Barriers faced by persons with disability

Many people have disabilities in the world making them to be marginalized in the society and denied some basic human needs like good health services. The disability makes the person totally not functional or partly functional making it even harder to take care of themselves. Disability rate is moving upwards due to faster ageing and presence of acute and chronic illnesses. Due to their condition disabled people find it hard to access health care services experiencing deficit in health care services. However this can change if the world views them as normal humans and not as people missing something.

Disability and health

The International Classification of Functioning, Disability and Health (ICF) defines disability as an umbrella term for impairments, activity limitations and participation restrictions. Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, Down syndrome and depression) and personal and environmental factors (e.g. negative attitudes, inaccessible transportation and public buildings, and limited social supports).

Over a billion people are estimated to live with some form of disability. This corresponds to about 15% of the world’s population. Between 110 million (2.2%) and 190 million (3.8%) people 15 years and older have significant difficulties in functioning. Furthermore, the rates of disability are increasing in part due to ageing populations and an increase in chronic health conditions.

Disability is extremely diverse. While some health conditions associated with disability result in poor health and extensive health care needs, others do not. However all people with disabilities have the same general health care needs as everyone else, and therefore need access to mainstream health care services. Article 25 of the UN Convention on the Rights of Persons with Disabilities (CRPD) reinforces the right of persons with disabilities to attain the highest standard of health care, without discrimination.

Unmet needs for health care

People with disabilities report seeking more health care than people without disabilities and have greater unmet needs. For example, a recent survey of people with serious mental disorders, showed that between 35% and 50% of people in developed countries, and between 76% and 85% in developing countries, received no treatment in the year prior to the study.

Health promotion and prevention activities seldom target people with disabilities. For example women with disabilities receive less screening for breast and cervical cancer than women without disabilities. People with intellectual impairments and diabetes are less likely to have their weight checked. Adolescents and adults with disabilities are more likely to be excluded from sex education programmes.

How are the lives of people with disabilities affected?

People with disabilities are particularly vulnerable to deficiencies in health care services. Depending on the group and setting, persons with disabilities may experience greater vulnerability to secondary conditions, co-morbid conditions, age-related conditions, engaging in health risk behaviors and higher rates of premature death.

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People with disabilities not only find it hard to take care of their personal health but also are denied the services. These two barriers make it even harder for these people to lead a normal life. It is almost impossible for those with missing limbs to do physical exercise or work to have the money to eat a balanced diet. When they get aid from the government or other organizations the aid is never enough and leaves them to surfer more.

Factors in a person’s environment that, through their absence or presence, limit functioning and create disability. These include aspects such as:

  • a physical environment that is not accessible,
  • lack of relevant assistive technology (assistive, adaptive, and rehabilitative devices),
  • negative attitudes of people towards disability,
  • services, systems and policies that are either nonexistent or that hinder the involvement of all people with a health condition in all areas of life.” 1

Often there are multiple barriers that can make it extremely difficult or even impossible for people with disabilities to function. Here are the seven most common barriers. Often, more than one barrier occurs at a time.

Attitudinal barriers

Attitudinal barriers are the most basic and contribute to other barriers. For example, some people may not be aware that difficulties in getting to or into a place can limit a person with a disability from participating in everyday life and common daily activities. Examples of attitudinal barriers include:

  • Stereotyping: People sometimes stereotype those with disabilities, assuming their quality of life is poor
  • Stigma, prejudice, and discrimination: Within society,

Communication Barriers

Communication barriers are experienced by people who have disabilities that affect hearing, speaking, reading, writing, and or understanding, and who use different ways to communicate than people who do not have these disabilities. Examples of communication barriers include:

  • Written health promotion messages with barriers that prevent people with vision impairments from receiving the message. These include
  • Auditory health messages may be inaccessible to people with hearing impairments, including

Physical barriers

Physical barriers are structural obstacles in natural or manmade environments that prevent or block mobility (moving around in the environment) or access. Examples of physical barriers include:

  • Steps and curbs that block a person with mobility impairment from entering a building or using a sidewalk;
  • Mammography equipment that requires a woman with mobility impairment to stand; and

Policy Barriers

Policy barriers are frequently related to a lack of awareness or enforcement of existing laws and regulations that require programs and activities be accessible to people with disabilities.2 Examples of policy barriers include:

  • Denying qualified individuals with disabilities the opportunity to participate in or benefit from federally funded programs, services, or other benefits;
  • Denying individuals with disabilities access to programs, services, benefits, or opportunities to participate as a result of physical barriers; and

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It is very possible to address the barriers to personal health of the disabled. This incorporates many things but first it must start with the society then with the disabled person. The society must change how it views the disabled and on the other hand the disabled themselves must and must get out of self-pity. Self-pity devastates the affected and makes them lose hope of living a healthy life just because of a condition.

Much as we described discrimination as existing at different levels, barriers can be personal, cultural, institutional and structural.

Different kinds of Barriers

Structural, where circumstances create or result in barriers – for example in access to a ‘good education’ adequate housing, sufficient income to meet basic needs. And as we have observed, structural barriers are associated with poor life outcomes that can be observed in the significant disparities in health between areas of affluence and those associated with poverty.

Institutional, where policies, processes, practices sustain an organisational or service culture that excludes certain people or groups; an obvious example being what has been called the ‘glass ceiling’, i.e. that while not visible, a ceiling exists beyond which women – find it very difficult to progress.

Cultural barriers can prevent, for example, consideration of spiritual, relational  or dietary needs that do not conform with traditional expectations. For example “it took 3 days to organize Halal food”.

Personal barriers, for example where healthcare staff hold individual prejudices that influence their practice. These actions may be conscious, but as we have discussed, they can often be unconscious or unwitting. Attitudinal barriers are not as easy to identify as physical barriers, but they can feel every bit as real to those who are exposed to them.

Barriers can be…

Physical in nature; observed in the built environment, for example in accessing buildings, narrow doorways, the absence of lifts or accessible toilets…

About communication; where for example the language, communication or information needs of certain group and individuals are assumed, not taken into account, valued or given weight.

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