By Harlan Hahn, University of Southern California (1987)
Among the issues that form the current agenda of political debate, perhaps few offer as much promise for achieving significant political change as the development of public policy affecting disabled Americans. Emerging from a legacy which commonly regarded disability either as a depressing topic to be avoided whenever possible or as a minor component of other policy issues, public leaders now have the opportunity to acquire a new understanding of this subject which embodies viable prospect of resolving crucial problems that confront disabled citizens. Most existing policies appear to be based on erroneous assumptions about the nature and meaning of disability. A reevaluation of the question, therefore, offers a rare chance not only to correct prior mistakes but also to establish the foundation of a society adapted to the concerns of disabled as well as nondisabled persons.
A major basis of the hope for changes in public policy can be traced in an important shift to prevalent definitions of disability (Hahn, 1982). In the past, disability was defined almost exclusively from a medical perspective which focused on functional impairments. Disability was considered a defect or deficiency that could be located within the individual, and primary emphasis was devoted to the etiology or causes of organic conditions that permitted persons of different types of disabilities to be placed in separate diagnostic categories. From the clinical perspective of medicine, efforts to improve the functional capabilities of individuals were regarded as the exclusive solution to disability; and policy changes were essentially excluded from consideration as a possible remedy for the difficulties confronting this segment of the population. As a result, the issue of disability not only was depoliticized, but the preoccupation with etiological diagnosis also fragmented the disability community by stressing the functional traits that divided them rather than the external obstacles which they faced as a common problem. Groups representing the interests of disabled persons were organized around separate diagnostic categories, and few attempts were made to form alliances or coalitions that might facilitate the emergence of a broad social and political movement of citizens with various types of disabilities.
Subsequently, as a result of legislative decisions, disability was viewed primarily from an economic vantage point which concentrated on vocational limitations. This approach implied that disability was defined as a "health-related inability" or limitation on the amount or kind of work that a person could perform (Berkowtiz, Johnson, and Murphy, 1976:7-8). Although the assumptions of this orientation appear more appropriate to an economy based on manual labor rather than on the delivery of services or on sophisticated technology, the economic definition has been widely adopted in income maintenance and support programs which seem to equate disability with unemployability, or an "inability to engage in substantial gainful activity." By focusing on the capacity to work almost at the expense of other life activities, this approach not only is unidimensional; but it also makes some unwarranted and untenable assumptions about the linkage between impairments and productivity. Hence, policies founded on an economic perspective have been criticized (Hahn, 1985 6:13) for tranforming disabled people into an "economically managed but politically vulnerable segment of the population."
Increasingly, however, laws and regulations adopted in the nineteen-seventies permitted the formation of a socio-political approach which considers disability as a product of the interaction between the individual and the environment. Wheras both prior orientations regard disability principally as a personal misfortune or limitation, the latter view stresses the role of the environment in determining the meaning of this phenomenon. Thus, disability cannot be defined simply by functional capabilities or by occupational skills. A comprehensive understanding of disability requires an examination of the architectural, institutional, and attitudinal environment encountered by disabled persons. From this perspective, the primary problems confronting citizens with disabilities are bias, prejudice, segregation, and discrimination which can be eradicated throught policies designed to guarantee them equal rights.
The disparity between these concepts underscores the fundamental fact that disability is ultimately defined by government policy. In other words, disability is essentially whatever public laws and programs say it is. Policy can be informed by research based on medical, economic or socio-political understandings of disability; but responsibility for deciding the definitional issue eventually must be vested solely in elected officials. The relatively broad description provided political leaders in choosing between alternative means of conceptualizing disability yields in important opportunity to introduce major changes in public policy. Yet, since politicians are accountable for their actions, the success of these efforts eventually may be determined by the extent to which researchers and the general public also are able to reach agreement about these definitions
Perhaps the most generally accepted definition of disability is Nagi's (1979:3) concept of "a form of inability or limitation in performing roles and tasks expected of an individual within a social environment." Yet, each of the prevalent theoretical perspectives seems to stress different terms within this definition. Whereas the medical orientation emphasises inabilities in individual performance, the economic approach focuses on individual limitations in performing the roles and tasks associated with work available in the labor market, and the socio-political view devotes primary attention to the social environment and to the notion of "expectations," which can be adapted to fit the capabilities of the individual rather than requiring all persons to adjust and conform to the demands of the economic or built environment. Policy makers have a relatively wide range of research traditions from which they can select the components of any definition of disability that is incorporated in public policy. But these decisions cannot be divorced from normative considerations. In fact, the common acceptance of the values implicit in the medical and economic viewpoints has appeared to have detrimental effects on disabled Americans. A major purpose of this paper, therefore, is to develop a case for the benefits that can be derived from policies founded on a socio-political understanding of disability. Rather than concentrating on the criticisms of earlier medical and economic theories, however, this study seeks to demonstrate the advantages to the latter approach to problems facing citizens with disabilities.
The differences which must be resolved before important contributions can be made to the formulation of disability programs, however, extend beyond mere definitional controversies. Fundamentally, the analysis of disability appears to be divided by competing paradigms (Hahn, 1984 a). The traditional framework for assessing the problems of disabled persons, which might be called the "functional limitations model," centers on restrictions imposed upon an individual by the loss of personal capabilities. Both the medical and economic definitions appear to be compatible with this approach. Although research has increasingly demonstrated that the employment opportunities available to disabled people are determined more by the state of the economy than by their vocational talents (Howards, Brehm, and Nagi, 1980), for example, emphasis in vocational rehabilitation program still focuses primarily on the individual rather than on the environment. The principal solution to the difficulties encountered by disabled individuals is sought through programs to improve their physical and work skills rather than by attempts to secure changes in the society with which they must cope.
Recently, however, the conventional orientation has not been challenged by a new theoretical perspective which builds on the socio-political definition.
This framework could be described as the "minority group model." This approach views prejudice and discrimination as the major issues confronting citizens with disabilities. Although the new paradigm is consistent with a socio-political understanding of disability, there appear to be some fundamental incompatibilities between the "minority group model" and the medical or economic conceptualizations. Since the primary source of the problem can be traced to defects in what might be termed the attitudinal environment of society rather than to personal deficiencies, the solution cannot be achieved solely by seeking continuous improvements in the functional and occupational capacities of disabled individuals. Instead, the eradication of bias and segregation requires extended efforts to secure equal rights for disabled citizens and the righteous enforcement of antidiscrimination measures.
There are obviously many issues which divide the "functional limitations" and the "minority group" models. While the former paradigm reflects the emphasis of medical and economic perspectives on individual performance on employment or in other activities of daily life, the latter model focuses attention on the extent to which the environment is a product of collective decisions or nondecisions by the public and political leaders that have a different impact on the members of society. Basic to the "minority group" approach is a recognition that all aspects of the external world - including architecture, communications, and social organization - are shaped by public policy and that policies are a reflection of pervasive cultural values and attitudes. Structures are built, messages are transmitted, and institutions are created primarily because laws, ordinances,and regulations permitted them to be constructed in that manner. As a result, governments bear an inescapable responsibility for those facets of the environment that have a discriminatory effect on persons with disabilities. Furthermore, evidence of widespread aversion to the presence of disabled individuals cannot be separated from the values and feelings that have contributed to the formation of social policy. Hence, if institutions allow the nondisabled majority to avoid and to exclude people with disabilities, that result cannot be attributed to mere happenstance. This realization also imposes a corresponding duty on policy-makers to protect the civil rights of disabled citizens by eliminating this form of segregation and inequality.
Major responsibility for the emergence of the "minority group model" probably can be ascribed both to increased studies of disability, especially in the social sciences, and to the growing strength of the social and political movement of disabled persons. Although the recognition that disabled citizens comprise a minority group in American society has been acknowledged by researchers for several decades, the concept did not become a focal point for the appraisal of disability until recent years. By failing to explore the theoretical assumptions that formed the basis of their investigations, academicians and activists often have found it difficult to engage in a meaningful dialogue about disability. Perhaps the basic discrepancies between the "functional limitations" and the "minority group" models must be resolved before additional progress can be made. Since the latter perspective may be less familiar than the former approach, this paper examines some of the major dimensions of the new paradigm which views the problems facing disabled citizens as an equal rights issue. The clarification of this alternative seems essential to fulfillment of the hope for significant advances in laws and programs affecting persons with disabilities.
In addition, the adoption of the "minority group model has important judicial and constitutional implications. In the legal tradition spawned by "equal protection" clause of the Fourteenth Amendment to the U.S. Constitution, courts have been loath to uphold the constitutionality of laws require differential treatment for separate categories of persons when at least one of those groups has been subjected to a history of invidious discrimination. Hence, legislation that mandates unequal status for black and white citizens probably would be declared unconstitutional; and a similar conclusion might be reached concerning policies that treat women and men in a different manner. Yet, despite the fact that numerous statutes and regulations impose significant burdens on disabled Americans and corresponding advantages for the nondisabled majority, judges have been reluctant to arrive at a comparable finding when they are confronted with cases involving disability. Much of this reticence undoubtedly can be ascribed to the widespread failure to acknowledge that disabled persons form a minority group in American society and to the relative absence of a substantial body of research literature which examines their problems from this perspective. Even though members of the judiciary often hesitate to admit that their opinions are influenced by studies in the social sciences, there is little reason to doubt that their decisions are affected by the information which they receive about issues such as disability not only in the mass media but also during their academic training. Thus, educational efforts that seek to explain and to clarify the analogies between the status of other minorities and the treatment of disabled citizens can contribute significantly to the struggle of the latter group for freedom and equality. While studies founded on the "functional limitations" paradigm have not appeared to result in major advancements in the civil rights of disabled Americans, research based on the "minority group model" offers the promise of strengthening the position of the disability rights movement in the courts as well as in other branches of the political process.
There are, however, many different groups which must be involved in the process of seeking agreement about solutions to the major problems of people with disabilities. Disabled persons may not always agree among themselves about these questions. Similarly, important sources of disagreement might be discovered among professionals and other nondisabled individuals interested in disability. While the general public still appears to regard disability primarily as a personal misfortune rather than as the basis of a new struggle for civil rights, major modifications of these attitudes and of the provisions of public policy seem to depend upon gaining some consensus between significant participants in the decision-making process. In the past, discussions of this subject frequently have been clouded by paternalistic expressions of sympathy and support by the nondisabled for the aspirations of disabled persons. The primary goal of this paper, therefore, is to examine crucial areas of agreement and disagreement about the "minority group model" both within and between disabled and nondisabled segments of the population. Although the endeavor is admittedly speculative, it is hoped the analysis will contribute to an enhanced understanding of major issues which must be resolved before an agenda for the reformulation of disability policy can be developed.
Disability and the Environment
Perhaps one of the most critical issues which separates the contrasting paradigms is the role played by individual and environmental characteristics in shaping the problems that face disabled persons. Since concern about disability originated primarily in the health sciences, many early studies of this subject in medicine and rehabilitation displayed a clinical orientation which reflected on almost exclusive preoccupation with improving the functional capacity of an individual. The surrounding environment was regarded as either fixed and immutable or as beyond the legitimate preview of investigation. Gradually, however, many professional have begun to recognize that environmental changes such as the removal of architectural barriers or modifications of the worksite can contribute to an amerioration of the difficulties of people with disabilities. As a result, the socio-political definition of disability as a product of interactive features of the individual and the environment has gained increasing support from nondisabled observers as well as among disabled persons who experience the restrictions imposed by an unyielding environment in their own lives. Examples of the growing consciousness of environmental constraints by people with disabilities could be enumerated almost endlessly. Many persons who use wheelchairs have begun to realize that they habitually follow routine paths in their everyday lives and that they are compelled to forego the choice of visiting locations which are inaccessible or blocked by architectural barriers. Similarly, individuals with vision or hearing impairments are seeking alternatives to an exclusive reliance on written or oral communications as a means of obtaining the information necessary to perform their jobs and to pursue a satisfying life. As computers and sophisticated technology permit meaningful activity even for people with severe functional limitations, the recognition of the role of the environment in the definition of disability seems almost certain to increase significantly. Perhaps the principal controversies concerning this issue, however, continues to revolve around the relative importance of the environmental or individual attributes in problems associated with disability and the type of environment which is the primary source of the difficulty.
The respective weight attached to individual and environmental characteristics in the assessment of disability can be arrayed across broad spectrum. At one end of this range, environmental configurations might be perceived as a relatively minor aspect of the problem. While studies guided by the "functional limitations model" of disability sometimes acknowledge the need for changes in the environment, for example, this objective usually is treated as secondary to the goal of improving personal capabilities. At the other extreme, the environment could be considered as the principal or even the sole determinant of disability. From this perspective, the difficulties encountered by disabled persons may be viewed as arising not from functional losses sustained by an individual but from the attitudinal and physical constraints created by a disabling environment. While supporters of the "minority group" paradigm generally ascribe greater significance to environmental than to individual traits and the followers of the "functional limitations model" display opposite proclivities, the precise value that would be assigned to each of these considerations probably reflects some as yet unspecified point between the two poles which can only be identified through further research.
The notion of a "disabling environment" encompasses both physical and attitudinal obstacles to full participation in society. Attitudes restrict opportunities even more blatantly than physical barriers. There is a link between the two types of obstacles; if evidence demonstrate a deep-seated and pervasive antipathy or aversion toward people with disabilities, the restrictions imposed by the built environment and by social institutions cannot be considered simply accidental or coincidental.
The controversy over individual vs. environmental attributes may be shaped both by the theoretical orientations of different observers, and by the limits of human imagination (Hahn, 1985 a). Some find it difficult to conceive of an environment which is adapted to the needs of everyone, including people with a variety of disabilities. For others who glimpse the vision of a future that encompasses vast technological change and a massive restructuring of human habitats, the design of such physical surroundings might seem possible and even feasible. Still others are able to foresee a potential world of this nature, with some exceptions for functional capacities which cannot be ameliorated through environmental modifications. Perhaps many at least can envision a society that might accomodate a broader range of human capabilities than the present environment. As noted elsewhere (Hahn, 1984b:24-25), even these variations may be associated with the extent to which thinking has been affected by "functional limitations" or "minority group" paradigms:
"The two competing models which evolved in research and disability have seemed to yield distinctive emphases on 'service delivery' or 'disability rights' as the primary solutions to the problems of this segment of the population. These differences also appear to represent contrasting estimates of the potential for environmental change. Whereas the 'functional limitations' perspective views the provisions of extensive services as the most appropriate means of assisting disabled persons in surroundings which cannot or will not be adapted to satisfy their needs and desires, proponents of the 'minority group' orientation refuse to abandon the prospect of a world in which these modifications are treated as a right rather than as a privilege or a special concession. Obviously, until these alterations are made, the need for a broad range of social services must be given a high priority. Yet, the vision of a society in which environmental adaptations will be viewed as part of a basic commitment to values such as freedom and equality must not be sacrificed to an inordinate concern with meeting the immediate functional requirements of disabled persons in the existing environment. Programs and policies which regard the delivery of services as the sole, exclusive or principal means of aiding disabled individuals may ultimately prove to be incomplete and even self-defeating."
The distinction between these prospectives becomes important in assessing the extent to which individual and environmental characteristics contribute to the problems of disabled people. If it is theoretically possible to plan an environment which can meet the requirements of almost every inhabitant, for example, the prevalent tendency to equate disability with individual limitations would be seriously undermined. Such a finding may form the basis for a need to adopt compensatory measures to ensure that disabled persons are provided with opportunities that would otherwise be available in an environment designed to fit the needs of everybody. Similarly, if there is some type of upper limit on the extent to which human settlements can accommodate persons with various disabilities, then this standard might replace the conditions of the existing environment as an appropriate benchmark for evaluating the support granted this segment of the population. Although observers may differ in their capacity to imagine a world without serious artificial obstacles, discussion of these hypothetical alternatives may promote an increased recognition of the contribution of environmental characteristics to the difficulties posed by a disability.
In general, there appears to be an emerging consensus among both disabled and nondisabled observers about the need to alter the built environment. Although architectural barriers have not yet been widely recognized as a fundamental constraint on personal liberty, the simple fact that many disabled people are virtually imprisoned in a vast range of circumstances has produced increased interest in accessibility. Yet even this concern has usually been limited to new construction and to buildings which are thought to be most appropriately frequented by persons with disabilities. The major objection to an expanded plan to modify the existing configurations of the landscape is, of course, cost. In a society truly committed to the principle of providing freedom and equality to all its citizens including those with disabilities, financial considerations might be considered secondary to guarantees of civil rights.
Perhaps much of the resistance to a comprehensive restructuring of the architectural environment also can be ascribed to the continued prevalence of the "functional limitations model." As long as disabilities are perceived primarily as individual traits rather than as characteristics produced by interactions with the environment, the restraints imposed by pervasive architectural obstacles may be viewed as unfortunate but unavoidable. By contrast, the "minority group model" permits an assessment of the extent to which the confines of the built environment represent a denial of civil rights which could be remedied by changes in public policy.
There does not yet appear to be much agreement about the control exerted upon disabled citizens by social institutions in American society. People with disabilities, however, have frequent contact with a diverse group of public and private agencies which reflect conflicting objectives and inconsistent programs. Perhaps many of the problems that they encounter in this environment can also be attributed to the prevalent influence of the "functional limitations model" of disability which seem to imply that the provisions of social services is the only appropriate method of assisting this segment of the population. A major consequence of these assumptions is reflected in the fact that there is simply no coherent disability policy in the United States. Current laws and programs are replete with contradictions and disincentives which, for example, often encourage disabled persons to seek employment while denying them the medical support they need to sustain their lives. Moreover, public and private groups serving disabled children and adults have spawned vested interest that might be even more difficult to combat than pervasive reluctance to modify the built environment. The tendency to organize around separate diagnostic categories reflecting different impairments also has inhibited the formation of unified social and political movement of disabled citizens.
In surroundings that have been designed with little regard for their needs, people with disabilities obviously require many types of services. But corresponding or equivalent emphasis also should be focused on efforts that would grant them independence rather than perpetuating their dependency. The realization that disabled citizens form a majority group in American society may compel public and private organizations to engage in programs of social, political and legal advocacy comparable to their activities in the delivery of social services. In addition, increased attention must be devoted to the relationship between disability and the social structure. Statistics indicating that three-fifths of disabled Americans are in a financial position which places them below the poverty line (Bowe, 1978, 1980), for example, cannot be dismissed as happenstance. There are undoubtedly many as yet undiscovered structural and institutional inequalities that consign disabled persons to a status incompatible with their right.
Perhaps the core of the controversy about disability and environmental attributes can be found in the assessment of public attitudes. Few persons acquainted with research on this subject probably would deny that the nondisabled majority holds - either consciously or subconsciously - unfavorable perceptions of people with disabilities. In analyses of disability founded on the "functional limitations model", however, these sentiments often are regarded merely as another unfortunate burden which must be borne by disabled individuals. From this perspective, the task of restoring functional capacities to meet the demands of the existing environment has seemed so compelling and the goal of changing public opinion has appeared so unattainable that attention has been diverted from this problem. The study of attitudes concerning disability has never occupied a prominent or critical position in research guided by a theoretical interest in functional impairments. Nevertheless, for the "minority group model" investigations of the so-called attitudinal environment surrounding disabled citizens seems fundamental.
The realization that prejudicial attitudes comprise the source of the unfair disadvantages and inequalities bestowed on racial, ethnic and other minorities has been widely accepted by political leaders and the American public. Yet the predominant emphasis on individual functioning seems to have impeded the accumulation of similar conclusive documentation about the origins of the treatment accorded disabled citizens. There does not yet appear to be a widespread consensus regarding the barriers imposed on disabled persons by public attitudes. For nondisabled professionals and researchers who appear to be preoccupied by the issue of functional loss, the impact of such opinions might seem minor in comparison with the consequences of physical or behavioral restrictions. To the extent that perceptions of disability are viewed as a problem by the latter group, the prescribed solution usually consists of public relations or educational campaigns to promote a more positive image of people with disabilities. For large numbers of disabled persons themselves, on the other hand, the recognition that prevalent attitudes comprise the foundation of many subtle form of bias, prejudice, and discrimination seems to be an essential prerequisite to their struggle for equal rights.
The focus on attitudes as a central issue in the analysis of disability also provides a means of developing a unified approach to the subject. In evaluating both the architectural and the institutional environment, many observers might argue that the needs of people with different types of impairments are so diverse that they could not possibly be accommodated by a comprehensive design or that separate organizations must be maintained to serve their distinctive interests. (One reply to this objection might point out that, while the present classification of disabled persons in separate diagnostic categories provides some information about the causes of their disability, it does not reflect an assessment of the functional effects of various impairments. Perhaps, even to preserve the traditional paradigm for the study of disability, a revision of present classificatory scheme may be necessary so that they more accurately represent different functional capacities rather than unique medical conditions.)
Fundamentally, however, conceptualizations of disability must be designed to permit a careful examination of the possibility that the treatment of disabled people depends more upon the sentiments which they elicit from others than by the restrictions produced by their functional impairments. Although additional research may be necessary to verify this statement definitely, the expectation is consistent with the daily experience of many people with disabilities. Moreover, this aspect of the "minority group model" facilitates a recognition of the difficulties shared by persons with sensory, mobility, and other types of disability. The emphasis on attitudinal responses to disability focuses on problems which they have in common rather than on impairments which seem to divide them. Further research on this subject also might yield an empirical method of disentangling similarities and differences in reactions to physical, mental, emotional, and learning disability. Although an appraisal of the independent effects of attitudes in an environment that also imposes severe functional restrictions on disabled people obviously represent a complicated endeavor, an important initial step might be taken by acknowledging that hypotheses derived from the new paradigm appear to be as worthy of investigation as the implications of the "functional limitations model" which previously precluded this type of study.
Perhaps one of the most serious obstacles to the progress of disabled citizens is related to widespread presumptions of biological inferiority. Ironically, these are the same assumptions that have been used to oppress other minorities. Just as racial or ethnic groups were once considered genetically deficient and women were regarded as weaker than men, the subjugation of people with disability often appears to be implicitly justified by individual limitations or inabilities. In a culture which places an extraordinarily high premium on physical agility, strength and appearance, the subordination of disabled people might even appear to be natural. Moreover, since they live in a world that we planned and constructed almost exclusively for the nondisabled counterparts, many disabled persons obviously experience severe disadvantages in their efforts to compete with their nondisabled counterparts.
The existing configurations of architectural and institutional environments are the products of public policy. Buildings can be erected to accommodate persons with greater or lesser functional capabilities primarily because laws and regulations permit them to be constructed in that manner. Even the structure of society is shaped by the distribution of rewards and costs contained in policy decisions. These observations must alert public officials to two possibilities: The deprivations imposed upon disabled citizens by present environmental features might have been prompted either by the political neglect of their interests and needs or by a deep and unrecognized aversion to this segment of society. Perhaps the "functional limitations model" has also contributed to incorrect assumptions about the physical and behavioral imperfection of disabled people. Presumptions of biological inferiority or superiority are antithetical to the competing paradigm that regards disabled citizens as a minority group.
The ethical and moral implications of these problems deserve further exploration. Attention must be devoted to the relationship between the problems of disabled persons and basic democratic values such as equality and liberty. For observers accustomed to the familiar paradigm of functional limitations, this topic might prove unfamiliar and even disturbing questions. In a culture which usually regards disability as personal misfortune, few have been willing to identify it as a characteristic that results in deprivation and the denial of constitutional guarantees supposedly granted to every citizen. Yet the realization that an environment molded by public policy also can be altered to meet the needs of people with a wide range of functional capabilities may promote a corresponding awareness that the inequalities and restriction plaguing disabled Americans are primarily the products of political decisions rather than of personal impairments. Perhaps the most obvious contradictions between the problems facing this group and the principles of freedom and inequality can be found in the built environment which not only imposes severe constraints on individual choice but which also places disabled persons at a competitive disadvantage with their nondisabled peers. Hence, people in wheelchairs who are prevented from reaching certain locations by architectural barriers and people with vision and hearing impairments who are precluded from obtaining information communicated in written or verbal forms exclusively suffer a denial of the right to choose which is usually regarded as a hallmark of freedom. But major constraints are also evident in social institutions, which limit the opportunities available to people with disability, and in the so-called attitudinal environment, which yields frequent rejection and exclusion. Furthermore, both the built and the institutional environments are based on prevailing public attitudes. Applying the concepts of liberty and equality to the circumstances of disabled persons, therefore, seems indispensable to a comprehensive effort to secure improvements in disability policy.
Although freedom has been variously defined by concepts of autonomy and by the availability of alternatives, evidence that a disability has a profoundly constricting impact of the exercise of liberty in the present environment seems almost undeniable. An understanding of the full extent to which environmental barriers impinge on personal freedom might require an intimate knowledge of the everyday lives of many disabled citizens. Nonetheless, few nondisabled individuals would tolerate the curtailments of individual options which become part of the daily experience of people with disabilities. Many disabled persons are continually denied access to public accommodations, barred from common organizational activities, and subjected to discrediting interactions with the nondisabled majority. Some disabled individuals may become so accustomed to habitual, safe, and predictable routines that they might not be completely aware of the autonomy and choices they are compelled to surrender in an environment which is poorly adapted to their interests and needs. Although constitutional guarantees of freedom of movement have been extended to international travelers, similar rights have not been extended to persons who use wheelchairs in their own neighborhoods. In countless ways, the liberty of disabled citizens is restricted in an environment implicitly designed by official acts to be reserved almost exclusively for the nondisabled.
The inconsistency between the standard of equality and the status of disabled citizens is obvious. Comparisons between disabled and nondisabled of the population fail to disclose indications of relative equality in almost any area of society. Some might attribute this pattern to functional limitations or the supposed biological inferiority of people with disability. Others may point out that the traditional American understanding of this social value focus on the concept of "equality of opportunity," which implies that all persons should be given an equivalent chance to demonstrate individual merit. In an environment which provides advantages to the nondisabled and disadvantages to disabled individuals, however, the assumptions of a meritocracy may not be sufficient to fulfill the promise of equality. Compensatory efforts also might be needed to ensure that disabled citizens are granted civil rights consistent with this basic democratic principle.
The lack of agreement about the disparity between the status of disabled Americans and fundamental ideas such as liberty and equality might be attributed to the fact that this issue has attracted relatively little interest. Yet mastery of the existing environment does not seem to be an appropriate prerequisite for exercising the rights of citizenship. Freedom and equality are legal guarantees that must be extended to all citizens, including those with disability. A full recognition of the importance of these standards, however, seems to depend upon the realization that disabled citizens form a minority group - with all the ramifications of that term - in American society.
The Identification of a Minority Group
There appear to be several different means by which deprived and disadvantaged segments of the population may qualify for designation as a minority group. Initially, for example, they might be considered a minority if others are willing to use that phrase in describing them. By this criterion, the status of citizens with disabilities appears to be somewhat ambiguous. Although the concept of minority group often has been invokes in prior studies of disability, it has been relegated to a relatively minor role. Hence, the aspirations of disabled citizens have not yet been widely understood as a quest for civil rights.
Secondly, the minority status of a group can be determined by comparing their position with dominant portions of the population on crucial social and economic indicators. According to this standard, despite the flaws in available statistics, there seems to be little doubt that disabled people deserve to be considered a minority group. Persons with disabilities experience the highest unemployment rate and the most prevalent levels of welfare dependency in the country. They have been disproportionately exposed to persistent poverty and inadequate schools, housing, transportation, and other services. Even the exclusion of disabled individuals from voting booths, juries, and political meetings seems to parallel the barriers impending other groups that have struggled to gain equal rights.
Finally, almost all minority groups have been subjected to similar experiences which include ascriptions of biological inferiority, segregation, stigmatizing, stereotyping, bias, prejudice, discrimination, and overt bigotry. Most people are reluctant to identify disabled citizens as a minority because they fail to examine the relationship between these concepts and the problems associated with disability. While numerous prior studies of disability have contained a reference to disabled people as a minority group, the use of this phrase frequently has seemed tentative or uncertain.
Perhaps nowhere is this ambivalence more clearly evident than in the discussion of segregation. Even the language employed that describe this issue seems permeated by doubt and reservations. Features of the built environment that prevent interactions between disabled and nondisabled portions of the population, for example, are called "architectural barriers rather than instruments of segregation. Similarly, the abolition of separate schools for disabled students is characterized as "mainstreaming" rather than as integration or desegregation. And the release of disabled persons from restrictive confinement is termed "deinstitutionalization" or a project of independent living. Much of this vocabulary probably can be ascribed to a focus on functional restrictions that has inhibited an awareness of the extent to which ordinary architectural configurations, institutional arrangements, and public attitudes result in the separation and exclusion of disabled people from the remainder of society. By contrast, the opposing paradigm recognizes that the combined effects of these environments may produce a pattern of segregation that is even more extensive than the most rigid apartheid policies of racist governments.
The interpretation of attitudes concerning disability, however, seems especially fundamental to the evaluation of the competing models. Ironically, while there appears to be general agreement that disabled people comprise a highly stigmatized group, this perspective has not become a major focal point for research on disability. Just as the analysis of disabled persons as a minority group has been overshadowed by an interest in functional limitations, the concept of stigma has appeared to suffer a similar fate. These developments have had a crucial impact on the understanding of public attitudes about people with disabilities. Without a clear acknowledgement that the status of disabled persons might be based on prejudicial attitudes, for example, environmental segregation and the denial of liberty and equality seemed to escape significant notice as pressing social issues. As a result, important components of the theoretical foundations of the "minority group model" have not yet been firmly established.
Perhaps even more significant than the relatively general acceptance of the concept of stigma is a lack of agreement about stereotyping. People with disabilities have not become the targets of the same type of hostile and vicious preconceptions that have been directed at other minorities, but there is controversy about the extent to which they have been the victims of a tendency to impute the unfavorable images of a group to an individual member. Many employers who refuse to hire disabled personnel, for example, can justify their decisions by asserting that an individual with a disability simply would not be able to perform the work. Similar rationalizations are used to support the development of physical or functional requirements for a wide range of jobs. These assertions, however, may cloak an unacknowledged tendency to underestimate the capabilities of this group of applicants or a deep-seated aversion to disability. Most nondisabled persons, including physicians as well as personnel officers, do not possess enough information to make a knowledgeable judgment about the capacities of disabled individuals or about their potential effectiveness in a modified environment. Disabled persons themselves are not permitted to challenge the myths and misconceptions which prevent them from securing an impartial evaluation in the pursuit of employment. Programs stressing the abilities of disabled people or urging businesses to "hire the handicapped" have not been notably successful. Perhaps stereotyping also plays a crucial role in the employment and other decisions that determine the fate of citizens with disabilities. While the traditional paradigm for the study of disability seems to provide implicit support for the legitimacy of functional requirements as qualifications for jobs and other resources, the "minority group model" approaches the issue with considerable skepticism. The task of unraveling stereotyped perceptions of disabled individuals and those which reflect a careful appraisal of personal competence is difficult but crucial to an objective analysis of this problem.
The results of such an investigation are essential to an even more fundamental task of determining whether or not the treatment of disabled citizens is affected by prejudice. This issue also is likely to provoke disagreement. In the research tradition supported by the "functional limitations model" there seemed to be little opportunity for serious exploration of the possibility that prejudicial attitudes might be an underlying problem for disabled Americans. The focus on developing the physical and other capacities of disabled individuals to meet the standards prescribed by the present environment appeared to detract from these issues. Hence, persons familiar with the conventional approach to the analysis of disability might find the notion of prejudice alien or strange. Alternatively, for the "minority group model, this concept is central. Decisions based on stereotypes of disability could be readily dismissed unless they reflect prejudice or bias about disabled people. Such prejudice - the kind that stems from fear, hatred, and ignorance - cannot be easily disregarded. Development of the new paradigm for the study of disability seems to depend upon a more intensive analysis of prejudicial attitudes than researchers have conducted previously.
Although an attempt to separate the effects of discrimination from other environmental and functional restraints imposed on disabled persons is a complex undertaking, there appear to be several means of approaching this teak. One relatively direct method would be to assess attitudinal change according to the extent to which various disabilities are perceptible or visible. Most groups that have been previously recognized as minorities possess some type of physical characteristic such as skin color, gender, or age which permits them to be distinguished from the rest of the population. While the focus on functional impairments has obscured the significance of personal appearance as an identifying attribute of disability, the presence of a distinguishing trait which is either immediately obvious or detectable by close scrutiny can have a crucial impact on how others perceive disabled persons. From this perspective, concepts such as visibility and permanency might even replace functional limitations as the defining features of disability. A possible means of testing this approach might be provided by developing a "disability continuum" which suggests a relationship between the viability of a permanent disability and the prejudice it invokes from others (Hahn, 1984a). This type of investigation not only could assist in sorting out the distinctive effects of responses elicited by physical, mental, and other kinds of disabilities; but it also might elevate theories of prejudice to a prominent position in research on perceptions of people with disabilities.
In some critical ways, discrimination against disabled persons differs from that directed at other minorities. The prejudice imposed on disabled persons usually has assumed a more subtle form than the displays of overt bigotry and even violence that have been inflicted on other groups. Perhaps this pattern can be attributed to the pervasive feelings of paternalism that permeate relationships between disabled individuals and the nondisabled. In an atmosphere in which disabilities are commonly regarded as signs of weakness, helplessness, and biological inferiority, open expressions of malevolent intolerance toward disabled people have been relatively rare. As a result, the social and political movement of persons with disabilities seldom has experienced the dramatic acts of discrimination that might arouse the conscience of a nation. In addition, this group has been compelled to contend with a nondisabled majority that claims to be sympathetic and supportive of their aspirations. In many respects, the difficulties in gaining recognition as a minority group probably are exacerbated by the relative absence not only of blatant manifestations of bigotry but also of an admitted adversary who might otherwise stimulate increased dialogue about disability rights. But neither of these factors seems indispensable to an understanding that citizens with disabilities often have been the victims of discrimination. Instead, the task of gaining acceptance of the "minority group model" of disability appears to depend upon the development of other sources of support.
The struggle to define disability as an equal rights issue requires an intense commitment by disabled persons. As a group that is estimated to encompass more than 36 million Americans, the potential persuasion of unified demand for civil rights by disabled persons is substantial. And yet people with disabilities never have been able to organize a constituency comparable to other voting blocs in U.S. politics. Many disabled persons are reluctant to identify themselves or to recognize disability as an issue that requires the expenditure of political energies. In a crucial sense, the disability rights movement is asking disabled citizens to concentrate on that aspect of their identity which is most negatively stigmatized by the remainder of society and to mobilize around it. The demand is admittedly imposing, but the ultimate test of minority group is self-identification. Although disabled persons are increasingly prepared to acknowledge their membership in a disadvantaged minority and to admit that they have been the target of discrimination, this consciousness has not yet become a sweeping force for social and political change. Perhaps there is a need for additional sources of strength to fulfill the promises implied by the mounting awareness of disabled people as a minority group in American society.
Deprived of a cultural heritage that might otherwise be an important source of political as well as psychological support, a growing proportion of disabled persons are searching for an new understanding of the nature and meaning of disability. The discrepancy between positions on this issue seems to be enormous. While many of the nondisabled still appear to be wrestling with an image of disability as an indication of biological inferiority, a significant number of disabled individuals seem prepared to enter what might be termed the "black-is-beautiful" phase in the development of a minority culture. Some disabled people are seeking a positive source of identity as a focal point for their political struggle (Anapach, 1979).
Although there has been little direct mention of the topic, many people with disabilities are beginning to realize that they share important values which might eventually become recognized elements of a subculture. A complete enumeration of common themes in the lives of disabled people obviously would be premature at this stage. Yet mention might be made of several significant experiences which contain positive as well as negative implications for the formation of a unifies perspective on policy issues.
One of the most unpleasant features of the lifestyles of many disabled individuals, for example, is the pervasive sense of physical and social isolation that is product not only by the restrictions of the built environment but also by the aversive reactions of the nondisabled which often consign them to the role of distant friends or even mascots rather than to a more intimate status as peers, competitors, or mates.
While the sheer energy to surmount artificial barriers undoubtedly has detracted from the cohesion of this community, the unyielding nature of their surroundings also has sparked an anger that many people with disabilities are learning to express and to channel in political directions. Emerging from a background which is often overprotective and permeated by perceptions that define disabled people primarily as recipients of help, many have gained a spirit of independence that not only spawns occasional feistiness but also supplies a strong motivation for social action. Many who have been taught that the existing environment is a place to be mastered primarily by "overcoming" their disabilities also have acquired an adaptability which may give them a problematic view of medical authority, a realization of the need for continuous planning, and an unusual capacity to develop "ad hoc" solutions to the obstacles they encounter. The simple ability to survive in a society which is poorly adapted to the needs of disabled people seems to bear implicit testimony to the superficiality of physical standards that society seeks to impose on its members.
In addition, persons with disabilities may have acquired means of accepting and adjusting to the inevitability of ageing and bodily decline that exceed the anticipations of their nondisabled counterparts. Although many people with disabilities have grown tired of gaining acceptance by the nondisabled majority only when they can be viewed as inspirational or courageous, important aspects of their lives can be identified as crucial sources of dignity and pride. Despite the unfavorable images of disability which have been widely adopted by the nondisabled community, the mutual experience of disabled people seem to embody valuable sources that might support a prolonged and intense struggle for equal rights.
The eventual goal of the social and political movement of disabled persons is, of course, to persuade the American public that citizens with disabilities should be granted freedom and equality. The objective may not be fulfilled without extensive support from other segments of the population. In the formation of coalitions and alliances, nondisabled professionals and others interested in disability court play an especially critical role. For many who have been familiar with the "functional limitations model" the prospect of adjusting to an alternative approach is not likely to be greeted with enthusiasm. Traditional ideas seldom disappear without a struggle, and the battles fought over academic theories are often vicious and destructive. Yet, without at least the tacit support of many disabled persons, the political credibility of professionals who seek to preserve programs and policies based on the conventional paradigm could be seriously undermined. Nondisabled professionals and people with disabilities appear to be joined by an uneasy relationship. Probably a major responsibility of this association is a realization that the "minority group" model. represents an alternative to an earlier theoretical framework which deserves at least equivalent support and respect.
Perhaps one of the most obvious implications of the tension between different paradigms of disability is the need for additional research. There are obvious gaps, especially in the "minority group model" that require exploration before major policy questions can be decided. A comprehensive attempt must be undertaken to examine the separate effects of functional, environmental, and attitudinal characteristics upon the status of disabled Americans. Much of this work might be performed by disabled researchers, some of whom are asking to develop a network known as the Disability Forum to develop new policy proposals and to promote a reconceptualization of disability. In the past, studies of this subject have been conducted primarily by nondisabled investigators who subscribed to the "functional limitations model". These developments reflect a marked contrast to the trends that have affected other segments of the population. Since the analysis of problems facing women is no longer dominated by males, for example, similar efforts must be made to facilitate the growth of innovative approaches to the study of disability that reflect the experience and perspectives of disabled people.
The recognition of disabled persons as a minority group also contains important implications for the resolution of a wide range of pressing political issues. One of the most troublesome controversies that has arisen in recent years, for example, centers on what might be termed "life or death questions" involving people with disabilities. These topics range from the "Baby Doe" cases of disabled infants to the so-called "right to die" request of Elizabeth Bouvia, a 26-year-old woman with cerebral palsy, to ethical dilemmas about terminating or sustaining the lives of older persons with severe disabilities. From a vantage point that emphasizes the difficulties posed by functional limitations in the exiting environment, seemingly legitimate concerns might be expressed about the "quality of life" available to disabled individuals at every stage of the life cycle.
By contrast, from a minority group perspective, these arguments might be interpreted differently. Along with the prevalence of telethons and the massive resources allocated to medical research, they seem to denote a widespread belief that the principal solution to the problem of disability is to eradicate it. As witnesses to a historical tradition which has included the widespread practice of genocide as well as the extermination of one million disabled persons in Nazi Germany, people with disabilities are understandably loath to grant others the power to determine their fate. Although this group has lacked the sense of generational continuity provided minorities that are defined primarily by genetic characteristics, disabled persons may possess a valuable though previously unrecognized culture that can inform these complex moral questions.
Similar considerations might contribute to educational policies affecting disabled students. Although the "minority group model" clearly supports the integration of schools, this perspective also suggests that the scholastic performance of disabled youngsters cannot be promoted solely by programs designed to meet their functional requirements or "special needs. Disabled children are not raised by parents who belong to the same minority or in homes influenced both by a legacy of oppression and by a tradition of protection against the assaults of the outside world. As a result, both disabled and nondisabled students might be provided with appropriate instruction that would allow the former group to develop a sense of dignity and pride in themselves and in the minority community of which they are a part. This orientation is consistent with evidence indicating that positive labeling is often a critical factor that contributes to academic achievement. The introduction of ideas designed to promote feelings of competence and confidence in disabled young people may require extensive curricular changes in higher education as well as in elementary and secondary schools. Individuals entering careers that involve frequent contacts with disabled persons also need to become acquainted with civil rights issues as well as the cultural values of this segment of the population.
Perhaps the most fundamental change implied by the assessment of disabled persons as a minority group, however, is the rigorous enforcement of anti-discrimination laws. The provision of P.L; 94 - 142, the Education of All Handicapped Children Act of 1975, and Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination against disabled persons in programs receiving federal financial assistance, have never been conscientiously implemented. The Office of Federal Contract Compliance Procedures in the Department of Labor, which has major responsibility for the administration of laws prohibiting employment discrimination, has even expressed reservations about the cost-effectiveness of these measures. But cost-benefit ratios must not be confused with legal rights. While some have thought it reasonable to ban discrimination against disabled persons only when these measures are financially acceptable, the new paradigm of disability is based on different assumptions. Recognizing that government policy bears a primary responsibility for determining the extent to which society is adapted to the need of disabled people and the mastery of the environment is not necessarily an appropriate prerequisite for achieving equality and freedom, the "minority group model" assert that laws and regulations must be guided by a respect for human rights rather than by economic calculation. Moreover, the demands imposed on disabled people by the present environment may have been shaped primarily by public attitudes rather than by historical coincidence. There is presently no empirical basis for rejecting the contention that the core of the problem can be found in stereotypical perceptions of disability as well as in prejudice and aversion toward disabled persons. Public leaders are hardly in a position to ignore the desires of disabled citizens for equal treatment in employment, transportation, housing, and public accommodations. Consideration also might be given to the enactment of several measures suggested by European experience such as an effective program of employment quotas, which would guarantee disabled workers a percentage of the jobs available in the labor force, and a disability allowance, which would offset the costs incurred by disabled individuals in their efforts to cope with an unaccommodative environment. Additionally, in a move which might help to break the current stalemate in the development of a national health program, disabled people might become the next group to be included in a government-sponsored plan of medical care. These proposals need not be viewed as substitutes for the vast system of social welfare programs which now dominates disability policy in the United States. As long as the existing environment remains relatively unchanged, the need for social services is not apt to diminish. And yet, by seeking a society in which constitutional guarantees of freedom and equality are offered to disabled citizens as a right rather than a privilege, the struggle for civil rights may lift a burden from the national conscience which would far exceed the economic sacrifices that might be required to implement these measures.
The political agenda of the disability rights movement extends beyond proposals which have been advanced by other minorities. A massive restructuring of the environment and of social institution seems to represent only an initial step toward even more crucial change. Perhaps even more fundamentally, this movement appears to be seeking a revolutionary shift in the way that people think and perceive other human beings. Too often, in our everyday interactions with other members of the same species, we engage in a process which might be called "short-circuited". We tend to look at other persons and assign them to a category or "pigeonhole" in our minds based on their physical or behavioral characteristics. We seldom take time to appraise the value or qualities of others and to develop a bodily image of them which is consistent with their inner properties. Many persons with disabilities, who have endured the effects of stigmatizing and prejudicial attitudes, are asking a predominantly non-diasbled world to reverse the usual processes that shape their perceptions. By participating in the struggle for civil rights in an environment that is not adapted to their needs, disabled citizens are asking recognition as valued members of society. Their aspirations represent a request that nondisabled Americans can deny only at the expense of profound national shame.
This is a revised version of a paper presented at the Wingspread conference on "Images of Disability/Disabling Images," November 8-10, 1984. The author would like to express appreciation to Alan Gartner for his comments on an earlier draft of the manuscript. Portions of the conceptual development of this paper were prepared with the support of NFS Grant CEE-8303654. However, any opinions, findings, conclusions, and/or recommendations are those of the author and do not necessarily represent the views of the National Science Foundation.
ANSPACH, R.R. (1979) "From stigma to identity politics: political activism among the physically disabled and former mental patients". Social Science and Medicine. 13:765-773.
BERKOWITZ, M., W.G. JOHNSON, and E.H. MURPHY (1976) Public Policy Toward Disability. New York: Preager.
BOWE, F. (1978) Handicapping America: Barriers to Disabled People. New York: Harper and Row.
BOWE, F. (1980) Rehabilitating America: Toward Independence for Disabled and Elderly People. New York: Harper and Row.
HAHN, H. (1982) "Disability and Rehabilitation Policy: Is Paternalistic Neglect Really Benign?" Public Administration Review. 42:385-389.
HAHN, H. (1984) The Issue of Equality: European Perceptions of Employment Policy for Disabled Persons. New York: World Rehabilitation Fund.
HAHN, H. (1984b) "Changing Perceptions of Disability and the Future of Rehabilitation." Unpublished paper presented at the ninth Mary Switzer Memorial Seminar. New York, New York.
HAHN, H. (1985) "Disability Policy and the Problem of Discrimination. American Behavioral Scientist (forthcoming).
HAHN, H. (1985b) "Toward a Politics of Disability: Definitions, Disciplines, and polices. Unpublished paper. University of Southern California.
HOWARDS, I., H.P. BREHM, and S.Z. NAGI (1980) Disability: From Policy Problem to Federal Problem, New York: Praeger.
NAGI, S.Z. (1979) "The Concept and Measurement of Disability," pp. 1 - 15, in E. D. Berkowitz (ed.), Disability, Policies and Government Programs. New York: Praeger.