8.1. OVERALL DISABILITY DATA AND POLICIES

8.1.1. Introduction

Physically or intellectually disabled people constitute particular vulnerable population groups, which require special health policies. Until now, models of disability were typically cast as “medical” (the result of individual pathology or deficit) or “social” (the result of social failure in providing access and support). The current construct of disability is fundamentally interactive and focuses on the individual’s expression of limitations in a social context (Schalock et al, 2007). Within this framework, the person’s limitations in functioning arise as the outcome of interactions between health conditions and contextual factors such as the environment or social attitudes. This approach has, to a certain extent, been incorporated into the model underlying the WHO International Classification of Functioning Disability and Health (ICF) (WHO, 2001), which separates the notion of functional limitation from disability. Functional differences are measured along three different domains: (1) body structure and function; (2) activities; and (3) participation. Disability is not equated with a disease state, but people with intellectual disability or any other disabilities are regarded as striving to promote good physical and mental health and also incur risks to their health.

Physically-disabled people include those affected by congenital anomalies as well as hearing and vision deficiencies or other limitations due to aging or to sequelae of some diseases, road traffic, home and leisure time accidents, or injured by unsafe products or extreme weather conditions. In many cases disabilities are associated with lifelong impairment. Although not accurately quantified, accidents and injuries are assumed to be the main cause of chronic disability among younger people, leading to an enormous loss of life years in good health.