Disability

The social construction of disability challenges some of the assumptions that have formed the basis of the definition of the term disability. The need to incorporate the experiences of those living with disabilities is apparent. Scholars, [1] (1984) and Asch and Fine (1998) were the first to reframe disability as a social construct. Prior to this, disability was determinedbased byon an individual’s health status, impairment, or capacity limitation. Proponents of social construction theory maintain that this medicalized view fails to address social factors such as prejudice, discrimination, and inaccessibility which prevent full participation in society and contribute to the experience of disability.

The social constructionist perspective of disability takes the view that disability is the “outcome of complex interactions between health conditions and features of an individual's physical, social, and attitudinal environment that hinder their full and effective participation in society.” It is therefore assumed that in many cases, it is the environment rather than the physical condition that causes disability.

Impairment vs Disability

Impairment and disability differ in that impairment is the loss or lack of a functioning part of the body. Whereas, disability refers to "a society that discriminates, disadvantages, and excludes people with impairments, as it does not make appropriate accommodations and gives preference to those without impairment”.

According to a social constructionist perspective, our understandings must be based within the context in which we interact with the world (Gergen, 1985). Susan Wendell maintains that “neither impairment nor disability can be defined purely in biomedical terms, because social arrangements, and expectations make essential contributions to impairment and disability, and to their absence.” Viewing disability as being socially constructed focuses analyses on the intersection of individual and social factors.

Social construction theory of disability acknowledges the existence of biological disability and the functional limitations involved with these conditions. The theory maintains that biological disabilities cannot be understood in a meaningful way without being considered within the “contexts, relationships, institutions, or situations” because these factors define and shape the meaning of disability.” Theorists, like Wendell maintain that “the distinction between the biological reality of disability and the the social construction of disability” cannot clearly be made “because the biological and the social are interactive in creating disability.”

Disability Binary

The term "disability binary" is based on the assumption that disabled people are either high or low functioning. Those who do not fall within the disability binary usually have a disability that is both visible and invisible, these individuals may experience prejudice; are assumed to be lazy, or to be lying about their condition in order to take advantage of the the associated 'benefits'. As a result, people who are wheelchair-bound, but can walk for short distances, may avoid doing so as it places them outside of the disability binary and can lead to ridicule and prejudice from bystanders. The disability binary does not recognize the varying forms and severities of disability, and only accepts the most extreme forms as legitimate. This assumption does not reflect the wide range of variance inherent in disabilities.

Social Causes of Disability

Social causes that directly lead to disability include social and cultural environments, violence and injurious crimes, poverty and lack of access to basic resources, medical causes and pace of life . These factors lead to disability through injury and illness, and contribute to the definition of disability.

Wendell notes that the social construction of disability takes into account a wide range of social practices that cause injuries and impairments, and therefore lead to disability.

The social construction of disability can be seen to have two aspects:

1. The social construction of disability, which occurs through disabling attitudes, behaviors, and environments
2. The social construction of suitability, which occurs through the social creation of impairment.

Physical, Social, and Cultural Environments

Social construction of disability theory holds that disability is relative to a person’s physical, social, and cultural environments. Physical conditions are seen to be disabling given the demands and lack of support in the environments in which people are affected, rather than physical conditions being inherently disabling.

Physically disabling factors include physical structures that are designed for particular body structures. For example, the shape, size and existence of stairs are disabling to some individuals. The lack of accommodation in communication technology and transportation systems are also examples of disabling mechanisms. Social organizations and institutional organization (such as the education system) are often exclusive, and therefore privilege some and disadvantage those who do not fit into these structures, such as individuals with physical impairments.

Violence and Injurious Crimes

A primary cause of disability is violence (in invasions, civil wars, and terrorism to name a few). The violence of of these events often leads to disability as a result of injury and/or the depreciation of basic necessities, resulting from the chaos that these situations create.

Injurious crimes (such as rape, knifings, and beatings) cause disability through the injuries they create. Society’s success or failure to protect citizens from injurious crimes is therefore seen to have significant effects on rates of disability.

Poverty and Lack of Basic Resources

“…Social factors, such as working in high risk conditions, abuse and neglect of children, low public safety standards, and degradation of the environment by contamination of air, water, and food, as well as overwork, stress, and the daily hardships of living in poverty” can be seen to create disability through the damage to the body that results from these factors. Some groups within societies are more affected by these factors as a result of racism, sexism, heterosexism, ageism, and advantages associated with class, wealth, and education.

The availability and distribution of basic resources within a society also affects disability. Much of the disabling damage results from malnutrition and disease, which do more harm to those who are malnourished or weakened by exposure to environmental factors. An example of this is the contraction of disabling diseases which result from drinking contaminated water when clean water is unavailable. Schistosomiasis and infectious colitis are both waterborne diseases that can lead to complications and disability

The world’s poor represent a disproportionate number of those with disabilities. Individuals with disabilities also tend to be poorer than those without disabilities. Poverty can cause disability through malnutrition, dangerous working or living conditions, and poor health care. In turn, disability can cause poverty by preventing the participation of individuals with disabilities in education as well as in economic and social life.

In order to receive proper funding from the government, people who live with disabilities such as Dyslexia, have to have repeated tests to prove the existence of their disability to the government. Each exam costs a significant amount of money, and is only refunded if the test results are positive. The condition is labeled as a 'permanent disability’, however recipients of the funding, are treated as if this is a temporary state. This may be problematic for individuals in lower social classes because they may be unable to take time of work and pay up-front for testing, in order to receive support from the government.

Medical Causes of Disability

Medical care and practice play a role in preventing and creating “disabling physical damage” as well as in defining disability. Rates of disability in a given society increase with improved medical care and the capacity to save lives of those who are ill or injured. Public health and sanitation measures that increase lifespan also increase the number of elderly people with disabilities in society by allowing people to live long enough to become disabled.

Pace of Life

Pace of life is often taken for granted by non-disabled people, however those with disabilities are often very aware of how pace of life marginalizes or threatens to marginalize their full participation in society. Increases in pace of life are a social cause of damage to people's bodies (through rates of accidents, drug and alcohol abuse, and illnesses resulting from people neglecting their bodies). Pace of life also affects disability through expectations of performance. Susan Wendell gives an example from her personal experience as a professor currently working three-quarter time, one quarter disability leave. She writes that there has been talk at her university about increases in the teaching duties of professors, which would not be paralleled by reduction in expectations for other components of professors’ jobs. She says that if such an increase in the pace of professors’ work (for example by having to teach an additional course) were to take place, she would be unable to work more than half-time because of the new standards, even though there is no change in her actual physical condition.

When pace of life in a society increases, there is a tendency for more people to become disabled because fewer people can meet the expectations of “normal” performance. This increases the relative disability of those with physical and/or mental limitations who can no longer keep up with society’s pace of life, even though increased pace of life does not always directly increase rates of physical injuries or illness.

Expectations of performance are assumed and reflected in the social organizations and physical structures of society which create disability. Societies that are physically constructed and socially organized with the unacknowledged assumption that everyone is healthy, non-disabled, and young, create disability through the neglect of what many people need in order to participate fully in society. Wendell asserts that disability is socially constructed by the failure to give people the amount and kind of help they need to fully participate in all major aspects of life.