The highest attainable standard of health for persons with disabilities
Disability is a global public health issue – approximately 1.3 billion people have significant disability, which is one in six people worldwide. This number is growing because of the rise and ageing of the population, and also the increased number of people with noncommunicable diseases, who are living longer and ageing with limitations in functioning.
Disability is also a human rights issue – people with disabilities are among the world’s most discriminated people, often experiencing violence, prejudice and denial of autonomy as well as facing barriers when accessing health and health-related services.
Disability is a development issue – nearly 80% of all people with disabilities live in low- and middle-income countries and disability and poverty mutually reinforce each other.
Persons with disabilities die earlier, have poorer health, and experience more limitations in everyday functioning than the rest of the population. For example, compared to persons without disabilities, many persons with disabilities:
- Die up to 20 years earlier;
- Have more than a double risk of developing comorbid conditions such as depression, asthma, diabetes, stroke, obesity or poor oral health;
- Experience more limitations in functioning. For example, persons with disabilities find inaccessible health facilities up to 6 times more hindering; and are up to 15 times more limited by inaccessible and unaffordable transportation.
- These differences often arise due to unjust and avoidable factors and conditions faced by persons with disabilities.
These factors can be:
Structural: Persons with disabilities experience stigma and discrimination in all facets of life, which affects their physical and mental health and often laws and policies may be discriminatory.
Social determinants of health: Poverty, exclusion from education and employment, and poor living conditions all add to the risk of poor health and unmet health care needs among persons with disabilities.
Risk factors: Persons with disabilities are more likely to have risk such as smoking, poor diet, alcohol consumption and a lack of physical activity. A key reason for this is that they are often left out of public health interventions.
Health system: Persons with disabilities face barriers in all aspects of the health system. For example, a lack of knowledge, negative attitudes and discriminatory practices among healthcare workers; inaccessible health facilities and information; and lack of information or data collection and analysis on disability, all contribute to health inequities faced by this group.
Disability inclusion is critical to achieving the Sustainable Development Goals and global health priorities to achieve health for all. WHO estimates that there could be almost an US$ 10 return for every US$ 1 spent on implementing disability inclusive prevention and care for noncommunicable diseases. Appropriate health services and support contribute to the full and meaningful participation of people with disabilities in society as anyone else.
Article 25 of the UN Convention on the Rights of Persons with Disabilities (CRPD) reinforces the right of persons with disability to attain the highest standard of health, without discrimination. However, the reality is that few countries provide adequate quality services for people with disability.