Health and Life Chances of Individuals with Disabilities in the UK

Introduction

Evidence suggests that disabled individuals are experiencing more barriers in the UK and are falling behind in terms of equal access to high standard of health care (Emerson et al., 2013). Disability is looked at as a shameful thing in society, with millions of individuals with disability not receiving equal treatment and are denied their everyday rights (Emerson et al., 2013). For instance, these people are denied equal access to appropriate housing, health services, employment and educational benefits and transport (Emerson et al., 2013). The pay gap experienced by individuals with disability is also continuing to widen. Their access to the justice system is also deteriorating and the welfare reforms are also continuing to affect their already poor standards of living (Emerson et al., 2013). This work intends to examine the extent to which social divisions and social inequality (from the sociology perspective) in contemporary society specifically impact the health status and life chances of individuals with disability in the UK. Major theoretical perspectives in sociology, including Functionalism by Emile Durkheim, Marxism by Karl Marl and Symbolic Interactionism will be underpinned.

Definitions

Sociology, from August Comte (1838), is a scientific examination of human behaviour and society (Little, 2014). This paper helps us to understand society and create useful public service policies. According to Marx Weber, society is divided into two, workers and their superiors, and that status or class plays a role in influencing people’s power in society (Halewood, 2014). Giddens and Sutton (2021) note that society is made of groups of individuals who associate, interact, and live together, sharing norm and values, language, culture, ethnicity and race. Giddens and Sutton (2021) suggest that a nation/country comprises of different societies, small and large and made of different social groups, where people with similar economic, professional, or academic backgrounds view themselves in the same group.

Disability is a mental or physical condition, which limits an individual’s activities, senses or movements (McCartney et al., 2019). On the other hand, health inequality is considered to be the difference in health resource distribution or health status between people in a population because of social conditions where individuals are born, work, live or grow in or because of age difference (McCartney et al., 2019). McCartney et al. (2019) note that health inequalities occur because of an unfair government policies that reduce some individuals’ access to high quality health standards that are recommended to everyone else in society.

Rousseau (2014) claim that society is made of interrelationships between individuals belonging to certain in-groups and with dynamic and sophisticated values, cultures, norms, or beliefs. This author suggests that the system requires all the important social organisations or institutions to be sustained. According to Emile Durkheim (1893), society is like an organism, ore which works together to attain social order and stability and where education, institutions or organisations are all part of it (Dew, 2015). According to Durkheim, society/sociology influences individuals both through socialisation, as well as interaction as people share values and norms or beliefs and by passing these down to other generations. This passing of beliefs or values to next generations is what Dew (2015) refers to as functionalism. According to Becker (1963), this leads to social solidarity and consensus in shared values, a situation that leads social institutions to work towards conformity and maintaining the existing or current way of life, where individuals who are seen as different are labelled as outsiders.

From the Functionalists’ standpoint, society is like the human body, which is made of many different parts, this is based on Spencer’s organic society analogy, that might operate together to successfully run (Oliver, 2018). From this perspective, it is a must for a society to reach consensus to run efficiently and to reach social order or social stability. If the opposite happens and the different parts of society do not function or are faulty, social problems occur (Doda, 2005)

According to Marx’s theory, it is not easy to reach a consensus in society because of the conflict that is created by capitalists (organisations that mostly over-utilise resources for their gains at the expense of others in society and work to maintain the status quo) (Lavalette and Ferguson, 2018). The Marxist school of thought suggest that capitalist societies are responsible for creating and defending ideological status quo tools that legitimise side-lining certain groups or individuals and sustaining their capitalist tendencies (Lavalette and Ferguson, 2018). This leads us to the structural view which suggest that these tools and structures are what have led to inequalities in societies and led to social structures that both manipulate and shape group and individual behaviour and socialisation in society. According to Marxists and Functionalists, society should be viewed at micro-levels and macro-levels because both group and individual interactions affect human behaviour and their health (Lavalette and Ferguson, 2018).

Based on the agency and structural debate, societal structures have the capacity to force and frustrate certain groups of people to join a certain categorization that either behaves in a certain way or fights for some rights (Rousseau, 2014). Rousseau (2014) suggest that based on the structures and societal influence, individuals can be forced to behave in a certain way, for instance, disabled individuals being reluctant to seek medical help because of the fear of being discriminated or treated in hospitals. This kind of behaviour then, has significant impact on their health outcomes. It means that individuals with disability will continue living with their health challenges because they are afraid of the societal structures that bar them from accessing equal standards of healthcare services like the rest of people in society without disabilities (Rousseau, 2014).

Impact of Social Inequality on the Health of individuals with disability in the UK

According to Slowie and Martin (2014), individuals that have disabilities are often increasingly likely to experience delays or difficulties in their health care needs met. They are also more likely not to make their yearly dental visits or receive other important health care services like mammogram visits (Slowie and Martin, 2014). Individuals with disability are also less likely to engage in physical exercise or fitness activities and are at risk of increased use of tobacco (Slowie and Martin, 2014). These persons are also increasingly likely to be obese or overweight and have hypertension or high blood pressure. For instance, according to the Public Health England (2016), of the 1304 individuals that have learning disabilities in Northern England, 28% are overweight, 14% are underweight, and 27% are obese. Slowie and Martin (2014) note that persons with disability are also more likely to suffer from psychological distress, with over 2.5% of the general population likely to suffer from intellectural disability and a limited cognitive and social functioning. Therefore, as compared to people without disability, those with disability are at higher risk of experiencing health challenges (Slowie and Martin, 2014).

Slowie and Martin (2014) claim that because of the diverse nature of disability, certain health conditions result in more health care requirements or needs or in poor health. Nonetheless, individuals with disabilities experience generally similar healthcare needs like the rest of society, hence need to access the mainstream health care facilities and services like the rest of society (Slowie and Martin, 2014). This is even reinforced by the UN Convention (Article 25) on the rights of individuals living with disability that was created to ensure that these people also attain high quality healthcare standards without any forms of discrimination (Yee, 2013). According to the Human Rights Commission (2017), disabled persons are highly likely to meet health inequalities and suffer serious health problems and die younger compared to other people in society. This commission claims that over about 73 deaths were reported between 2013 and 2013, with half of these being linked to mental health among individuals with disability and 11 suicides and three deaths in compulsory treatment centres.

These individuals find challenges when they attempt to access health services by being treated as second-class citizens, the lack of appropriate walking ramps, adjustable tables and seats and properly trained personnel to offer appropriate services among other challenges (the Human Rights Commission, 2017). Despite the UK government’s commitment to enhancing health care service provision to everyone through policies and legislations like The Equality Act 2010 that enforces equal treatment of people in all aspects of life regardless of their difference or disabilities, considerable shortcomings are experienced, and this special group of people have continued to report barriers in accessing the services (Human Rights Commission, 2017). Human Rights Commission (2017) report shows that disabled men who have mental health challenges are likely to die, at least twenty years earlier compared to the rest of population, while women are more likely to die thirteen years earlier.

According to Yee (2013), of the Health Disparities for People with Disabilities, DREDF, individuals with disabilities experience several health care barriers, including programmatic and physical inaccessibility, stereotypes and prejudice, lack of cultural competence and provider training to sufficiently care for them and inadequate monitoring and research on how their health care provision can be enhanced.

Research indicate that very few hospitals and care facilities in the UK have the required height-adjustable tables for examining individuals with disabilities (Bowen et al., 2020). Additionally, few care facilities in the UK have relevant weight scales that are accessible for disabled individuals (Bowen et al., 2020). Some care facilities or buildings are also not accessible for individuals with disabilities. Such inaccessibility has made it difficult for individuals with disability to fully access health care services (Bowen et al., 2020). From the Marxists’ perspective, the capitalist authorities in charge of developing and equipping these facilities pay less attention and consideration for the needs of disabled individuals (Flynn, 2017).

Instead, they focus on a continued exploitation of resources and benefiting in profit without considering the impact that this profit-oriented approach has on the environment and those around their operation. The beginning of capitalism was initially seen as a significant advancement from the previous underdeveloped societies. The capacity of production, for instance, was able to house and clothe the global population and the medical and scientific advances provided unlimited opportunities in curing illnesses. However, the majority poor individuals and those suffering from mental or physical impairments or pain have become excluded from decision-making, production, and wider society. As a result, Marxists believe that capitalism, the growth and development of infrastructure and facilities, has also become a social oppression against people with different types of impairment, including those with disability, where there welfare and wellbeing are not considered, but instead, the capitalists have focused on benefiting themselves more (Flynn, 2017). Furthermore, individuals who are different, those with physical or mental impairment and those from low economic backgrounds have continued to suffer from stereotyping and prejudice, an indication that people with disability are still looked at as second-class citizens even in the health sector, denying them equal access to the recommended high health services standards like non-disabled individuals in society (Flynn, 2017).

Stereotype and Prejudice

The capitalist institutions and organisations are working to maintain their status quo where individuals with different forms of impairment are marginalised. The rest of society also is following suit where disabled individuals experience stereotype and prejudice in healthcare facilities where in addition to finding inaccessible facilities, for instance those without ramps for easy disabled access and adjustable beds for examination, these individuals are also not attended to promptly and are either made to wait longer compared to people without disability (Galli et al., 2015). According to the Functionalist theory, more emphasis in the field of medicine often emphasise the role of medicine to maintain being normal as a human being and to be cured (Zhong et al., 2017). As a result, individuals who are seen as sick are expected to want to be cured and to comply with the established forms of treatment (Zhong et al., 2017). The functionalism theory highlights a problem in provider training where some disabled individuals have suggested that there are medical professionals who have the misguided notion or belief that the sole acceptable treatment outcome is cure (Yee, 2013). As a result, these doctors stay away from disabled patients because to them, these individuals represent treatment failures (Yee, 2013). As a result, the patients are not referred for early disease detection or prevention unless the patients are related to them (Yee, 2013). This has led to disabled individuals and the social functionalists being reluctant to seeking care or deviant to the existing medical systems and recommended treatment approaches (Yee, 2013).

According to Zhong et al. (2017), the link between the social deviance by the functionalists and individuals with disability support the healthcare facilities that should provide welfare and health services for the disabled to continue their dominance and unfair treatment of disabled individuals. As a result, the current welfare plans ensure that more money and spending goes on the professionals’ salaries and not the health services or wellbeing of disabled individuals. According to Zhong et al. (2017), functionalism does not differentiate disability and impairment or the fact that there is nothing wrong with disabled individuals (Zhong et al., 2017). Instead, discriminatory values and norms are reproduced rather than addressing the economic and cultural forces that exacerbate them (Zhong et al., 2017).

Evidently, this could be the reason why there is insufficient progress, in terms of monitoring and research, and why there are no standard questions or tools that can help reporting the health of disabled individuals, including data exchange and health information technology (Yee, 2013). This is also the reason why there is insufficient knowledge regarding the disabled people, the accessibility, quality and effectiveness of healthcare services offered, and insufficient progress in creating good measures for community-based and home care support measures for individuals with disability (Yee, 2013). This is also the reason individuals with disability are not recognised as a population that is highly underserved to integrate them in public health and reduce the health disparities they suffer.

The minority problem

Research suggest that millions of individuals live with disability globally (Barnes, 2016). It is also expected that the number of individuals living with disability will grow significantly (Barnes, 2016). Therefore, the number of people living with disability is high today and will be higher in future, yet they are still categorised as a minority (Barnes, 2016). From the social constructionism theory, the many interpretations of what disability is have failed to look at the critical structural factors that influence the people (Barnes, 2016). As a result, people with disability are treated and perceived as an abstract group that is different from the human race (Barnes, 2016). Meanwhile, important questions concerning what causes disability and how their welfare and wellbeing can be improved are left unanswered (Barnes, 2016). For instance, one thing that social constructionists believe that a question that has been left unanswered for long is the way the disabling environment socially constructs physical disability (Barnes, 2016).

Individuals with disability have been made to feel like an inferior group of humans by society (Nicholls et al., 2016). In addition to the structures put in place by institutions and capitalist organisations which reinforce a status quo without necessarily considering the needs of other people, and the many other ways in which people who are different are discriminated and prejudiced, society has reinforced certain behaviours through symbolic interactionism, where individuals with certain disabilities are not interacted with and are shunned and hidden. This kind of treatment has made the individuals without disability to, in some instances, doubt themselves and see themselves as outsiders. According to what symbolic interactionism states, their behaviour has depended hugely on how they interpret how they are treated by society and the events or situations created by society (Nicholls et al., 2016).

Conclusion

Individuals with disability are met with numerous barriers to accessing healthcare like the rest of people in society because of their disabilities. Marx’s theory highlights a capitalist society which is focused on material gains rather than the wellbeing of everyone else in society. In fact, people who are seen as different are side-lined and discriminated against because of, for example, their physical impairments or disabilities. Based on Durkheim’s functionalism concepts, society is like an organism with a shared way of life, often working to maintain some values, which in some cases do not favour the wellbeing of individuals with disability. This leads to deviance by the group feeling oppressed, which further strengthens the structures which offend them. The social constructionism theory has also noted that social constructions have failed to tackle the main causes of or factors that make the lives of individuals with disability worse. The society also interacts in a way that reinforces prejudice against individuals with disability where they are forced to behave in a certain way or join a similar group with a particular way of life. This makes them to be seen, not as part of the whole group but as a special group that should be treated in a certain way.

References

Bowen, C.N., Havercamp, S.M., Bowen, S.K. and Nye, G., 2020. A call to action: Preparing a disability-competent health care workforce. Disability and Health Journal, 13(4), p.100941.

Barnes, E., 2016. The minority body: A theory of disability. Oxford University Press.

Dew, K., 2015. Émile Durkheim: Social Order and Public Health. In The Palgrave Handbook of Social Theory in Health, Illness and Medicine (pp. 75-90). Palgrave Macmillan, London.

Doda, Z., 2005. Introduction to sociocultural anthropology. Lecture note for health science students. In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.

Emerson, E., Vick, B., Graham, H., Hatton, C., Llewellyn, G., Madden, R., Rechel, B. and Robertson, J., 2013. Disablement and health. In Routledge handbook of disability studies (pp. 264-281). Routledge.

Flynn, S., 2017. Engaging with materialism and material reality: critical disability studies and economic recession. Disability & Society, 32(2), pp.143-159.

Galli, G., Lenggenhager, B., Scivoletto, G., Molinari, M. and Pazzaglia, M., 2015. Don't look at my wheelchair! The plasticity of longlasting prejudice. Medical education, 49(12), pp.1239-1247.

Giddens, A. and Sutton, P.W., 2021. Essential concepts in sociology. John Wiley & Sons.

Human Rights Commission, E., 2017. Being disabled in Britain A journey less equal. [online] Equalityhumanrights.com. Available at: [Accessed 20 May 2021].

Halewood, M., 2014. Rethinking the Social through Durkheim, Marx, Weber and Whitehead. Anthem Press.

Little, W., 2014. An Introduction to Sociology. Introduction to Sociology-1st Canadian Edition.

Lavalette, M. and Ferguson, I., 2018. Marx: Alienation, commodity fetishism and the world of contemporary social work. Critical and Radical Social Work, 6(2), pp.197-213.

McCartney, G., Popham, F., McMaster, R. and Cumbers, A., 2019. Defining health and health inequalities. Public Health, 172, pp.22-30.

Nicholls, D.A., Atkinson, K., Bjorbækmo, W.S., Gibson, B.E., Latchem, J., Olesen, J., Ralls, J. and Setchell, J., 2016. Connectivity: An emerging concept for physiotherapy practice. Physiotherapy Theory and Practice, 32(3), pp.159-170.

Oliver, M., 2018. A sociology of disability or a disablist sociology?. In Disability and society (pp. 18-42). Routledge.

Public Health England, 2016. Making reasonable adjustments to obesity and weight management services for people with learning disabilities

Rousseau, N., 2014. Society explained: An introduction to sociology. Rowman & Littlefield.

Slowie, D. and Martin, G., 2014. Narrowing the health inequality gap by annual health checks for patients with intellectual disability. British Journal of General Practice, 64(619), pp.101-102.

Yee, S., 2013. Health Disparities Research At the Intersection of Race, Ethnicity, And Disability: a National Conference April 25 & 26, 2013. Dredf.org. Available at: [Accessed 20 May 2021].

Zhong, J., Chen, D.Q., Nantes, J.C., Holmes, S.A., Hodaie, M. and Koski, L., 2017. Combined structural and functional patterns discriminating upper limb motor disability in multiple sclerosis using multivariate approaches. Brain imaging and behavior, 11(3), pp.754-768.

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