Contribution To Disability Research Articles

Temporal decomposition of life years lived with disability in India: a growing demographic concern

BackgroundTo draw optimal benefits of the demographic dividend, healthy life years of the young adults is a growing concern in India. Rising prevalence of chronic non-communicable diseases among the younger population is responsible for increasing the life years lived with disability among them and for affecting their productivity in turn. This study measures the disability burden in various Indian sub-populations and assesses the contribution of disability to the change in person years lived with a disability during 2001–11.MethodsData from the Census of India, 2001 and 2011 was used for estimating the age distribution and disability prevalence among males and females. The Sample Registration System was used for age-specific mortality rate to calculate the life table for 15 states in India. Life years Lived with Disability (LLD) were estimated using the Sullivan method. The extension of Arriaga method was used to decompose change in life years lived with disability into Mortality and Disability Effect (ME and DE, respectively). Positive ME explains improvement in life years due to decline in mortality rate and a negative DE explains a decline in disability incidence in 2001–11.ResultsAt national level, the disability prevalence has increased from 2001 to 2011. The prevalence of disability and the share of LLD to Life Expectancy (LE) is higher for males. High and medium fertility states scored highest on living with disability to LE ratio and measured DE in the decomposition analysis. At the national level, the DE increased in the age groups of 20–35 years. It was higher among the females. The states that are in the advanced stages of demographic transition show a negative DE.ConclusionThe study highlights expansion of DE in prime productive years of life, especially among females, in medium and high fertility states. Decline in skilled employment and productivity can be two major economic adversities due to increasing DE in working ages. Disability among young and working age population needs to be prioritised as most of the Indian states stand at crucial stages of demographic transitions.

Theological Accessibility: The Contribution of Disability

Religious institutions and communities that have embraced the cause of disability have invested a great deal of energy in struggles against architectural barriers, including the elevated pulpit. Valuing this engagement but also recognizing that access to physical space is only a first step in a project of accessibility, this paper claims that it is time to open the entire breadth of religious traditions to an "accessibility audit." Not only does such an examination highlight potential barriers — challenges of scripture and metaphor, for example — but it also suggests new theological possibilities in which disability is not simply a consumer or an evaluator of tradition but rather a constructive element that offers new options for theological reflection. This paper briefly reviews the disability theology models that have been offered to date (the Accessible God by Jennie Weiss Block, the Inclusive God by Kathy Black, and the Disabled God by Nancy Eiesland), highlighting ways in which these proposals make significant contributions to the breadth and depth of Christian theological reflection. This analysis shows that the value of disability theology is confined neither to people with disabilities nor to the arena of religion, but rather, as has been the case with other liberation theologies, has the potential to affect wider worlds and fields of study as well.

Another way to look at high service utilization: the contribution of disability

High users of health services are usually identified in terms of their health complications stemming from the coincidence of a number of chronic conditions. Instead, this analysis attempts to characterize high users in terms of disability, based on the belief that disability provides a more detailed and accurate representation of functional needs and health consequences. The study compares the characteristics of high users of health services among Canadian adults (aged 20-65) with those of low to moderate users and non-users. Secondary analysis of data collected for the National Population Health Survey, a cross-sectional public-use population-based national survey, conducted in 1998-99. No matter how disability is conceptualized and measured, it has the strongest association of all the variables considered with health service utilization. Whether looking at the simple presence of a disability or at specific impairments or activity restrictions, there is at least a two-fold increase in the risk of high use over the non-disabled. The present study challenges the clinical wisdom that high users should be the target for efforts to reduce the overall consumption of health services. Many high users consume on the basis, not of choice, but of need rooted in disability. Moreover, when compared with low or moderate service users, their clinical condition is exacerbated by social factors, including lower income, less education and less immediate family support. Equity cannot be achieved by focusing on reducing consumption by this clinically and socially vulnerable group.

Theoretical and Applied Issues in Defining Disability in Labor Market Research

The contribution of disability to labor market behavior is a subject of considerable attention. Notwithstanding this tremendous interest, a great deal of variation exists in the use of terms such as health, impairment, and disability. Consequently, comparing results across studies is often difficult, and the impact empirical research can have on policy making is diminished. This article outlines the conceptual issues involved in defining disability, reviews definitions of disability commonly used in empirical labor market research and by policy makers, examines the problems that accompany the use of the various methods, and offers some thoughts for future work in the area of defining disability.