WHO updates fact sheet on Disability (2 December 2015)

The World Health Organization (WHO) has updated its fact sheet on disability.

Background information:

The International Classification of Functioning, Disability and Health (ICF) was developed through a long process involving academics, clinicians, and – importantly – persons with disabilities.

The ICF emphasizes environmental factors in creating disability, which is the main difference between this new classification and the previous International Classification of Impairments, Disabilities, and Handicaps (ICIDH).

In the ICF, problems with human functioning are categorized in three interconnected areas:

impairments are problems in body function or alterations in body structure – for example, paralysis or blindness;
activity limitations are difficulties in executing activities – for example, walking or eating;
participation restrictions are problems with involvement in any area of life – for example, facing discrimination in employment or transportation.

Disability refers to difficulties encountered in any or all three areas of functioning.

Key Messages:

Disability is the interaction between individuals with a health condition (e.g. cerebral palsy, Down syndrome and depression) and personal and environmental factors (e.g. negative attitudes, inaccessible transportation and public buildings, and limited social supports).

Globally, more than 1 billion (1 in 7) people are estimated to experience disability. This corresponds to about 15% of the world’s population.

Disability is extremely diverse. While some health conditions associated with disability result in poor health and extensive health care needs, others do not.

However, all people with disabilities have the same general health care needs as everyone else, and therefore need access to mainstream health care services.

People with disabilities have greater unmet needs: a recent survey of people with serious mental disorders, showed that between 35% and 50% of people in developed countries, and between 76% and 85% in developing countries, received no treatment in the year prior to the study.

People with disabilities are especially vulnerable to deficiencies in health care services. Depending on the group and setting, persons with disabilities may experience greater vulnerability to

secondary conditions (pressure ulcers, urinary tract infections, pain)
co-morbid conditions (diabetes in people with schizophrenia)
age-related conditions (premature ageing in some people with developmental disabilities)
engaging in health risk behaviors (smoking, poor diet, physical inactivity)
higher rates of premature death (mental health disorders, intellectual impairments)

People with disabilities encounter a range of barriers when they attempt to access health care including

Prohibitive costs: Affordability of health services and transportation are two main reasons why people with disabilities do not receive needed health care in low-income countries
Limited availability of services: Research shows that after the cost, the lack of services in the area was the second most significant barrier to using health facilities.
Physical barriers: Uneven access to buildings (hospitals, health centres), inaccessible medical equipment, poor signage, narrow doorways, internal steps, inadequate bathroom facilities, and inaccessible parking areas create barriers to health care facilities.
Inadequate skills and knowledge of health workers: People with disabilities were more than twice as likely to report finding health care provider skills inadequate to meet their needs, four times more likely to report being treated badly and nearly three times more likely to report being denied care.