Background

The World Health Organization defines health as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.[1] ” It has been said that, while “health is not everything, everything is nothing without health.” This is because good health is a prerequisite for the enjoyment of and participation in many fundamental aspects of life, including education, work and society.

Health is determined by a broad range of factors, most of which are outside the health sector. Social, economic and environmental factors are the main external determinants of health. Persons with disabilities who experience disproportionately high rates of poverty often face conditions that impact negatively on their health, including lack of access to education, sanitary living conditions, clean water and food security, among others. At an individual level, factors such as age, sex, hereditary factors and lifestyle choices are important.

The number of persons living with disabilities is growing due to factors such as population increase, ageing, and medical advances that preserve and prolong life. This has increased the demand for health services. Some persons with disabilities are more susceptible than the general population to secondary health conditions. As a result, persons with disabilities may have greater needs than the general population. Health promotion services for the prevention of further disability and the promotion of health in general are important in determining the quality of life and health status of those with disabilities.

Persons with disabilities experience significant barriers to accessing health care. Barriers, which can be particularly severe for those residing in rural areas, can include the following:

physically inaccessible medical clinics and hospitals;
lack of appropriate transport to enable them to seek medical care or rehabilitation services; lack of communications and accommodation in health care settings;
untrained personnel and inadequate staffing;
negative attitudes of health care providers;
harmful practices, particularly in relation to persons with psychosocial disabilities;
denial of treatment on grounds of disability.

As with all members of the general population, the health needs of persons with disabilities can vary broadly. The range of services available to the general population must also be accessible to persons with all types of disability. Care must also be taken to meet the health needs of those with invisible disabilities, particularly those with psychosocial disabilities and other mental health conditions. Ensuring optimal mental health is an integral part of health service provision, but has received inadequate attention by policy makers and also by society in general. As a result, it imposes an enormous disease burden and an increasing obstacle to development in countries around the world.

While governments cannot offer guarantees against illness or disease, they are responsible for undertaking measures to advance human health, whether in the social, physical, legal or economic environments.

The Medical Model vs. The Social Model of Disability

The Medical Model of Disability:

Perhaps the most significant and widespread myth affecting human rights and disability is the idea that disability is simply a medical problem that needs to be solved or an illness that needs to be “cured.” This notion implies that a person with a disability is somehow “broken” or “sick” and requires fixing or healing. By defining disability as the problem and medical intervention as the solution, individuals, societies, and governments avoid the responsibility for addressing the barriers that exist in the social and physical environment.

Instead, they place the burden of addressing the “problem” in the person with the disability on the health profession. Many governments throughout the world have fueled the medical model by funding extensive medical research that aims to find the “cure” for certain disabilities, while not providing any funding to remove the barriers that create disability in society.

The Social Model of Disability

The social model envisions disability as something that is created by the barriers and attitudes in society, not a trait or characteristic that is inherent in the person. Under the social model, society creates many of the social and physical barriers we consider “disabling,” and this model focuses on eliminating those barriers, not on “fixing” or “curing” disabilities. This includes modifying the created environment, providing information in accessible formats and ensuring that laws and policies support the exercise of full participation and non-discrimination.

[1] Constitution of the World Health Organization. Geneva, World Health Organization, 1948