Disability as a Social Construct

There has been a major shift in the understanding of disability in recent decades. The social model and the medical model of disability are often mentioned in the literature so a short introduction to this very complex topic will be given here. There are other models of disability; however these two are the most commonly referred to due to their conflicting representations of disability.

• The medical model
• The social model
• The WHO model
• Other disability theories

The Medical Model

The medical model historically focuses on the dysfunction or impairment of the individual. It conceives disability as the outcome of impairment. Focusing on physical differences the model seeks to cure the impairment rather than address the disabling factors in the environment. It sees people with disabilities as people with bodies that are impaired, don’t work and cannot be productive. Often this approach focuses on particular groups such as "the blind" or "the deaf".

The medical model has been criticised because it reduces disability to a physical construct when in fact there are many dimensions that contribute to disability.

The Social Model

The social model of disability asserts that the impairment itself is not an obstacle for the disabled individual, but is a socially-created problem and demands a political and social response. Disability in this understanding is caused by physical barriers, personal attitudes and other features of the social environment. Inaccessibility to buildings and difficulty using transportation are some of the barriers that limit full social participation of people with disabilities. This model seeks to change the environment in which people with disabilities live, work and play. The model focuses on society and not on curing the person.

The WHO Model

Over the last four decades, a gradual shift in the conceptualisation of health and disability from a medical model towards a combined model of disability has occurred. The WHO model synthesises the medical and social models of disability and creates a "bio-psycho-social" model, which reflects the complex phenomena of disability.

Disability is in this model understood as "a complex phenomenon that manifests itself at the body, person or social level. According to this model, these three dimensions of disability are outcomes of interactions between health conditions, other intrinsic features of the individual and extrinsic features of the social and physical environment" (Üstün et al. 2001, p. 5). Because of its wide definition, the model is capable of including abnormal perceived phenomena that are usually not captured by the medical model of disability.

Click here for the WHO model diagram.

Within the WHO model a certain feature, like albinism, can limit a person’s activities. For example, albinism can affect vision and cannot endure excessive exposure to the sun without special protection. Provided the person is offered the appropriate visual aid and has access to the necessary sun protection then he/she will hardly feel any consequences of the disorder.

However, the experiance will be very different in a hot, sunny country, where the person is not provided with the necessary aid, as then he/she might not be able to participate in everyday activities and will need to stay out of the sun. The person might even suffer loss of eyesight and not be able to access school or work.

Furthermore, if the cultural interpretation in a country stigmatises albinism, the person might experience exclusion to an even greater extent and be denied the opportunity to participate accordingly. Stigmatisation is usually based on presumptions about the affected people. These presumptions might for instance include that PWDs are useless, less worthy than others, asexual or possessed by bad sprits.

By extending the model one can also explain how a certain feature, that might not even be impairment in a medical sense, can be negatively interpreted and cause exclusion of the affected person. Depending on the cultural circumstances, features like red hair, skin problems, or a certain skin colour have been described to have non medical negative effects.

See also:

• Üstün, T. B., S. Chatterji, et al. (2001). Disability and Culture: Universalism and Diversity. Seattle, Hogrefe & Huber
• WHO (2001) International Classification of Functioning, Disability and Health, Geneva: WHO

Other Disability Theories

Of the many valuable theories on disability the following few may be recommended for further reading:

• Goffman - In his sociological analysis he describes stigma as an attribute that triggers social discrediting. This leads to denial of privacy, superficial acceptance in a group, and a perception of being a non-person.Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Harmondsworth, Penguin.
• Neubert / Cloerkers - They offer the concept of "Andersartigkeit" (abnormalities). Their definition of abnormality pertains to anything that falls outside the concept of normality. The concept of abnormality is closely linked to cultural meaning.Neubert, D. and G. Cloerkes (1994). Behinderung und Behinderte in verschiedenen Kulturen. Eine vergleichende Analyse ethnologischer Studien. Heidelberg, Schindele.
• Murphy - Murphy writes about the theory of liminality, which is seen as a more flexible approach to the social model of disability. Liminality refers to the status of individuals who have not yet been accepted as full members of society due to social restrictions.Murphy, R. F. (1990). The Body silent. New York, Norton.
• Shakespeare - Shakespeare proposes that a category of disability should not be reduced to a straightforward social relation, but claims that an analysis of discursive practices offers a richer and more complex picture of disability.
  
  • Shakespeare, T. (1996) Disability, identity and difference. In C. Barnes and G. Mercer (Eds.) Exploring the divide Leeds: The Disability Press
  • Shakespeare, T. and Watson, N. (2002) The social model of disability: an outdated ideology? Research in Social Science and Disability, 2: 9-28