Disability, Citizenship, and Public Policy

Disability is a normal part of the human condition. Some people are born with a disability; others develop a disability through the course of life owing to an accident, illness, aging; still others have disabilities that reoccur throughout their lives. Many people experience more than one condition that could be considered a disability.

Disability occurs as a result of the interaction of health conditions such as disease or injury, personal factors such as age, gender or cultural identity, and one’s social environment. Not all disabilities result in significant limitations or restrictions on everyday life and work. For example, eyeglasses are a common intervention that effectively eliminates the impact of poor vision. Most people who wear eyeglasses would not consider themselves disabled, but without this intervention they might not be able to drive an automobile or pursue other aspects of their lives without limitation. Disability is usually important only when it affects a person’s ability to function with normal independence and self-sufficiency.

The Participation and Activity Limitation Survey (PALS) is conducted by Statistics Canada every ten years to collect information on disability in the country. According to PALS, the overall rate of disability in the general Saskatchewan population in 2001 was 14.5%. The survey reported that 3% of children from birth to 14 years of age, 11% of individuals from 15 to 64 years of age, and 44% of individuals age 65 and older have one or more disabilities. Because disability and aging are closely connected, it is important to plan to address the needs of individuals throughout their life cycle.

There are a number of perspectives reflected in current public attitudes and policies for people with disabilities. The charity model is the oldest and still most prevalent approach—one that views people with disabilities as unfortunates or victims of circumstance, whom society must care for as a moral responsibility. While this approach may enrich benefits and services for people with disabilities, the charity model tends to under-emphasize the capacities of people with disabilities to participate more fully in work and community life.

The medical model views disability primarily from the perspective of health conditions, and emphasizes rehabilitation, restoration or repair of an abnormality or defect. While medical approaches are important for stabilization and treatment of conditions, they tend to focus on deficits rather than capacities, with less emphasis on the individual’s capacities to function in his or her social and physical environment.

The social and human rights model sees disability as society’s failure to meet the needs of an individual with a disability, and to recognize his or her inherent rights as a human being. This model is based on the premise that if the environment is adapted to the person, the effects of a disability can be reduced or eliminated. Its advocates focus on public policy measures to address physical, attitudinal, and social barriers to participation in society.

The functional limitation model emphasizes the capacity of the individual to perform typical tasks and social roles, and pursues interventions through which that capacity may be strengthened. The functional limitation model blends a focus on measures that support individual capacity for daily living with a concern for the physical and social environment and its capacity to accommodate needs specific to disability.

The Canadian Charter of Rights and Freedoms prohibits discrimination based on mental or physical disability, but the Charter contains no definition of disability. The concept is not easy to define because the range of possibly disabling conditions is very broad and their impact can differ from individual to individual. The practical impact of the Charter on disability issues is evolving slowly through legal precedent.

In Saskatchewan a significant array of supports exist to help people with disabilities. These range from income support to health services, employment supports, and other benefits or services. Sometimes eligibility for disability programs is established on the basis of diagnosis or functional impact assessment alone. Other programs combine disability criteria with other criteria such as the individual’s personal income or assets. Choices in eligibility criteria affect the accessibility of programs and services to individuals, as well as the capacity of public programs, with limited budgets, to address the full scope of need in the population.

In recent years, governments and advocates have begun to view people with disabilities in a different way. Saskatchewan’s Disability Action Plan, a position paper released by the Saskatchewan Council on Disability Issues in 2001, describes a vision of a society in which “individuals with disabilities are citizens in the full sense of the term. They have the same rights and responsibilities as other citizens to be included and to participate fully in society.” This integrative vision represents a great step forward from the early days of the province, when people with disabilities were often isolated from the mainstream of life. Consistent with this view, Saskatchewan public policy is moving toward a functional impact model of disability, with more focus on impact than on diagnosis, and greater recognition of the relationship between an individual’s disability and his or her environment, resources, skills, and personal support network.

Many past failures of disability policy were rooted in a simplistic view of disability, and a tendency to segregate people into “disabled” program categories. Public policy is evolving towards recognition of disability as a quality all humans share in some measure. Approaches are emerging that will gradually minimize the practical effect of disabilities on citizens’ lives. Such developments have the potential to improve the quality of life of individuals with disabilities, and to strengthen the social and economic fabric of the province as a whole.

Tara Truemner

Further Reading

Bickenback, J.E. 1993. Physical Disabilities and SocialPolicy. Toronto: University of Toronto Press; Saskatchewan Council on Disability Issues. 2001. Saskatchewan’s Disability Action Plan.