAH Magazine of History. 23 (3): 11–15. doi:10.1093/maghis/23.3.11. ISSN 0882-228X.
• "From disablement to enablement: conceptual models of disability in the 20th century". Disability and Rehabilitation. 30 (17): 1233–44. 2008. doi:10.1080/09638280701602418. ISSN 0963-8288. PMID 18821191. S2CID 19377518. {{cite journal}}: Unknown parameter |authors= ignored (help)
• Rose, Sarah F. (2017). No Right to Be Idle: The Invention of Disability, 1840s–1930s. University of North Carolina Press. pp. xvi, 382. ISBN 978-1-4696-2489-1.

External links

• The dictionary definition of disability at Wiktionary
• Quotations related to Asmaley/sandbox at Wikiquote
• Media related to Disabilities at Wikimedia Commons

Category:Social concepts