6 The Disabled
Learning Objective:
- Understanding how the disabled community can be excluded in a society where inclusiveness is desired.
Disabled Community
As with any other group covered in this textbook, those who identity as disabled are relevant in this discussion of inclusiveness in communications. Given the high prevalence of disability worldwide (World Health Organization, 2023), it is important for practitioners to be prepared to effectively and respectfully engage with disabled people and disability communities (Slayter, Kattari, Yakas, et al. 2023).
Disabilities vary widely and can be related to vision, hearing, motor skills, cognition, health, mental health, or a combination of any of these.
In the Beginning
To begin, let’s define disability, which is not simple due to how it is socially constructed, or embraced by society). Social constructs include social conditions that create illnesses, injuries, and poor physical functioning or even subtle cultural factors that determine what is considered normal or considered to exclude those from full participation in their societies.
Making the distinction between disability and impairment is also important. An impairment is a physiological condition that can lead to disability. A disability is a result of people living with impairments when there are physical, attitudinal, communication, social, or other barriers in the environment (People with Disabilities Australia, 2016; Cameron, 2014).
An example that speaks to impairment and the social and cultural constructions of disability is found in the fact that an estimated 75% of adults in the U.S. have vision impairments; we wear eyeglasses or contact lenses for these impairments (The Vision Council, 2017). With the availability and social acceptability of corrective lenses, this impairment is not necessarily considered disabling for individuals who have access to corrective lenses and their vision is improved as a result. However, if someone with a vision impairment does not have access to corrective lenses (due to lack of financial means, limited insurance coverage, etc.) or if their vision is not sufficiently corrected by the lenses, their impairment, coupled with the ways our physical, social, and policy environments are structured (requiring annual eye exams to update lens prescriptions while only covering the cost of the exam every other year, for example), would be considered disabling.
In the Present
Considering recent research and statistics, over one-fourth of Americans live with an impairment that causes a disability (Center for Disease Control and Prevention (CDC), 2021). Distinguishing impairment from disability can be a challenge, so establishing the prevalence of disability in a given locale is not a straightforward matter and generally uses a medicalized approach. In the United States, public health officials define disability across a spectrum, including challenges to mobility (i.e., walking or climbing stairs), cognition (i.e. concentrating, remembering, or making decisions), sensory (i.e. seeing, hearing), self-care (i.e. dressing or bathing, known as some of the activities of daily living) and independent living (i.e. cooking or doing errands alone, known as instrumental activities of daily living). Drawing on this approach to the definition of disability, 27% of U.S. adults had a disability – over 61 million people (Varadaraj et al., 2019). The most common types of disabilities were related to mobility (13.7%), cognition (10.8%), independent living (6.8%), vision (4.6%), and self-care (3.7%) (CDC, 2021).
It is also important to consider both race and ethnicity when analyzing disability prevalence rates. One example relates to adults who identify as Black or African American who reported the highest rates of any disability and of each disability type at one in four population members (Courtney-Long, Romano, Carroll, et al., 2017). While people of color have traditionally been under-reported in disability prevalence statistics, Black and African American children are simultaneously overly diagnosed with intellectual and developmental disabilities (Innovate Public Schools, 2019) – and often tracked into lower-level courses and special education programs at disproportionate rates. For example, non-Hispanic/Latinx Black children (16.9%) were more likely than non-Hispanic/Latinx White (14.7%) or Hispanic/Latinx (11.9%) children to be diagnosed with either attention deficit hyperactivity disorder or learning disability. Yet at the same time, we see Black children are less likely to be identified as having an autism diagnosis than White children (Mandell, Wiggins, Carpenter, et al., 2009).
There are patterns that emerge when considering disability intersecting with sexual orientation. Rates of disability among people who identify as lesbian, gay, or bisexual were higher than in the heterosexual population, even when age was taken into consideration. Data suggest that lesbians and bisexual women were more likely to be disabled than were gay or bisexual men. Overall, among lesbian, gay, and bisexual adults, 30% of men and 36% of women reported being disabled (Fredriksen-Goldsen, Kim & Barkan, 2012).
Finally, socioeconomic status is a primary factor related to disability prevalence. Poverty rates among people with disabilities are more than twice the rate of people without disabilities and people with disabilities account for more than half of those living in long-term poverty (National Council on Disability, 2017). People with higher incomes and more years of education had lower rates of any disability – a pattern that continued within each disability type. Almost half of adults with an income of less than $15,000 and 40.0% of adults without a high school diploma had a disability compared with only 10.8% of adults with an income of over $50,000 and 11.8% of college graduates. Unemployed adults were more than twice as likely to have a disability (33.5%) as compared to people who were employed (12.6%) (Courtney-Long, Carroll & Zhang, et al., 2013).
Most recently, we have seen an increase in the number of people in the U.S. with a diagnosed disability due to the ongoing effects of COVID-19, or “long covid.” For people of color, this has been a mass disabling event (Kendi, 2021). Many people will develop ‘long COVID’ after testing positive for COVID-19 and experiencing substantial limitations in at least one daily life activity (U.S. Department of Health and Human Services, 2022). This is now designated as a disability. U.S. studies suggest that between 10-30 percent who have been diagnosed with COVID-19 develop ‘long COVID’ (Government Accounting Office (GAO), 2022). This indicates that between 7.7 million and 23 million people may have developed this condition as of February 2022 (GAO, 2022).
In the Future
The end result of this information is awareness and helping people to be seen and heard regardless of what disabilities they may have. A sense of community is established for those who feel isolated or excluded. This could lead to the creation of more resources that are made available to those who experience exclusion, including those in the autistic community (look at the Bring to Light feature below for an example).
Bring to Light:
On Kayla Smith, a young self-advocate who created the hashtag campaign, #AutisticBlackPride (National Disability Rights Network, 2020).