Impairment and Disability

In disability studies, there is generally a distinction that is made between “impairment” and “disability”. The former is a medical problem whereas the latter is a social issue. While often the two go hand in hand, it is possible to conceive of a society in which an impaired person will not be impacted by the process of disablement.

Let me explain.

For most of human history, physical impairment has meant social exclusion. At its most basic, this might have been the result of straightforward issues of access. The person relying on a wheelchair couldn’t make it into town because the curbing was not cut to enable wheeled travel, building entrances were stepped, transport was inaccessible, corridors were narrow, bathrooms were small, et cetera. Great strides have been made in Australia in these matters, although until you spend time in a chair you don’t realise how far we are yet to go. In the suburb in which I live – Ingleburn – three quarters of the shops have a single step entrance, so I’m kept out of restaurants, hairdressers, florists, butchers and the like (sometimes that is a good thing!). But this is nothing compared to the primary area of physical exclusion, which is the family home. By far the vast majority of private houses in Australia have multiple steps for entry, narrow corridors, internal stairs, and tiny bathrooms. But I don’t want to complain. As I said, I am fortunate to be born in 21st century Australia, where I can catch a taxi, ride a train, get on most (but not all) buses, access most public buildings, and find an accessible toilet. What all of this means is that I am less disabled (socially excluded) then I might have been. In fact, most of the time I am not access disabled at all.

Beyond access, though, disability is more subtle. In the first place, many impairments cause social exclusions that are virtually inevitable. The deaf person, for example, is automatically excluded from much of our verbally grounded society, and even the vital help of a translator establishes a certain amount of social distinction. For the person with some form of intellectual impairment, there is the difficulty in engaging in the philosophical and political life of the community, although intelligence has many dimensions and a person’s capacity to participate is often greater than we think. Once again, in these areas I am fortunate, since my spinal-cord injury has not affected my capacity to think or communicate. I am challenged, however, by the amount of social life that occurs at night – since tiredness and pain send me to bed early. My injury has also removed me from involvement in the sports that I used to do with my friends and my kids. Now, I cannot expect people to move all their parties to the daytime, and nor can I demand that everyone take up chess rather than go surfing. My point is that it is at night and on the weekends – the times when people party and play – that I feel the frustrations of being disabled.

The connection between impairment and economic power is another sphere that creates disability. I was listening to a debate today about whether Australia should become a republic, and one of the arguments in favour was that Australian society was a meritocracy rather than an aristocracy. I would not want to return to the latter (and I am a Republican and not a monarchist), but the assumed understanding of merit as being deserving of political and economic power is necessarily framed over and against demerit, by which is meant disability (even if that is unintended). People with impairments may not be able to work, or they may only be able to work part-time, and often in low paying jobs. Whether they live on a pension or a minimum wage, they often struggle to participate fully in money driven, consumerist societies such as ours, and thus their impairment has become a disability. [At this point I should note that I’m not appealing for money or crying poor – so don’t feel the need to send cash! neither am I arguing for Marxism – but that is a debate for another day.]

There is finally, an element of social exclusion that is nothing other than an evil that needs unmasking – prejudice. Human society has almost always judged people by the shape and capacity of their bodies, and such judgements permeate every sphere of life. It is this fact that connects disability studies to the spheres of gender, race, and sexuality. This area is important enough for me to explore in a blog post to come.

In conclusion, reflecting on the distinction between impairment and disability has left me wondering whether I’m disabled. My preliminary conclusion is that, while my impairment is permanent and unbending, my disability comes and goes. It is a liberating thought. It means that my injury doesn’t define me, at least not all of the time, and never completely.

9 thoughts on “Impairment and Disability

  1. There is not just the physical or intellectual impairment, but those with a mental illness also live either on minimum wage or disability pension and cannot afford to do much and because of the stigma that still exists, against mental illnesses means that they cannot keep friends because of their illness. Frequent or in our case infrequent stays in a mental health facility, means that people do not want to be seen visiting such a facility or admit that they know someone in the facility, It means that they too ,miss out socially. As far as I am concerned any sort of disability does not define the person, for they are not their disability or impairment.
    My daughter has lost a lot of “friends” over the past few years because they do not know how to cope with her meltdowns or are too embarrassed to be seen visiting a mental health facility and then just leave her .
    Society still has lot of stigma towards those who through no fault of their own are different from the so called norm in society

  2. Some really good thoughts and observations in there Shane. I like your question at the end. I think one of the most disabling aspects of crisis is that of our shattered identity and the loss of the old self (perceived old self) and how that shapes our experience of the crisis at the time.

    Over time, as our attitudes change and evolve with the transition of life, perhaps its more that our minds (attitudes) that become enabled and we see ourselves once again as God sees us as being fully human.

  3. tks for my continuing education on this subject. I didn’t realise you were in pain. Is this bec stronger meds wld dampen your mind or that’s just how it is?

    1. I get two types of pain. One is nerve pain, and the other is aches in various muscles and joints that you would imagine I would not be able to feel – but my injury is an incomplete one so I get odd sensation. I don’t want to overstate it though. it is generally manageable and I can ignore it – and I do take various drugs. My point in this post is that it gets worse as the day goes on so that when I’m tired I am generally also experiencing pain, hence earlier nights a preferred.

  4. Hi Shane, thankyou for sharing the concept of impairment vs disability! It has lingered in my mind for a while, especially since making friends with a man who can’t read or write.

    Interesting to ponder that a few centuries ago, it wouldn’t have been a problem as most social functioning didn’t assume literacy. He manages quite well, he is in charge of a missional church op shop warehouse and has taught me a lot. He talks about buying chocolate with the ‘nut with a H’. He was able to get his driver’s licence because his mother made a tape recording of herself reading out the road rules. But gosh, I can’t imagine living without the joy of reading! I guess his mind and time is free to focus on other joys though.

    Sorry, I think I wandered off topic. I’m glad there are better facilities these days so you don’t always have to experience ‘disability’. And I certainly don’t think you are defined by your disability – of course it does profoundly affect your thoughts, actions, and daily life – but you also have so much more value, identity, and experience before and beyond your spinal cord injury. I feel like I should propose a toast – “to Shane!” (Hear, hear!)

    PS Does Troy realise his contact details are at the bottom of his last comment?

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