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Towards Understanding Disability – Sociology and Models of Impairment

Understanding and conceptualizing disability and impairment is crucial to the modern pursuit of social justice and therefore, is essential to academic study and sociology in general. The social sciences hold tremendous potential for bringing about true inclusion and total diversity to the world at large; however, this potential has not historically been fully realized, particularly in the areas in which discussion and debate of difficult social topics would have been most appropriate. Indeed, comparatively little attention has been devoted to disability or people with disabilities as a group.

Disability - Sociology and Models of Impairment

            This oversight has been a harmful exclusion of a vulnerable population that has been ignored, if not silenced, for far too long. Not only does this oversight cause harm and results in drastic underrepresentation of people with disabilities in society’s academic literature, it makes little in the way of logical sense, purely on the basis of what percentage of persons are affected. For example, the World Health Organization noted that an estimated 1.3 billion people worldwide experience significant disability, the equivalent of 16% of the total population, and roughly 1 in every 6 persons, (2023). When only looking at the United States, those numbers increase to 27% or 1 in every 4 people, (Centers for Disease Control and Prevention, 2023).

            Although defining both terms are complex, disability is generally defined as “any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them,” (Centers for Disease Control and Prevention, 2020), resulting in impairment, activity limitation, and participation restriction; impairment refers to a person who experiences physical, mental, or emotional difficulty resulting from the loss of or diminished capacity of one’s body functioning or significant difference in body structure. Activity limitation refers to how the disability limits one’s activity, whether that be in seeing, hearing, thinking, or ambulating (moving). Lastly, participation restrictions refer to one’s reduction of ability or complete inability to engage in routine activities of daily living and functioning.

            Each of the aforementioned terms fits under the greater umbrella of disability and comprise, what few will contest and most will quickly confirm, possibly one of the largest of societies’ minority groups. Appropriately, a minority group may thus be defined as “a group living within a society that is disadvantaged in terms of power, control of their own lives, and wealth,” (Hammond et al., “Minorities and Dominant Members of Society” in ‘Chapter 11 – Race and Minority’ 2020). By this definition, people with disabilities, impairments, and limitations may constitute one of the largest minority groups.

This status grants them susceptibility to prejudice – “an unjustified or incorrect attitude (usually negative) toward an individual based solely on the individual’s membership in a social group,” (Mcleod, 2023) – and discrimination – the unjust and unfair prejudicial behavior that results in differential (often poorer) treatment of a person or group based upon certain characteristics the discriminator finds undesirable. Unfortunately, people with disabilities have, and continue to be, very vulnerable to marginalization as well, particularly in reference to their identity (or identities); it is defined as “the purposeful mistreatment of minority group members that yields them geographically part of the society while simultaneously being functionally left out of most of its opportunities,” (Hammond et al., “M” in ‘Chapter 21 – Glossary of Terms’ 2020).

Tragically, society has seen to it that the disabled population regularly experiences significant social disadvantages that places individuals in poor socioeconomic circumstance. For example, people with disabilities have a higher unemployment rate than the average and they are more likely to suffer from poverty and poor health service accessibility. Thorough examinations of social institutions reveal ableism (prejudice and discrimination based on one’s ability) and ableist standards pervading our culture.

Academic studies such as sociology have become known as the study dedicated to social justice; as such, the study of disability is well within the domain of sociologists and sociological scholars. In a certain light, the very promise of sociology and the sociological imagination may be seen as uniquely appropriate to understanding and conceptualizing disability; in the words of C. Wright Mills, possessing and utilizing one’s sociological imagination results in what could be considered its first fruit: “the idea that the individual can understand her own experience and gauge her own fate only by locating herself within her period, that she can know her own chances in life only by becoming aware of those of all individuals in her circumstances,” (Mills, 1959).

Considering the fruit of this sociological imagination, it seems rather unjust to seek to deprive anyone of the understanding that this view provides. In a study of social justice, it is simply not reasonable to do so. When discussing society’s many injustices and social problems, we must acknowledge that a social problem exists surrounding the public’s understanding of disability that instigates the issues of prejudicial attitudes and discriminatory behavior aimed at the already- vulnerable of our population.

In order to attempt understanding and conceptualize the meaning of ‘disability,’ we conventionally resort to the use of models, as we do to make sense of many phenomena in this world. Only after examining and shifting the focus onto disability as a subject for academic and personal research will we be able to engage in the complex problem solving that is needed to rectify social wrongs perpetuated by ignorance of knowledge and experience of people with disabilities.

This paper explains the basic framework to six of the many models of health and disability that have been identified. The basic message of each will be conveyed and I may offer my own personal opinions or comments on each, but please be mindful of the fact that delving into deep and intense analyses of each of these models is beyond the scope of this paper; as such, you are encouraged to further delve into topics and models that interest you on your own.

Of the most common models you will find featured in sociological research, you will no doubt come across a discussion of the medical and social models of disability; each of which are detailed below.

The medical model regards disability as a result of an illness or otherwise significant medical event or deformity. The impairment is perceived as a defect or failure in ‘normal’ bodily functioning; therefore, people with disabilities are looked on as abnormal. It is seen that the overall goal is to cure, fix, or reduce the sources of malfunction in a person, so that their body may function the same as that of a person who does not have a disability. This view dominated the United States in the mid- twentieth century and is currently held by many healthcare and service professionals, (Olkin, 2022; University of California, San Francisco; Olkin, 2002).

Although the medical model certainly can be beneficial in some cases, such as when someone’s disability is able to be eliminated through treatment and suffering could then be reduced, strict adherence to the model can be quite damaging when applied indiscriminately. For instance, consider someone with a chronic or terminal illness or a disorder that modern medicine cannot yet cure. If they are made to feel as if their existence itself is an aberration and one that severely disadvantages them when compared with other people, the acceptance of this model could very well be a major detriment to their mental health.

From a sociological point of view, I think of the medical model as aligning with the functionalist perspective, whereas the social model seems reminiscent of both the conflict theory and symbolic interactionist perspectives. The social model regards people with disabilities having been disabled by their environment, not their specific medical condition. It distinguishes between an impairment and a disability; the impairment is their particular medical condition or state, while the disability is caused by society’s ableism and inaccessibility. The significant problem is that “the interaction between functional limitations or impairments and physical and social barriers to full participation create disabling environments,” (University of California, San Francisco).

Under this model, disability is seen as a social construct and the goal is to change the environment to make it more accommodating and accepting rather than seeking to rectify some flaw in a person’s character or biology. This view originated fairly recently in 1975 as supporters were lobbying for the passage of the Rehabilitation Act and is much more inclusive; policymakers are people that may take this view, (Olkin, 2002). To this, I would add that this model is one through which anyone can attempt to understand disability; it’s a lens that celebrates diversity!

Though it is indeed difficult to think of many disadvantages to adopting the social model of disability, a significant one is when one’s impairment could be aided, their condition could be improved, or they might otherwise benefit from medical attention. That is, if one were to entirely embrace this perspective, any potential chance for bettering their medical state would be overlooked.  However, if on the other hand, one was completely to adopt the medical model, the societal barriers of ableism may, too, be overlooked.

The medical and social models are definitely the two perspectives most addressed in academic literature, but I have come across others in my own research. Originally, the goal of this essay was to describe most or all of the models briefly, but it became clear quite quickly that this was not a possible task. There are too many models that have contributed to the literature on disability to cover in such a brief paper; however, I have taken the liberty of compiling a list of other models that I came across in my research and was unable to describe here. Please don’t forget to check them out at this article’s conclusion!

Though this compilation is by no means complete, my hope is that this article piques your interest and helps you to learn about a model that you had not heard of before. Each is briefly described below, although they merit further additional research; this is meant merely as an introductory essay to get you thinking.

The ‘moral’ model of disability sees disability as having occurred as a form of reward or punishment for either moral or immoral behavior and having been imposed by a supreme authority, such as God. Through this lens, impairment carries stigma, shame, and judgement – an amount that can be so severe as to encourage a person to attempt hiding their disability or others seeking to hide the person with disabilities from sight. This view is the oldest in existence and still pervades our culture, (Olkin, 2022). I can personally attest to its prevalence.

Sample statements reflecting the persistent and unfortunate belief in this model include the paternalizing statement of “God only gives us what we can handle,” or the idea that someone was specifically chosen to have their disability because they were best equipped to handle it. Both the aforementioned statement and idea are ones that I find to be equally offensive and quite untrue. This model is incompatible with a society valuing disability and completely ignores the incidence of any medical occurrences.

For instance, statistics often note that a disability could affect any one of us – each of us are one day, one accident, one significant event away from being disabled ourselves. Indeed, much of the elder populations live with a disability. So, from this logic, disability can strike at random, which is a statement at odds with the idea of being ‘chosen’ at all. Furthermore, as an impairment often carries with it a certain amount of suffering, the very notion of being ‘chosen’ seems tantamount to punishment.

Many religious texts regard a higher power (i.e. God) as being kind, compassionate, and merciful, yet what could be a crueler punishment than electing to give somebody an impairment that serves to complicate one’s quality of life? Additionally, this requires that assumptions be made (one should never assume). For example, what if they’re not a Christian (I use this example because this idea condones ‘Christian charity’ and the model may have even originated from Christianity)? What if the person does not worship the same god as the commenter does? How would this view logically follow? What if they don’t believe in a god at all (atheist) or question the existence of one at all (agnostic)?

Showing belief in this view can and does harm the experience of people with disabilities. I have seen it myself. Ill treatment can result in shame, even if that may not be the intention. This so-called ‘moral’ model views disability as a form of divine punishment or a novelty and has blurred the lines of etiquette; it has complicated the communication between people of different abilities. Even viewing disability a certain way can cause significant emotional damage and trauma.

As a personal example (yet unfortunately one that I’m sure has been shared by many others), I have been in the store, just minding my own business and shopping for groceries with my walker – getting from place to place the best I can and feeling rather proud of myself to be doing such so independently in a local grocery store – when multiple strangers have approached me, looked me in the  eyes, and assured me “God loves you.” On the surface, this is not a particularly offensive statement to make, but it also implies that ‘this happened for a reason’ or that my quality of life has to be so small that the speaker could not possibly live the same way, which carries the further inference that someone would rather give up their life rather than live in the same position as me.

Oftentimes, it is clear that the speaker does not mean these comments in an offensive way, which makes it feel wrong to get angry at them for having said something so insensitive. That’s the sad part – people don’t always look on the impaired with empathy; they look at them with sympathy (there is a notable difference between empathy and sympathy). They don’t realize that what they’re saying is insensitive because this view is so deeply engrained in public consciousness. That, and few, in reality, think about what experience the other person is having.

The speaker didn’t consider that I could have been nervous about being in such a public space surrounded by so many people where I would be (even for a brief moment) the center of attention or that I could be having a really good day because I conquered my fears by shopping in a public space; they never considered that, after I was trying to go about my day and maybe put my disabilities out of my mind for a few seconds, I might not want to be reminded that my vulnerabilities are so obvious that strangers feel the need to voice their pity for me. Why, oh why, did they feel compelled to dispense such patronizing statements?

This leads me to wonder – why have we developed so many spoken and unspoken rules for etiquette that our society employs for talking to other people, and yet throw out any that would respect common decency when talking to people with disabilities? But I digress…

Unfortunately, mine is just one of the negative experiences that result from widespread adoption of the moral model of disability. In my view, this is perhaps due to a lack of knowledge and awareness surrounding disability and profoundly displays the lack of perspective-taking and empathy toward people with disabilities that has come to pervade modern society.

The eugenics model may be seen as somewhat like a more perverse and extreme offshoot of the medical model’s perspective on disability. Both models identify disabilities as impairments to functional living; however, the eugenics model poses a much more insidious agenda for ‘fixing the problem.’ Where the medical model seeks to address and reduce disability by attempting to use cures for physical ailments, eugenics seeks to rid the world of people with disabilities through practices such as forced sterilization and co-erced birth control practices, (Ralph, 2017).

In this model, the disabled are regarded as unfit, inferior, undeserving, and a drain on society. This thinking was evidenced in the mass killings of minorities and people with disabilities in the Nazi Holocaust. Although it has become public knowledge that this approach was highly unethical and very discriminatory, subtle elements of this model continue to exist by fueling constant stigma and stereotypes of marginalized communities. Indeed, much debate around social issues in the country remind us that these malevolent views continue to serve as a detriment to the quality of life of many.

Society now outrightly condemns such explicit attempts at discrimination as eugenics, but there continue to be informal norms and attitudes that are informed by the same ideologies.

The inspirational and religious model views disability in relatively the same light as the moral model, asserting that people are given disabilities as an act of God; this can take the forms of either viewing people with disabilities as having been touched by God, being in direct communication with Jesus Christ, or being supremely gifted or looking at them as though they incurred their disability as divine punishment for their sins. Under this model, these individuals may be viewed as ‘inspirational.’

On the surface, being called ‘inspirational’ is not necessarily a bad thing – but this can lead to what disability activist Stella Young termed ‘inspiration porn,’. An internet blogger aptly defined inspiration porn as follows; “it refers to idolizing disabled people for very basic tasks, or even nothing at all– just for existing,” (Yarborough, 2021). This phenomenon led to Young’s commonly-quoted proclamation “I am not your inspiration,”.

Along the same religious lines, the tragedy and charity model exist. I think of this as the social follow-up to the inspirational or religious and the moral model. Perceiving people with disabilities leading lives of tragedy and being needy recipients of religious Christian charity is what happens when society internalizes moral or religious views of disability. The tragedy and charity model is very harmful to society as a whole. One could also go so far as to assert that this line of thought is also uniquely dangerous, because it is often cloaked in a sense of compassion toward the less fortunate.

Most people would not feel comfortable to approach someone that they viewed as being in a less fortunate position than them and basically vocally acknowledge to that person that their life is seen as a tragedy; however, these regularly occur for the disabled community. For some inexplicable reason, people abandon rules of conversational etiquette when in the presence of persons with disabilities.

Fortunately, people’s willingness to understand and the various lenses through which they have begun to examine disability as a phenomenon worthy of study are increasing. Progress is slow, to be sure, and indeed, is slower than it should and could be, but any activity or study where one can dedicate oneself to true social justice, promote diversity, and encourage inclusivity is a worthwhile endeavor.

In stark contrast to some of the rather discriminatory and disparaging models that have been discussed, the affirmation and identity model seeks to portray disability in a relatively positive light. Like the social model, disability is viewed as somewhat of a social construction, yet only insofar as disability becomes thus “primarily defined by a certain type of experience in the world – a social and political experience of the effects of a social system not designed with disabled people in mind,…”, (Brewer et al., 2012).

In spite of this thinly veiled critique of modern society, this model reassures us that all is not lost. It does not dwell on the negative or the many ways people with disabilities are further disabled by cultures, norms, or societies, but remains “more interested in forging a positive definition of disability identity based on experiences and circumstances that have created a recognizable minority group called ‘people with disabilities,’ (Retief & Letšosa, 2018).

The model goes on to portray disability as an identity of minority group status, but notes that it uniformly remains a positive identity. It is important to note that disabilities and impairments are viewed in a positive light and not one that could be construed as unaware. This model is perhaps most encouraging and conducive to equity. This places emphasis on what a person can do and not on what they can’t or aren’t able to.

This lens values (positive) participation, in all of its forms. It acknowledges the contributions that we can all make. While we are unable to guarantee results, we can and should do all that we can to give everyone the opportunity to make a difference in the world at large or in their own world. People’s efforts to do good things are to be encouraged and appreciated; they should not be limited by the one-dimensional constraints that we put on ourselves.

This paper has described and elaborated on six models for understanding and conceptualizing disability. I hope that my summaries and opinions of them have informed you – maybe even taught you something new or given you something to think about. Please conduct your own research on models and lenses through which to view disability. I have compiled some into a short list for your reference.

  • The biomedical model
  • The biopsychosocial model
  • The customer and empowering model
  • The diversity model
  • The economic model
  • The expert and professional model
  • The human rights-based model
  • The interface model
  • The functional model
  • The legitimacy model
  • The limits model
  • The market model
  • The minority model
  • The radical model
  • The rehabilitation model
  • The relational model
  • The social adapted model
  • The spectrum model

As is illustrated above, there are models to aid in understanding and conceptualizing disability; there are many more than this essay can possibly account for. Nevertheless, familiarizing oneself with them is a good way to attempt to understand society’s social problem when it comes to truly understanding the trials and travails of the life led by people with disabilities and those who love them.

Also Read:

The Very Significant, Yet Underrepresented Social Problem of Disability Representation in Media and Film

Deviance, Disability, and Anomie

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