Statistics New Zealand (SNZ) released its 2013 Disability Survey yesterday – the first report of its kind since 2001 – and it says some interesting things about disability in New Zealand. The study’s main findings indicate that:
- 24% of New Zealanders self identified as disabled – which equates to 1,062,000 individual people
- The 3% increase in self-reported disability since 2001 can be partly explained by our ageing population
- 59% of people aged 65 or over were disabled
- 11% of children were identified as disabled by their parents
- Māori and Pacific people were over-represented in the data
- For adults, physical limitations – note, not ‘disability’ – were the most common type of impairment.
- 18% percent of people aged 15 or over, 64% of disabled adults, were physically impaired.
- For children, learning difficulty was the most common impairment type. 6% of children and 52% of disabled children ‘had difficulty learning’ (equated, in the report, to being disabled).
- Just over half of all disabled people (53%) had more than one type of impairment.
- The most common cause of disability for adults was disease or illness (42%) (note, that disability here is caused by disease or illness).
- For children, the most common cause of disability was a condition that existed at birth (49%).
A closer reading of the report shows up some other interesting findings. For instance, the population is ageing, and this is supposedly resulting in both higher rates of reported disability, and greater prevalence of multiple co-morbidities. (63% of adults over 65 report having more than one impairment). But age is a confounding variable here because 48% of children were also reported as having multiple impairments. And although percentage rates of self-reported disability among Māori and European populations were similar (26% vs 25%), the demographic profile of Māori is much younger and so if age is a factor in developing disability, we can predict that there will be suggestions of an explosion of dependence in both of these groups in the coming years.
A full set of data can be found at the Statistics New Zealand site following this link.
From a critical theory perspective, there are some things about the report that are troubling.
- Firstly, there is the persistent medicalisation of disability. SNZ defines it as ‘as long-term limitation (resulting from impairment) in a person’s ability to carry out daily activities.’ To continue conflating disability with impairment may be consistent with the approach taken in 2001, and reflect the way the public still views disability, but can it really be countenanced after years of struggle to overcome the limitations of the medical model of disability and attempts to move away from defining disability only as the result of an impairment? What happened to the work to establish a social model of disability that argued precisely that impairments are often irrelevant to a person’s meaningful engagement in a world devoid of the barriers imposed by a normalising culture?
- Then there is the tacit assumption that disability is by necessity bad or a problem. Accepting this normative judgement of disability ignores literally thousands of research studies that have shown that people neither presume that all disability is bad or that more than one kind of impairment makes matters worse (see, for example, Albrecht and Devlieger’s classic paper ‘The disability paradox: High quality of life against all odds). Of course the report does not overtly claim to make these judgements. It is a statistical report, after all, and we all know how objective and value-free statistics can be (!), but it doesn’t need to make overt claims for the ‘badness’ of disability to imply that this is exactly what is meant. Promoting a press release that states that ‘One in four New Zealanders [are] disabled‘ carries quite a different message than saying 76% of New Zealanders are not. Will health professionals take a balanced view of disability when arguing for increased funding to manage the ‘growing problem of disability’ that this report promotes? I think not. The report is exactly what’s needed if you want to push for more funding, but in doing so whose interests are being served and whose rights are being marginalised, again?
- Speaking of which, there also the problem of the ongoing quantification of a deeply human phenomenon. What harms are done to our appreciation of the nuances and subtleties of disability: its good and its bad sides; its variation among people with different socio-cultural and lived experiences; and its significance as a phenomenon that speaks volumes about our attitudes to diversity and inclusiveness in society, when we reduce the full breadth of this experience to the level of incidence and prevalence rates? Are the 2% of people reported as having an intellectual impairment suitably grouped together? Are they all of the same ilk? I think not. As a physiotherapist, I have always known that each of my patients is unique. Why then should I suspend this belief for the lazy convenience of thinking about all people with mobility impairments (10%) as the same?
On the surface, the report purports to tell us a great deal about the growing ‘problem’ of disability in New Zealand. But I suspect what it really does is to offer the veneer of objectivity and the allure of transparency, while all the time concealing more than it reveals. We should be very skeptical about this kind of data and look beyond the simple slogans and press release headlines. Disability is not universally understood – despite what the report would have us believe – and we should be careful implying that it is either bad or a problem to be fixed.
Albrecht, G.L. and Devlieger, P.J. (1998). The disability paradox: High quality of life against all odds. Social Science & Medicine 48, 977-988.