Medicine and the Aesthetic Invalidation of Disabled People

Contemporary disability discourse is marked by a struggle between medical and social meanings and models. The latter reflects the aspirations and youthful radicalism of the disability movement, while the former regards itself as the legitimate voice of truth in all matters associated with bodily function and process. This paper argues that the battle lines between these two camps need not be redrawn. Despite hints to the contrary, the proposed extension of the social model to accommodate a sociology of impairment does not involve a rapprochement with the medical model. On the contrary, a sociological account of impairment seeks to augment the armoury of the social model by developing one of its weaknesses, namely the cultural critique of medicine. This paper examines some of the ways in which medicine has been involved in the 'aesthetic invalidation' of disabled people and proposes that 'geneticization' is an important current contributor to this form of disability discrimination.     

Impact of the National Minimum Wage on Disabled People

The survey reported here found disparities in the impact of the introduction of the National Minimum Wage on disabled people. These were associated with age, gender, impairment and type of employment setting. The main determinant of whether individuals gained from the NMW was their status as claimants of welfare benefits. We also found evidence that paid hours had been reduced to implement the NMW with no net increase in earnings, possibly to enable people to retain benefits entitlements. We make recommendations about how the anomalies can be tackled. It may be unrealistic to expect the Act to have been implemented fully so soon after it became law and some of the anomalies found may eventually disappear. However, many of the inequalities uncovered by this survey are not addressed by the NMW, specifically those inequalities associated with impairment and gender.     

Work and Work Alternatives for Disabled Young People

This paper presents results from a population based action research study in East Devon of the needs of 383 young people aged 16-25 years with a whole range of impairments and disabilities, and 152 able-bodied controls. A comparison between these two groups is made of their current and past experiences of work and work alternatives. The aspirations and expectations of the disabled young people are also compared with those of their families and service providers, and the preferred occupations of the young people, with various profiles of disability, are explored. Although the analysis pinpoints groups of disabled young people with particularly high levels of employment handicap, there is, throughout the study group, a need for progress out of static or unstable occupational paths. The handicapping features of employment services that impede this progress are discussed together with an examination of society's response to high levels of unemployment among disabled people. The research findings, set within this context, provide a basis for action research now being undertaken in local communities within East Devon to improve employment opportunities.     

Disability, Dependency and the New Deal for Disabled People

The emergence of the 'New Deal' and its attendant claim to be part of a new political and social future based on the 'third way' seems to offer formerly excluded people new horizons for social inclusion. This paper provides a critical exploration of the likely impact of the 'New Deal' for disabled people. The paper contextualises the 'New Deal' in the wider ideology and rhetoric of 'Welfare to Work'. In doing so, it highlights similarities between 'New Deal', 'Welfare to Work' and the victim blaming ideas which characterised discussions of a growing 'social underclass' in the 1980s. By looking at the way the disability problem is framed within the 'New Deal' and 'Welfare to Work', it will be argued that it is unlikely to address the nature of employment barriers, indeed risks seriously misrepresenting the causes of disabled people's economic and social exclusion. In this way, its ideological underpinnings may simply reaffirm disabled people's economic and social dependency.     

Civil Society and the Sexual Politics of Difference

This paper discusses the sexual politics of anti-normalization within the context of the sociological discussions of civil society and the public sphere. The sexual politics of anti-normalization is less centered around identity as a means of securing group solidarity and representing sexual communities in civil society. A politics of anti-normalization comprehends identity as a means of normalizing and regulating sexual desire and difference. Anti-normalization entails the politicization of ethical-moral issues concerning sex and desire and the production of sexual differences beyond the usual opposition of heterosexuality to homosexuality. I discuss the ways that the theoretical discourses on civil society reduce conceptions of difference to identity and develop a framework for analyzing the sexual politics of difference beyond identity in the public sphere.     

Counselling Disabled People: a counsellor's perspective

For many years professionals have assumed that disability is a problem for impaired individuals and that it is the disability that causes emotional or psychological problems. Whether this is true and whether a specific model of counselling is needed to help disabled people to cope with the emotional effects of their disability has not been widely researched and this is examined in this piece of research. The causes of psychological distress are discussed and the ways in which counsellors work are studied. Using a grounded methodological approach, disabled and able bodied counsellors of disabled people were interviewed as this was considered to be the most sensitive way of exploring this area. The findings show that more often than not it is the client's lack of control over their physical and social environment and not the impairment that causes emotional difficulties. Counsellors indicated that, through the facilitation of counselling, a sense of self empowerment in practical, emotional and social areas could be achieved and this was the central theme emerging as the most distinctive aspect of counselling clients with physical impairments.     

Representing the Views of Disabled People in Community Care Planning

The 1990 NHS and Community Care Act requires social services departments in Britain to involve representatives of service users in the preparation of their annual community care plans. This paper gives a critical account of the different ways in which the views of disabled people are sought and represented in community care planning; and of the organisational and practical barriers which disabled people and their organisations are likely to encounter in representing their views to service planners. People with learning disabilities, older disabled people, people with sensory impairments and disabled people from Black and ethnic minority communities are particularly likely to be excluded from current consultation procedures. The paper concludes that present methods of representation place considerable burdens on both individual disabled people and on their organisations. Consequently, disabled people may increasingly question the effectiveness and usefulness of their involvement in community care planning, in the light of the many other issues which are important to them.     

Government Policies and Disabled People in American Indian Communities

Although services and resources for disabled people in the United States have improved greatly as a result of legislation and advocacy efforts, many of the disabled in American Indian communities have yet to benefit from these advances. Inaccessibility to services is often complicated by problems and debates over which agency, state or federal, is responsible or has jurisdiction to provide the services. Meanwhile, Indian communities struggle to accomplish what they can with limited resources.     

Poverty and Disabled People: challenging dominant debates and policies

This article explores the relationship between poverty, disability and impairment in a global context. It challenges dominant critiques of poverty and disability, and explores the critiques, policy proposals and developments of the disabled people's movement to combat poverty. It offers an international perspective including the experience of both the North and South.     

Official Development Assistance to Disabled People in Ghana

Research was conducted in Ghana to (1) determine the extent to which the 1994–95 Official Development Assistance (ODA) donors to Ghana subscribed to inclusionary disability policies or mandates, (2) determine the extent to which disabled people were included in their mainstream development activities, (3) estimate the proportion of Ghana's 1994–95 ODA that went to activities specifically intended to benefit disabled people, and (4) estimate the proportion of those activities that were designed to foster the inclusion and empowerment of disabled people. In 1994–95, only two of the 16 donors examined subscribed to disability policies or mandates, and none took affirmative steps to include disabled people in their mainstream programmes and projects. Only 0.1282% of the total ODA examined for the entire 2-year period went to disability related activities, of which only 44.12% went to inclusionary and empowering activities.     

Aging,Disability, and Disabled Older People in India

Summary

India is witnessing a demographic revolution, leading to a considerable increase in the proportion of older people in the population. Similarly, life expectancy of both the mentally and physically disabled has improved considerably. About 5% of Indian older people have problems with physical mobility. Aging has become a gender issue in India not only because more women are surviving into old age; they are also vulnerable and disadvantaged in many ways. In most cases they are the only caregivers available for the old and disabled. Older Indians are considered a high-risk group for multiple morbidity. It is estimated that nearly four million Indians suffer from mental problems. India has around 12 million people designated as “handicapped.” However, little information is available about disabled people who grow older. The National Policy on Older Persons, which has been recently formulated, aims at providing an improved quality of life for millions of older Indians. However, the concerns of older disabled and of the disabled who grow old are still treated separately in both policy and practice.     

Charities, Authority and Disabled People: a qualitative study

Disabled people are greatly under-represented in positions of authority within traditional charities. Using qualitative data from original empirical research, this paper identifies some of the causes of their exclusion. The values, attitudes and beliefs of those who govern traditional charities accord largely with the 'personal tragedy' or medical model of disability, and a major consequence of this perspective is that disabled people are confined to roles in which they have little opportunity to exercise power in the traditional voluntary sector.     

Disabled People, Service Users, User Involvement and Representation

The issue of representation and representativeness has become central in debates about user involvement, disabled people and users of social care services. This article examines the emphasis of service agencies on the 'unrepresentativeness' of disabled people and service users; looks at how this is experienced by the latter and considers why the issue has gained such importance. It examines the different meanings attached to representation by recipients and providers of services. As well as looking at how the issue of representativeness is used to devalue, exclude and disempower disabled people and service users, the article explores its relation with the competing participatory and representative models and practices of democracy employed by disabled people and service providers.     

The Effectiveness of Adult Day Services for Disabled Older People

Abstract

Adult day care has attracted a considerable amount of attention among researchers, practitioners, and policymakers. However, there have been few efforts to synthesize empirical results. This paper reviews research that determines the effectiveness of adult day services in improving client functioning, alleviating caregiver stress, and delaying nursing home placement. In addition, the strengths and limitations of the research are considered. This paper concludes with a discussion of policy-relevant issues that must be addressed when determining the effectiveness of adult day services.     

Cultural Representation of Disabled People: Dustbins for Disavowal?

Impairment and imagery are neglected within the social model approaches to disability. This is connected to a neglect of representation. Comparing the experience of disabled people to that of women, I explore the prejudice underlying cultural representation, using a variety of theoretical models. I conclude by suggesting an explanation for popular prejudice against disabled people.     

Supporting the Participation of Disabled Children and Young People in Decision‐making

Increasing children's and young people's participation in decisions, about their own care and about service development, is a policy priority. Although in general participation is increasing, disabled children are less likely to be involved than non‐disabled children and it is unclear to what extent children with complex needs or communication impairments are being included in participation activities. This article presents research exploring factors to support good practice in participation and discusses policy and practice implications.     

The Influence of the Socio-economic Characteristics of Disabled People on Their Employment Status and Income

Most of the studies of the employment and income levels of disabled people focus on a specific disability or on severely disabled persons. A few studies are cross disability ones, but they fail to go beyond simple associations or else have extremely small sample sizes. There is a need for studies which are cross disability and which have an adequate sample size in order to determine if there are structural variables in society—like a class system-which operate upon the employment opportunities of disabled persons. Using a sample (n = 733) of the Disability Community in Massachusetts, socio-economic variables related to employment and income are studied. Statistically significant relationships are found. Several models are developed and the implications for social theory are discussed.     

A Global Perspective on Social Security Programmes for Disabled People

By the mid-1990s, 163 countries had statutory general disability programmes. Most have adopted social insurance as their primary policy instrument, which restricts coverage to those in paid formal employment, makes benefit eligibility dependent upon the satisfying of specific minimum contribution period requirements and provides earnings-related pensions. Many countries also provide supplementary and special need benefits. Programme funding comes overwhelmingly from employer and employee contributions, with a majority of countries providing government subsidies. Using a methodology that assesses national statutory social security intentions, a ranking of these disability programmes reveals that Australia has the best designed one.