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Home / Healthcare & Medicine / Global Health and Disability / Attitudes to disability

Attitudes to disability

Contextualises previous debate and tension between social and medical models, and how this affects the priority placed on health/wellbeing
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11.8
TOM SHAKESPEARE: So the social model of disability has been called the big idea of the disability movement. It came about back in the 1970s, a group of disability activists in Britain coming together to discuss their experience and the difficulties they faced. And their revolutionary idea was that people were disabled by society, not by their bodies or minds. So they made a distinction between impairment– that is to say the health condition– and disability, which for them, was the disadvantage, the oppression, the exclusion, the discrimination, and the prejudice. So people are disabled by barriers. That might be environmental barriers; no lift, too many stairs. It might be information barriers; no Braille, no voiceover, no sign language.
64.3
It may be attitudinal barriers; ‘We don’t want people like you, you’re not welcome’ - the whole prejudice and stigma. And so UPIAS, the Union of the Physically Impaired Against Segregation, and the other organisations said, we must remove those barriers. We don’t fix the individual. We don’t worry about that. We try and remove the barriers so people are enabled. And the wave of disability discrimination legislation; the Americans with Disabilities Act, Disability Discrimination Act, and even the Convention of the Rights of Persons with Disabilities are all about that, removing the barriers. And this is a global issue. It started in the UK, but it was taken up by Disabled People’s International in 1981.
106.3
And everywhere I go in Africa or Asia, you hear people say, look, the prejudice disables me, the lack of provision disables me, my lack of a wheelchair disables me. My difference is OK. The way that you exclude me is not. Now, that was revolutionary. It built a movement. It identified what needed to be changed, and it inspired individuals to be proud, angry, not ashamed, and thinking that they were of fault. But academics and people of experience began to say, hang on a minute. My pain, my physical or mental health problems, they’re also an issue. It’s not just the way I’m treated. And folk began to think about people who are disabled by society and by our bodies.
155.4
We need a middle way, if you like, between what’s been known in medical model and the social model, because disability is very complex. It’s multifactorial. It’s the pain I feel. It’s the paraplegia I’ve got, as well as the lack of access I have. So we’re kind of thinking in a laminated way, the different layers of this multifactorial experience. The biological level, the medical level, psychological level - really important, emotions and so forth. The architectural level, can I get in the building? The provision, the sign language, the social stigma and discrimination. Will I get a job? Are you going to let me in? Are you prejudiced against me? The legal rights I have, the cultural representations in society.
202.3
How do we think of disabled people? So all of these are important. We can’t reduce everything to the medical. Of course not. But neither can we reduce everything to the social. It’s about all of these things. We can intervene in different ways at different levels. Self-help groups, counselling, barrier removal, perhaps health care, medical care, prevention, legal rights. None of them on their own are enough. We need them all and that way we can try and make the lives of disabled people better, which is what we’re all about. But we need to do so in a way that doesn’t say, it’s wrong to be disabled. Disabled is part of life. We face many barriers. We can do something about it.

The last step explored what having a disability means to individuals, from a personal perspective. In this step, Professor Tom Shakespeare from the University of East Anglia contextualises previous debate and tensions in defining and describing disability in the context of global health.

Professor Shakespeare, who co-authored the World Report on Disability whilst previously working at the WHO, has had a long involvement with the disabled people’s movement both in the UK and internationally.

In this video, he describes how different attitudes towards disability, and the response of disabled people to this in the 1970s, changed the way that disability was understood and described both in the UK and beyond. He explains the positive advocacy that arose from this movement, and the way that thinking about disability has started to develop even further since.

Perhaps use the comment section below to reflect on Professor Shakespeare’s interview, and prevailing attitudes to disability in your setting.

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This content is taken from
London School of Hygiene & Tropical Medicine online course,

Global Health and Disability

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This content is taken from London School of Hygiene & Tropical Medicine online course
Global Health and Disability
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