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Disability in Society: An Overview
The social context of disability in the United States sets the stage for any discussion about how the church has responded to disability. Whereas an obvious case for understanding the social context of disability can be made in relation to including people with disabilities in the churchâs life, discussions of disability in Scripture and in church history as well as disability theologies and ethics have also emerged as contemporary developments because of efforts to include people with disabilities in the churchâs life. They are also products of the current environment in which disability is situated.
Three Levels of Analysis
In order to produce a thorough analysis of the social context of disability, I will discuss disability as interfacing three levels of social lifeâthe individual level, the social level, and the societal level; these levels come from the work of Barnes, Mercer, and Shakespeare in the wake of work of Bryan S. Turner. While Turnerâs aim is to provide an analysis of health and medicine at each of these levels, Barnes, Mercer, and Shakespeare apply Turnerâs model to disability.
At the individual level, Turner analyzes the âillness experienceâ using âphenomenology (the analysis of everyday life to establish its underlying assumptions) and symbolic interactionism (the study of social life as a system of communication of symbols).â In turn, Barnes, Mercer, and Shakespeare suggest that phenomenology and symbolic interaction might be employed to analyze the experience of disability and impairment in terms of challenges to self-identity, to look at disability not as a
At the social level, âmedical sociology,â according to Turner, âwould focus on the social construction of disease categories (âillnessâ, âsinâ and âdevianceâ) whereby individuals are classified and regulated by professional groups.â Turner also maintains that at this level there is an âattempt to explore the emergence of institutions with a special responsibility for the sick and the deviant (asylums, hospitals and clinics)â as well as âthe concept of the sick role.â In contrast, Barnes, Mercer, and Shakespeare argue that in addition to the specific concept of the sick role, attention should turn to âsocial roles and norms, and the social construction of concepts, such as disability, impairment and stigma, through which individuals are classified and regulated by the main institutions of social control.â They believe that the sociology of disability at the social level should be extended to include âthe perception of the âdisabled bodyâ itself as the product of social and cultural practices.â
It is at the third level where disability is related to the overall structure of society. For Turnerâs medical sociology, this level of analysis âconcerns the societal organization of health-care systems, their relationship to the state and the economy, and the problems of social inequality both within and between societies.â Barnes, Mercer, and Shakespeare specify their analysis to include âthe overall organization of systems of health, education and social welfare of disabled people, [and] how these link to the state, economy and social policy.â This extends to âissues of conflict and power, social disadvantage and discrimination,â as well as to the ways advantaged groups dominate and âforce or persuade weaker social groups into a subordinate position.â People with disabilities are viewed as belonging to a âweaker social groupâthat is socially dominated, with the dominant group having âaccess to disproportionate power, economic resources and knowledge.â Nevertheless, âsocial domination may be achieved by persuasion, overt control and constraint, as well as by more covert manipulation, or âideological domination.ââ At the same time, it is important to examine how far social order and relations are destabilized through individual resistance and collective mobilization.â
Barnes, Mercer, and Shakespeare seek to employ political economy models in analyzing societal responses to disability. They use neo-Marxism or materialist analysis, particularly in reference to the structural relationship between capitalism, power, and inequality. This raises specific questions about the institutional and policy links between the state and organized medicine, especially since medical practitioners âenjoy power, status and material rewards that rank them within the dominant class.â
Because of the general tendency to reduce various phenomena that are social in nature to the personal level, I will start with an examination of disability at the societal level. Then, I will discuss the individual level and the social level as one unit because both are influenced by societyâs response to disability, and because individual level responses to society are normally reflected in the immediate social context. In my view, this is a logical follow-up to what Barnes, Mercer, and Shakespeare have outlined.
Disability and the Overall Structure of Society
Joseph Stubbins once commented that âThe toughest item on the agenda of disability is that modern America has no need for most disabled persons.â This forthright statement probably exceeds what most people would regard as an acceptable critique, and while most people who work in various rehabilitation fields would label Stubbinsâs comment unthinkable, the statement does force the question, are we as good a society as we claim to be? That depends on oneâs perspective. If one has received benefits from the âsystem,â then perhaps one can develop a positive view of it and how it works. On the other hand, if a person with a disability has not received a good response in terms of understanding and service, then disappointment, even outrage are both possible and necessary. Most programs offered through the state, either directly or through agencies contracted by the state, are not designed to change societyâs attitudes and treatment of people with disabilities. Indeed, they are often engaged in making do with what is, often so as not to endanger financial support for their services.
In order to understand the systemâs offerings and benefits in larger context, both historically and presently, I will discuss four areas of action that have shaped how society has responded to disability: medicalization, education (including special education), program and supports, and disability rights.
Medicalization
Historically, industrialization and medicalization of previous centuries brought about âa significa...