People with disabilities

Disability is traditionally associated with morbidity and mortality as the negative public health outcomes. Primary prevention activities addressing birth defects, developmental disabilities, injuries, and chronic illnesses associated with disabling conditions are seminal to public health. There are, however, always going to be people in the population who fall through the primary prevention net and live with disabling conditions. Public health is beginning to acknowledge the potential role it plays in promoting the health and well-being of this population. This chapter addresses the emerging field of public health and disability.

The essential public health functions of assessment, policy development, and assurance are outlined for this population across countries and age groups. The World Health Organization’s International Classification of Functioning, Disability and Health provides the framework for the conceptual and scientific issues. Clarifying definitions of ‘disability’ for purposes of public health surveillance and epidemiology, as well as research, are major emphases, including child disability measurement and caregiving or carers. Policy development emerges from the national and international conventions and activities, including the recently adopted UN Convention on the Rights of People with Disabilities, and supports the notion that the public health and disability communities have mutual responsibility for improving the health and well-being of this population. Assurance begins by asserting the relationship between poverty and disability, and includes discussion on interventions such as clinical preventive services, along with community-based rehabilitation activities.

Finally, the chapter outlines directions for public health and disability to develop more fully. Recommendations are made for improving communication, cooperation, and coordination of activities between the public health and disability communities. Curricula are coming available for the education and training of public health professionals in disability. Use of these curricula is strongly encouraged so that people with disabilities are included in public health science, programmes, and policy activities.