COVID-19 and disability
In recent years, the understanding of disability has evolved from a medical to a social concept. In the medical model, disability was perceived as an individual’s problem due to their physical condition. In the social model, as set out in the United Nations Convention on Rights of Persons with Disability (CRPD), “persons with disabilities are those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others”1. In this current conceptualisation of disability, disability arises not only from a person’s physical condition but also various contextual barriers that they experience that restrict their full participation in society.
Nearly 1 billion people globally have a disability, which is a significant figure when ensuring that the needs of people with disabilities are met in COVID-19 responses. People with disabilities are more likely to be poor, experience limited opportunities for education and employment, and face stigma and discrimination compared to those without disabilities. It is estimated that 80% of people with disabilities live in low- and middle-income countries2 whose resource-limited health care systems may not have had adequate preparation for the COVID-19 pandemic.
The prevalence of disability is nearly 40% among people aged 60 years and over2, which is especially significant when we acknowledge the fact that older populations are at an increased risk of being severely impacted by COVID-193.
People with disabilities have higher rates of comorbid health conditions such as diabetes and cardiovascular diseases and are more likely to report poor health compared to those without disabilities3. Yet, they often have limited access to health care3 due to barriers related to lack of information, physical accessibility, negative attitudes of service providers and costs. These challenges and inequities further increase the risk of morbidity and mortality if they contract COVID-19.
A significant proportion of people with disabilities require additional support which increases the risk of exposure as they are less able to maintain physical distancing. Some people rely on caregivers who may be their family members or disability support workers for their daily living activities. Further, people with certain chronic conditions require regular ongoing care to manage their underlying condition as well as rehabilitation (e.g. physiotherapy, occupational therapy) to maintain their physical functioning.
It may also be a challenge to maintain hygiene practices due to limited water and sanitation resources, inability to independently access hand washing facilities or physically rub hands, and needing to touch and feel the environment for obtaining information or physical support.
Disability also significantly affects family caregivers, with long term impacts on health, employment and quality of life. It is critical to consider the needs of caregivers during this pandemic as they may be at increased risk of exclusion and experience increased levels of stress as well as poor mental and physical health.
Thinking of your own local context, what are two or three inequities that people with disabilities face that increase their risk of experiencing adverse socioeconomic outcomes due to the COVID-19 pandemic? Share your thoughts in the Comments section below.
© Nossal Institute for Global Health 2020