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A Billion People with
Disabilities by 2000
by Art Blaser
Art Blaser is a professor of political science at Chapman University.
People with disabilities are often asked, "Just how many people
like you are there?" There's the temptation to say something cute
like, "Only one so far." But what the questioner is really trying
to hear, of course, is a figure with which to compare our numbers against
those of other groups who are also minorities.
The answer is, "it depends." If you want a higher number
or a lower number, change the definition of "disability."
I've tried, though, to make an actual count. My count is 900,000,000
now, and is sure to increase as the ability to diagnose disabilities (which
is far from being the same as the ability to cure them or to alleviate
their effects) increases with time.
The effort to count us leads to the same kinds of criticisms leveled
at those who count by race: that it's counterproductive and divisive. Yes,
it can be; but in the end I believe that counting by race and by disability
(as well as by gender, occupation, education, and sexual identity) is helpful
in efforts to bring about equality. But it's true that it isn't "neutral
and scientific" or unrelated to efforts to change society. You can't
successfully understand disability if you separate it from its societal
and cultural factors. Measurement is a tool for social action.
I hate the "Whose oppression is worse?" game. Whether it's
one person or a million, their oppression is still immoral. Unfortunately,
it seems, most people don't feel this way. Remarkably few people are disposed
to look favorably upon programs whose primary beneficiaries are members
of minorities - particularly when the minority is very small (and does
not include them) - even though it should seem logical to people that when
a small number of people are affected, then including them and providing
them services should be more, rather than less, feasible.
"In 1990 those people most Americans would consider disabled -the
blind, deaf and wheelchair-bound-numbered about four million," wrote
Trevor Armbrister in a May Reader's Digest article trashing the Americans
with Disabilities Act ("A Good Law Gone Bad" see page 26). He
considers the "43 million" number one concocted by activists
to better their cause. He sees the larger number as the cause of the ADA's
"problems" - among them the "91,000 ADA charges filed with
the EEOC."
"Agency investigators found 'reasonable cause to believe that discrimination
occurred' in just 3.1 percent of the cases," he writes. Had Armbrister
been pro-ADA, he could have suggested that the smaller number could mean
stronger rights protections, since a relatively small expenditure for
legal services would have made a difference in the appalling success figures
for those EEOC complainants.
(Opponents of gay and lesbian rights are similarly illogical in responding
to the new, lower figure announced for the homosexual population.)
Civil rights adherents fear the new approach to "counting by race"
in the 2000 Census will prove that reduced numbers equal reduced clout
and reduced concern with equal rights.
Numbers do make a big difference to officials who calculate "political
clout." They also make a difference to foundations, which seek assurance
that programs they fund help large numbers of people. And that difference
is probably greater in disability policy than in other areas - thanks in
part to the Americans with Disabilities Act's focus on "reasonable
accommodation" and "undue hardship." How many employees
or consumers might benefit from an accommodation may be at the heart of
whether or not it is "reasonable."
Activists hoped the attention to disability issues in the last Presidential
campaign would draw votes from both disabled and nondisabled people - based
on the belief that there were a large number of people with disabilities.
The Americans with Disabilities Act of 1990 states that Congress found
that "some 43,000,000 Americans have one or more physical or mental
disabilities, and this number is increasing as the population as a whole
is growing older." In 1990 that figure was already four years old;
it had come from a survey by Louis Harris and Associates for the National
Organization on Disability. The precise number was not the essential point;
the point was that there were a lot more of us than was commonly realized.
The more recent estimates of 49 million are taken from the 1990 Census.
And that figure is already exceeded by others. Today a figure of 54 million
is widely used: 1 in 5. Census Bureau data calculated that "Between
October 1994 and January 1995, approximately 54 million Americans (1 in
5) reported some level of disability and 26 million (1 in 10) described
their disability as severe." That number still does not include people
with AIDS, people with many learning disabilities, and those with other
sources of "disability."
And "severe" is one of those terms like "serious"
which one person might apply to a hangnail. The Census Bureau meant something
specific: that the individual is unable to perform one of a number of main
activities or tasks ("seeing, hearing, talking, walking, climbing
stairs and lifting and carrying a bag of groceries... getting in or out
of a bed or chair, bathing, getting around inside the home, dressing, using
the toilet and eating"), or requires personal assistance.
In public policy debates, we also need to add in the many millions who
may use a baby stroller, tote a briefcase on a wheeled luggage carrier
or otherwise be inclined to take advantage of adaptations designed first
for disabled people. In fact, we should add everyone, given that she or
he could potentially be one of those temporarily injured (conservatively
estimated at 57 million in 1985).
Many estimates are already dated by the time they are calculated.
And most calculation methods which seem to make common sense are problematic
when examined.. If we simply ask people whether or not they are "disabled,"
some who would obviously fit the category would insist that they are not,
alleging that inclusion as a member of a minority group is demeaning.
A "common sense" alternative is to ask whether a person can
do certain things. But why would we expect a person to be more honest
to a pollster than they have been to their loved ones, whom they have
tried to persuade that, as members of a "can do" culture, they
can do almost anything, worthwhile or not? And there are people who,
if they can do something sometimes - like walk up a step sometimes when
their arthritis isn't too bad - tell the pollster that yes, they can climb
steps, even though, in fact, they can't do it a lot of the time. Those
people are not defined as "disabled," even though they do, in
fact, have a functional limitation.
If we change the definition of disability, we change the result.
What about a global figure? The one often given is 500,000,000. That
was based on 1 in 10 a long time ago. Yet it was used by United Nations
Secretary General Kofi Annan in commemorating the UN's International Day
of Disabled Persons, on December 3, 1997; the World Programme of Action
concerning Disabled Persons had used the same figure when it was approved
by the General Assembly 15 years earlier.
Some factors might limit the size of the population of people with
disabilities: some may not be born because they will have been aborted;
some will join the nondisabled population as a result of medical science;
the death of some may be hastened when they are chosen not to receive scarce
food supplies; some may be the subjects of euthanasia, whether voluntary
or involuntary.
But these factors do not make for a shrinking population of disabled
people. Far from it. The total population is increasing. People are not
dying like they used to. Although many of the causes of death - automobiles,
workplace hazards, and unclean water - are still with us, they now often
disable people rather than kill them.
Many disabilities are easily preventable, but that does not mean that
they are being prevented. A plethora of easily preventable disabilities,
such as river blindness, are still with us. So is famine, such as the
recent one in North Korea in which television audiences have witnessed
babies too weak to cry. A favorite foreign policy tool of the 1990s, "economic
warfare" (such as the withholding of needed supplies from Cuba and
Iraq) keep food from masses of the population, many of whom become disabled
as a result.
A high rate of disability may be the result of a society's success,
rather than of its failure. Such is the case with the increasing number
of people with Alzheimer's - the result of better diagnoses, and of the
fact that people are living longer. Having Alzheimer's is increasingly
accepted as a fact of life. Data released in conjunction with World AIDS
Day showed a dramatic undercounting of people with AIDS, who are among
those people surviving as people with disabilities.
Although it may make rhetorical sense to speak of "cures"
for disability, often the cure merely changes the nature of the disability,
perhaps lessening its effects; the disability is not eliminated.
The convention banning land mines was opened on the International Day
of Disabled Persons, but an estimated 110 million mines are still in the
ground. Even as one source of disability is banned, new weapons (whose
end result will be the creation of disabilities) are produced. The saying
"If you want peace, prepare for war." should be accompanied by
the caveat: "If you want war, prepare for people with disabilities."
Or perhaps we should say, "in any case, prepare for people with disabilities."
Yes, my "one billion" figure is just a guess - although in
time it is certain to be accurate. It is not outlandishly high, and a
number of trends (some of them the realization of high hopes in medical
science) will bring us to that figure.
We are then left with the question of whether the certain increase in
people with disabilities is good or bad new. I say it's good news. The
challenge for society is to raise the quality of life for all of us, many
of whom will be people with disabilities.
- The ADA's definition of disability is
a good way of getting discussion started.
From the ADA:"The term 'disability' means, with respect to an individual:
(A) a physical or mental impairment that substantially limits one or more
of the major life activities of such individual; (B) a record of such an
impairment; or (C) being regarded as having such an impairment."
But that definition not only starts the discussion; it also raises questions:
how well defined must a "record of such an impairment" be? (That's
the question before the U.S. Supreme Court right now, in Sidney v. Abbott
- ed.). When is a limitation "substantial?" What constitutes
"regarded"?
When applied to particular cases, the lines appear very fuzzy. A "good"
doctor or a "good" lawyer becomes one who can move the lines.
This is particularly the case since "disability" is defined
differently for Social Security and ADA purposes (and sometimes even within
the same Act or agency).
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