According to the WHO, the level of disability in the world averages 10% - that is, every tenth inhabitant of the planet is disabled.
Thus, in the Russian Federation, officially registered and registered disabled people make up less than 6% of the population, while in the United States it is almost a fifth of all residents.
Kholostova E.I. and Dementieva N.F. indicate that “this is, of course, not due to the fact that citizens of the Russian Federation are much healthier than Americans, but to the fact that certain social benefits and privileges are associated with the status of disability in Russia. Persons with disabilities strive to obtain an official status of disability with its benefits, which are essential in the face of a shortage of social resources; the state, on the other hand, limits the number of recipients of such benefits to fairly strict limits.
As of January 1, 2005, the number of persons with disabilities of all categories in Kazakhstan amounted to 413.6 thousand people, or about 3% of the total population (according to the data of the MoT and SZN RK).
According to the information and reference material of the Ministry of Foreign Affairs of the Russian Federation, there are more than 60 million disabled people in China, which is 5% of the population, in the USA - 54 million disabled people, which is 19%. The increase in the total number of persons with disabilities in all developed countries of the world and, especially, the number of children with disabilities (there are from 0.12% in the UK to 18% in Canada of the total number of persons with disabilities) has made the problem of prevention of disability and the prevention of childhood disability among the national priorities of these countries. .
Despite the increasingly impressive advances in medicine, the number of people with disabilities is not only not declining, but is steadily increasing, and in almost all types of societies and all social categories of the population. This trend is also confirmed by sociological research methods, the results of which are shown in the figure.
The results of a survey of experts from the Public Opinion Foundation:
FOM database, 29.09.2000, Survey of experts
DISABLED PEOPLE AND SOCIETY
QUESTION: Do you think the number of disabled people in Russian society is increasing, decreasing, or staying the same?
QUESTION: Are there disabled people among your relatives, friends or acquaintances or not?
There are many different causes of disability. Depending on the cause of occurrence, three groups can be conditionally distinguished: a) hereditarily conditioned forms; b) associated with intrauterine damage to the fetus, damage to the fetus during childbirth and in the earliest stages of the child's life; c) acquired in the process of development of the individual as a result of diseases, injuries, other events that led to a permanent health disorder.
There are forms of disability, in the origin of which hereditary and other (infectious, traumatic) factors interact. In addition, it is often not so much the objective state of his health that makes a person disabled, but the inability (due to various reasons) of himself and society as a whole to organize full development and social functioning in the conditions of just such a state of health.
Unfortunately, it should be noted that a significant part of both childhood and adult pathologies is caused by insufficient or poor-quality development of medical services. This, for example, can be a direct consequence of inaccurate diagnosis, errors in delivery, incorrect, inconsistent or insufficient treatment. If modern diagnostic equipment is concentrated only in large centers, its services are inaccessible to the majority of the population.
Of course, the intensive development of technology, transport technologies and urban processes, not accompanied by the humanization of technical impacts, leads to an increase in man-made injuries, which also leads to an increase in disability.
The tense state of the environment, the growth of the anthropological load on the enclosing landscape, environmental disasters, such as the explosion at the Chernobyl nuclear power plant, lead to the fact that man-made pollution affects the increase in the frequency of genetic pathologies, the decrease in the body's defenses, the emergence of new previously unknown diseases. Deterioration of the state of the environment, unfavorable ecological conditions lead to an increase in health pathologies for both children and adults.
Analysis of data on the causes of primary disability for 2004 in the Republic of Kazakhstan showed that the so-called environmental causes of primary disability due to environmental emergencies are becoming increasingly important - for example, 2% of all causes or third place (after general illness and disability since childhood) , takes the cause of disability due to diseases associated with nuclear tests at the Semipalatinsk nuclear test site, which confirms the high importance of the influence of environmental factors on the health of the population and, as its integral indicator, on the level of disability of the population of the republic.
Paradoxically, the very successes of science, primarily medicine, have their reverse side in the growth of a number of diseases and the number of people with disabilities in general. This is due to the fact that in all countries at the stage of industrial development there is a significant increase in life expectancy and diseases of old age become an inevitable companion of a significant part of the population. The United Nations, which leads the 21st century research program on aging, has named 1999 the Year of the Older Person. The number of cases of various disorders and disabilities increases with age (Graph 1). According to the World Program of Action for Persons with Disabilities, adopted by the resolution of the UN General Assembly on December 3, 1982, “In most countries the number of older people is increasing, and already in some of them two thirds of persons with disabilities are also elderly.”
Schedule. Age-specific prevalence of disability (according to the United Nations Guidelines for the Development of Statistical Information for Programs and Policies on Persons with Disabilities).
The current topic of modern society - the problem of "Older Persons and Disability" is covered by the Report of the Commission for Social Development of the Second World Assembly on Aging, held in Madrid on April 2, 2002, which defines the goal and measures to address this problem. To achieve the stated goal: Maintaining maximum functional potential throughout life and promoting the full participation of older people with disabilities in all aspects of society, the Assembly recommended the following Measures:
a) Ensure that national disability policy-making and program coordination agencies pay attention to issues relating to older persons with disabilities in their work;
b) Development, as appropriate, of national and local policies, legislation, plans and programs for the treatment and prevention of disability, taking into account health, environmental and social factors;
c) Providing physical and mental rehabilitation for the elderly, with particular attention to those who have acquired a disability;
d) Development of community programs to raise awareness about the causes of disability and about measures to prevent or adapt to disability throughout life;
e) Setting standards and creating conditions that are age-appropriate in order to prevent disability and prevent the exacerbation of its symptoms;
f) Promote the construction of housing for older persons with disabilities that reduces barriers to independent living and promotes such self-reliance; providing older people, where possible, with access to public places, transport and other services, as well as to commercial buildings and services open to the general public;
g) Facilitating the provision of rehabilitation and appropriate care services for older people, as well as their access to appropriate technologies, so that they can meet their needs for support services and full integration into society;
g) Ensuring that pharmaceuticals or medical technologies are accessible to all, without any discrimination, including the most vulnerable segments of the population, and that they are affordable and accessible to all, including socially vulnerable groups.
Encourage employers to be responsive to older people who remain able to work and are available for paid or volunteer work.
This report highlights that the incidence of various disorders and disabilities increases with age. Women are particularly vulnerable to disability in old age, due, inter alia, to differences between men and women in life expectancy and resistance to disease, and to inequalities between men and women throughout their lives.
At the present stage, it has become possible to save many children who, having been born with certain defects, were previously doomed to “natural dropout”. The advent of new medicinal and technical means saves their lives and in many cases makes it possible to compensate for the consequences of a defect. But in other cases, at the same time, the number of persons with certain pathologies is growing, which originate precisely in these prenatal and perinatal abnormalities, in the circumstances of the first days or months of a child's life.
The Ministry of Labor of the Russian Federation estimates the target group of social policy in relation to the disabled as 40 million people, including all low-mobility groups of citizens of our country. From region to region, people note the impossibility of just leaving the house, they only dream of real mobility. Evgeny Glagolev, Director of the Orthodoxy and the World Charitable Foundation, spoke about an interesting study.
Evgeny Glagolev
This year, a study by the Russian Academy of National Economy and Public Administration (RANEPA) entitled “Disability and the social status of people with disabilities in Russia” was published, and this event went unnoticed. It seems that only in one media there was a mention, and I stumbled upon it by accident. Meanwhile, on 256 pages of this three-year work of the Academy's staff there is very important information that would be useful for a wide range of people, and not just specialists.
Know about disability - why it matters to healthy people
The authors were interested in specific data on the real socio-economic situation of disabled people in Russia, the problems of collecting and analyzing information, and the effectiveness of the state's work in this area. The main part of the work is based on in-depth sociological surveys conducted by the Institute of Social Forecasting and Analysis of the RANEPA for three years: from 2014 to 2016, and the disabled themselves and their relatives participated in the survey. As a result, data were obtained that are extremely important for all of us, because the study reveals significant problems in the social policy of the state, based on specific figures.
In 2006, Russia signed and in 2012 ratified the Convention on the Rights of Persons with Disabilities adopted by the UN General Assembly. To date, this document has been signed and ratified by the vast majority of countries in the world. Ratification implies that our state must bring the internal social policy towards disabled people in line with international standards.
Since 2011, there have been major changes in our country: changes in legislation, the adoption of new norms, and the implementation of the Accessible Environment project. Among other things, a special website has been created with open information on the number of disabled people in Russia: if at the time of the study there were 12.5 million disabled people in the country, then according to information from the Federal Register of Disabled People, at the time of writing this article, there are significantly fewer of them - 11.5 million people. It would seem that we are seeing a significant decrease in the number of people with disabilities, and this should give us confidence that everything is fine in our country with the prevention of disability, but let's take a closer look at the numbers and what is behind them.
The International Classification of Functioning, Disability and Health (ICF) formed the basis for the definition of disability in the world community. Functioning is the key concept of the classification and is considered at three levels: organism (functions and structures of the organism) - person (activity, performance of tasks and actions) - society (inclusion and involvement in life).
Disability, according to the ICF, is impairment or limitation of functioning at one or more of these three levels.
In 2012, Russia changed the criteria for determining disability, but did not bring them to the UN-recommended standards.
In addition, the researchers identified the deepest problems in collecting information about people with disabilities and their situation in our country and came to the conclusion that, in general, federal statistical observation does not make it possible to solve any of the tasks of collecting data on disability, including the main one - assessing well-being and equality of opportunity for persons with disabilities.
For example, in countries such as England or Germany, there is the concept of “registered disability”, when a person applies for official disability status, but constant surveys are conducted and people with functional health limitations are identified, and in general statistics on the number and The status of persons with disabilities in these countries includes not only registered persons with disabilities, but also those who have disabilities, but do not have an official status.
It is also important to understand this in order to determine the quality and level of healthcare in the country, the burden on the work of social services, but first of all, in order to adequately assess the number of people with disabilities in Russia, especially when the Ministry of Labor states that the decrease in the number of people with disabilities in the country not related to the work of medical and social expertise. At the same time, the authors say that the Ministry of Labor of the Russian Federation estimates the target group of social policy in relation to the disabled as 40 million people, including all low-mobility groups of citizens of our country.
What comes out? Almost 12 million people with disabilities in Russia is 8% of the total population, while this is 20% more than in Germany, if we consider the reduced coefficient, but Germany, when determining the number of people with disabilities, takes into account not only officially applied for such a status, but also all people with a functional limitation, but we are not! It turns out that it is beneficial for the state not to apply international standards, reporting on the decrease in the number of disabled people, otherwise it will not be able to cope with social policy at all.
Accessible environment is not only ramps
By the way, in issuing the status of a disabled person in our country, the authors revealed some "regional peculiarity". For example, in a number of Russian republics, almost 100% of applications for the establishment of disability are satisfied, while in others this figure is lower. The authors suggest that this may be due to the socio-cultural features of obtaining additional income by the inhabitants of these republics - and recommend paying attention to such obvious discrepancies.
As for the employment of disabled people, we see that only 16% of their total number work. Another 16% would like to, and all the rest do not even consider such an opportunity. This point points to several problems.
The first is the lack of truly equipped jobs for the labor of people with disabilities, and the second is the disbelief that you can work and earn income if you have a disability. Knowing the level of salaries in the regions, it can be assumed that it is much easier to receive a disability pension than to work where there are no conditions and they pay not much more than the pension itself.
And, of course, let's not forget that our society is still not ready to accept disabled people as its full-fledged part. This affects everything: how they communicate with people with disabilities in state and municipal bodies (and people complain about the bad attitude of officials towards them) and how you and I, healthy people, perceive an accessible environment.
After all, what is an “accessible environment”? It's not just the ramps that people in wheelchairs say are impossible to use. It is also the attitude of society towards people with various disabilities.
We often do not allow the idea that a person with mental or physical limitations can be not only an example of a heroic overcoming of difficult life situations, but also be in our eyes an equal member of society who is able to work.
It's great that the authors of the work got to know the real problems and expectations of people with disabilities across the country. From region to region, people note the inability to simply leave the house, not to mention the lack of leisure centers adapted to their needs.
That there is no real inclusion and so far these are just slogans. That specialized medical centers are far away, they often offer not what a particular person needs, but what is available - of very low quality, like medicines that are constantly in short supply or on which they save. That they only dream of real mobility.
See for yourself, judging by the numbers, each of us will face the illness of a relative or our own illness, one way or another limiting our physical capabilities. Look at the main causes of disability in the population - these are diseases: cancer, cardiovascular diseases, diseases of the musculoskeletal system.
Everyone wants to be just people, not heroes
Quite recently, Dmitry turned to our foundation for help. He wrote that he was involved in a Paralympic sport - wheelchair rugby. His team has a great desire to go to the competition in Poland, but there is not enough funding, so Dima decided to contact us.
Dmitry Khamov
We recently opened the Not Disabled program, one of the goals of which is to help people with disabilities: when it is already clear that it cannot be cured, but it is possible to help them integrate into society. The program was born as a natural continuation of our targeted assistance in rehabilitation - a huge number of people get into road accidents, tens of thousands die and are injured. Someone needs expensive rehabilitation, and we help with this, but some people lose the ability to walk and need completely different help. Therefore, we responded, and I decided to meet with Dima personally.
10 years ago, Dmitry's car skidded in a turn and ended up in a tree standing next to the road. A severe head injury, a long rehabilitation, Dima could not walk. We did not talk about the difficult experiences of a guy who, at the age of 21, loses a lot, what is important is what is now. In 2012, he comes to wheelchair rugby - a new Paralympic sport for Russia - and has been playing rugby ever since.
To grow in sports, you need to have a constant practice of competing with equal and stronger opponents. However, the Russian wheelchair rugby team consists of 80% of the Moscow team - there is practically no competition in our country. The state gives money for rating competitions, for example, for the European Championship. But in order to win this tournament, you need to grow, and with whom to fight with us to become stronger? So the guys go to other tournaments at their own expense, where high-level teams meet, but there is not enough money.
Workout
After meeting with Dima, I got to the training of the national team. Captain - Valery Krivov. In 2003, when he was only 14 years old, he was injured by a “diver” - like all the guys, Valera went swimming and jumping into the water, and one day a terrible thing happened - he broke his neck. Then - another life, from which only 2 friends remained, the rest turned away, left. At home schooling, he graduated from high school and entered a technical school. Valery got married and moved to Moscow after an injury, came to the sport and became the repeated champion of Russia in Paralympic athletics, and then he was invited to rugby, where he stayed.
Sergei Glushakov
The head coach of the national team Sergey Glushakov is also the President of the Wheelchair Rugby Federation of Moscow. Before the accident in 2003, he worked in construction, was engaged in the reconstruction of airports. Then the same story: rehabilitation, meeting other guys, joining the sport, from which you no longer want to leave - everyone says that sport changes the consciousness of a disabled person, that he grows above himself, his condition and problems, which, nevertheless , remain.
Dmitry does not have the opportunity to live in a Moscow apartment - there are steps in the entrance and there is no lift, because according to the standards it is impossible to install it. Dima himself believes that it is possible to install it, he has already seen lifts in the same entrances, but, in his opinion, people who are far from the needs of the disabled sit on the commission, and issues are considered formally. Therefore, now Dima lives in Domodedovo with his parents - after all, he will not be able to climb the stairs himself. The authorities installed a ramp, but it is also impossible to move out and drive along it without outside help.
Active wheelchairs, in which people unable to walk can move around themselves, are expensive. According to the statistics that I know, among all the disabled in wheelchairs, an insignificant percentage of people move in this way. The rest use what the state gives. Example: the cost of an ordinary stroller is 13,000 rubles. With active use already during the first year, it begins to fall apart and requires constant repair. A good German one costs 80,000 rubles, and an active type - from 150,000. The state compensates only 54,000, that is, you have to buy a stroller yourself, and then some of the money will be returned to you.
I look at them and cannot get rid of the thought that I see heroes. I don’t like this word, but you can’t call it anything other than a heroic overcoming of circumstances. I really want to help them go to competitions in Poland, where teams from different countries will meet, including those that they will have to fight in the European tournament.
The goal is to get to the Paralympics in 2020, for this you need to improve your playing level. I believe they can. Despite all the statistics, the real state of affairs and forced heroism. After all, everyone wants to be just people, not heroes. Play wheelchair rugby not in spite of, but thanks to.
And I really want people to be able to choose what to do, even if they can't walk. So that everyone can leave the house, so that inclusion is real and the ramps are not made for us - the healthy ones, who, looking at these often useless structures, would think that something is being done for the disabled, but so that they really could move out and drive in . So that the queues for the installation of a lift in the entrances do not stretch for 5 years, it should not be that a person cannot leave the house for 5 years. And for the state to look at the problems and gaps in working with people with disabilities as facts, goals and objectives for solution, and not bashfully hide real numbers behind beautiful reporting.
In the meantime, we have to collect money - like this, through funds, to help those who have already embarked on their difficult path to go through it to the end. We just need to help.
The disability of society is the scourge of our time!
As of 01.01.2018 the number of disabled people in Russia is - 11,750,000.0 for a population of 146,800,000.0 people. Just think about these figures, this is about 8% of the population.
1,083,000.0 are citizens who have received their disability since childhood, their number is 9.21% of the total number of people with disabilities in Russia. For children, the statistics are also sad, as of 01/01/2018. disabled children under 18 years old in the Russian Federation - 655,000.0 is 5.6% of the total number of disabled people.
If you look at the statistics, the percentage of children with disabilities is growing, despite the demographic decline. The population is practically unchanged, only due to migration growth. The natural increase has been in huge minus since 1992.
The number of disabled children registered in the pension fund system of the Russian Federation
The results of primary examinations of children under the age of 18 and recognized as disabled in the category "disabled child"
The results of re-examination of disabled children under the age of 18 and were repeatedly recognized as disabled in the category "disabled child"
If we take into account children who were first recognized as disabled due to diseases of the nervous system, as well as children with mental and behavioral disorders, then the picture does not look rosy at all.
Also pay attention to the statistics by region. There are regions where there are many times more children with disabilities than the average throughout Russia.
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The number of disabled children under 18 in the Russian Federation as of 01/01/2018 - 655014 people |
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the Russian Federation |
Population by region |
Number of disabled children under 18 by region |
Amount of children |
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Central Federal District |
39209582 |
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Belgorod region |
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Bryansk region |
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Vladimir region |
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Voronezh region |
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Ivanovo region |
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Kaluga region |
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Kostroma region |
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Kursk region |
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Lipetsk region |
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Moscow region |
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Oryol Region |
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Ryazan Oblast |
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Smolensk region |
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Tambov Region |
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Tver region |
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Tula region |
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Yaroslavskaya oblast |
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Moscow city |
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Northwestern Federal District |
13899310 |
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Republic of Karelia |
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Komi Republic |
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Arkhangelsk region |
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including Nenets aut. county |
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Arkhangelsk region without author. districts |
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Vologodskaya Oblast |
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Kaliningrad region |
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Leningrad region |
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Murmansk region |
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Novgorod region |
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Pskov region |
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St. Petersburg |
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Southern federal district 3) |
16428458 |
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Republic of Adygea |
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Republic of Kalmykia |
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Republic of Crimea |
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Krasnodar region |
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Astrakhan region |
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Volgograd region |
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Rostov region |
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Sevastopol |
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North Caucasian Federal District |
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The Republic of Dagestan |
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The Republic of Ingushetia |
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Kabardino-Balkarian Republic |
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Karachay-Cherkess Republic |
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Republic of North Ossetia - Alania |
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Chechen Republic |
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Stavropol region |
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Volga Federal District |
29636574 |
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Republic of Bashkortostan |
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Mari El Republic |
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The Republic of Mordovia |
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Republic of Tatarstan |
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Udmurtia |
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Chuvash Republic |
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Perm region |
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Kirov region |
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Nizhny Novgorod Region |
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Orenburg region |
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Penza region |
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Samara Region |
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Saratov region |
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Ulyanovsk region |
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Ural federal district |
12345803 |
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Kurgan region |
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Sverdlovsk region |
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Tyumen region |
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including Khanty-Mansiysk Aut. district - Yugra |
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Yamalo-Nenets Aut. county |
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Tyumen region without author. constituencies |
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Chelyabinsk region |
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Siberian Federal District |
19326196 |
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Altai Republic |
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The Republic of Buryatia |
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Tyva Republic |
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The Republic of Khakassia |
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Altai region |
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Transbaikal region |
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Krasnoyarsk region |
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Irkutsk region |
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Kemerovo region |
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Novosibirsk region |
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Omsk region |
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Tomsk region |
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Far Eastern Federal District |
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The Republic of Sakha (Yakutia) |
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Kamchatka Krai |
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Primorsky Krai |
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Khabarovsk region |
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Amur region |
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Magadan Region |
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Sakhalin region |
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Jewish auth. region |
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Chukchi aut. county |
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1) According to the Pension Fund of the Russian Federation. |
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2) Since 2015, taking into account the number of disabled people in the Crimean |
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3) Starting from 2016, information on the Republic of Crimea |
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All data was obtained from the official website of the Federal State Statistics Service. And taking into account the fact that in Russia there has been no natural increase in the population since 1993, the statistics are not entirely accurate, because. in the population, migration growth is taken into account, which is very high - 250/300 thousand annually. According to statistics, an average of 700 thousand people since 1992. declined every year.
From 2007 to 2017, state support programs managed to reduce the population decline to 118 thousand on average per year. But here, too, there are kinks. Since Russia began to fight against infant mortality and nurse non-viable children born at short terms, the number of disabled children has increased. Almost every premature baby is at risk for cerebral palsy.
Let's hope that our State keeps abreast, and will continue to take steps aimed at the health of the nation, to increase natural growth. And it would be great to give the parents of sick children the opportunity to go to work and benefit the State, give birth to healthy children. By creating kindergartens with medical services for children with disabilities, where they accept not only walking children, but also those who do not serve themselves. Thus, it would be possible to save many families from disintegration, to give the mothers of such children the opportunity to realize themselves in the professional sphere, to give birth to a healthy child in the future, thanks to State support measures.
Disabled people - a group of the population, which includes persons with disabilities due to their health characteristics. There are quite a lot of such people today. Formerly disability statistics didn't matter much. Now it is being done very carefully. Statistics allows not only to count the number of people with disabilities, but also provides information about their lives, difficulties, needs.
These data are important for national policy. They allow assessing how high-quality and effective programs for people with disabilities are being implemented in the country.
The situation in the world
The statistics of disabled people in the world is 23% of the total population of the planet. That's over 1 billion. According to WHO, the number of people with disabilities is increasing every year. Reasons for the increase in the number of people with disabilities:
- increase in the number of the planet;
- significant progress in medicine;
- increase in people.
In countries where people live for 70 years or more, many people become incapacitated in old age. Among children and middle-aged people, 80% of disabled people live in developing countries, where the population has a low level of and. The picture shows how many percent of disabled people out of the total number of inhabitants in European countries.
Disability among children is a huge problem. Not only medical and social, but also economic. There are more and more people with disabilities in the world. This is a worrying trend. According to scientists, the numbers will continue to grow.
Employment of people with disabilities
The International Labor Organization reports that nearly 400 million of the working-age population are disabled. Many of them do not work anywhere. Most employers consider them incompetent. According to the statistics of working disabled people, only 20% of their total number. The remaining 80% are .
For example, in India, 70 million disabled people and only 0.1 million of them managed to get a job. In the United States, only 35% of employed citizens of this category are employed.
Many people with disabilities claim that they would like to work and get a decent salary for it, but they are hardly accepted anywhere.
How is it in Russia
The statistics of disabled people in Russia in 2015 totaled more than 12 million people. Almost half of them are men and women of working age. That is, for every 10 thousand people there are approximately 59 citizens of the incapacitated category. Most of them belong to the third group. Least of all representatives of the first group.
An analysis of the statistics of disabled people across the country shows that we have much fewer of them than in European countries. Domestic rates are among the lowest in the world. But this is not a reason to be proud. The reason lies not in the fact that our fellow citizens are in perfect health. In Russia, in order to receive and then annually confirm their disability, people with disabilities often have to fight against an imperfect system. Many patients are simply denied the award of incapacity. Doctors often demand for disability registration.
The diagram shows the statistics of disabled people in the Russian Federation. It shows how the number of people with disabilities living in Russia changed from 1995 to 2005.
So, the statistics of the number of disabled people in Russia and the world suggests that the number of disabled people on the planet is steadily increasing. This is a global problem for all mankind. Representatives of the authorities should think about improving the situation.
In the world, more than one billion people (15% of the population) suffer from various forms of disability. According to a WHO study, 785 million people aged 15 years and older live with a disability, of which 110 million suffer from severe forms of disability. Among children aged 0 to 14, these figures are 95 million and 13 million, respectively.
According to the World Health Organization (WHO), this figure is increasing due to the aging of the population and an increase in the number of people suffering from chronic diseases directly related to disability: diabetes, cardiovascular diseases, mental disorders, etc.
In countries where life expectancy exceeds 70 years, disability-related years account for an average of about 8 years, representing 11.5% of a person's total life expectancy.
Years associated with disability account for an average of about 8 years, which is 11.5% of the total life expectancy of a person
According to the Organization for Economic Co-operation and Development (OECD), population groups with lower levels of education have higher rates of disability. On average for OECD countries, it is 19%, compared with 11% among the population with a higher level of education. According to the United Nations Development Program (UNDP), 80% of people with disabilities are in developing countries.
1. International instruments on the status and rights of persons with disabilities
Comparative studies of disability legislation show that only 45 countries have laws against discrimination and other laws relating to persons with disabilities. At the same time, there are a number of international regulations and standards that are informational or recommendatory in nature.
2. International classification
International Classification of Functioning, Disability and Health - ICF (International Classification of Functioning, Disability and Health, ICF) - developed by WHO and adopted by the World Health Assembly on May 22, 2001. The document describes the concept of "disability" in relation to physical health (body condition), the individual and society as a whole. The structure of the ICF is based on an assessment of the functions and condition of the human body, the level of social activity and participation in public life.
Features of the ICF approach to the concepts of "health" and "disability" - a shift in focus from the cause of the disease and its consequences to the assessment of all components of health, including the social aspects of disability and "contextual" factors (environment and personality traits). The main idea set out in the document is that every person can experience a deterioration in health, and the resulting disability is not a characteristic phenomenon only for a certain social group.
Everyone can experience deterioration in health, and the resulting disability is not a characteristic phenomenon only for a certain social group.
According to the ICF, a disorder is the loss or deviation from the norm of a certain physiological function or part of the body. The term "disability" is used to refer to individual functioning characteristics associated with physiological, sensory and mental impairments, perceptual disorders, as well as various types of chronic diseases. Disability is considered in relation to three main aspects: organs and related functions and dysfunctions: paralysis, blindness, etc.; activity and activity limitations: inability to stand or sit, etc.; social activity and its limitations: discrimination in employment, difficulties in moving around the city, etc.
Types (categories) of disability include various physiological and mental disorders that make it difficult or impossible for a person to perform daily activities, as well as complicate communication with others.
Mobility and physiological disorders
- violations of the structure of the upper limbs;
- violations of the structure of the lower extremities;
- violations of fine motor skills of the hands;
- incoordination of various organs of the body.
Mobility disorders can be congenital or acquired with age. They can also be the result of illness or injury. For example, people who have a fractured limb also fall into this category.
Violations of the structures of the spinal cord
Spinal cord injuries often lead to lifelong health problems. As a rule, damage occurs as a result of serious accidents. Damage can be complete or incomplete. In the case of incomplete damage, the conductive capacity of the nerve fibers of the spinal cord is partially preserved. In some cases, damage may be the consequences of birth trauma.
Head trauma is a disorder of the brain. Brain damage leads to disruption in its work. There are two main types of injuries - acquired and traumatic, the degree of damage varies from mild to severe. The first type of damage is not congenital, but occurs after birth. The second type of injuries is mainly due to the influence of external influences: traffic and domestic accidents, sports injuries, criminal incidents, recreational injuries, etc. Traumatic injuries can lead to emotional dysfunction and behavioral disorders.
visual impairment
Hundreds of thousands of people suffer from various visual impairments - from minor to serious. Some disorders can lead to blindness over time. Most often, visual impairments are caused by damage to the cornea of the eye, damage to the white of the eye, diseases provoked by diabetes, dry eyes, corneal transplants.
Hearing disorders
Hearing loss can be partial or complete. Deafness can be congenital or develop with age due to diseases. For example, meningitis can cause damage to the auditory nerve or cochlea.
Perceptual disturbances and learning disabilities
Perceptual disorders include dyslexia, various difficulties in acquiring knowledge, and speech disorders.
Mental disorders
affective disorders- short-term or long-term mood or well-being disorders.
Mental disorders- a term that is used to describe the condition of people suffering from psychological problems or diseases, such as: personality disorders - inadequate behavior patterns, in such severe forms that they do not allow a person to lead a life, socialize and, in general, maintain a normal lifestyle.
Schizophrenia- mental disorder associated with the disintegration of thought processes and emotional reactions.
Invisible Violations differ in that they cannot be instantly recognized by others. As a rule, they have a neurological etiology. For example, not all people with visual impairments wear glasses, someone experiences chronic back pain when sitting or constant fatigue, suffers from sleep disorders, depression or agoraphobia, etc. According to statistics, 10% of US residents suffer from this type of impairment.
3. Accounting for disability
Geographically
Global Burden of Disease (GBD) is a group of indicators that characterize mortality and disability from major diseases, injuries and their risk factors. These indicators have been identified as a result of comprehensive regional and / or global medical statistical studies of the World Health Organization.
WHO measures the global burden of disease (GBD) in terms of years of life lost due to disability (DALYs). This temporal measure combines the years of life lost due to premature death and the years of life lost due to health conditions that do not meet criteria for full health. The DALY indicator was developed during the original 1990 GBD study to provide a consistent estimate of disease burden by disease, risk factor and region.
Table 1. World population with moderate and severe disabilities by region, sex and age. Data from the Global Burden of Disease study, 2004 estimate
High income countries- These are countries whose Gross National Income (GNI) in 2004 was $10,066 or more (according to World Bank estimates).
Low income countries- These are countries whose Gross National Income (GNI) in 2004 was less than $10,066 (according to World Bank estimates).
The classification of diseases according to forms is given in Table 2. Here and below, we propose to consider a severe form of disability as an analogue of disability group I according to the classification adopted in the Russian Federation, and an average form - II disability group.
The severity coefficient is calculated for both sexes and all age categories for the entire world population. In some cases, one person may have pathologies of different degrees of severity; in this case, he is assigned up to seven classes of disability. The severe form of disability corresponds to classes VI and VII, the average form - from III and above.
Table 2 Classification of disability groups in the Global Burden of Disease study, with indication of chronic diseases and complications for each class
Due to disability
The most common causes of disability worldwide are adult hearing loss and refractive hearing loss. Psychiatric disorders such as depression, alcohol use disorders, psychiatric disorders (such as bipolar disorder and schizophrenia) are also among the top 20 causes of disability. The picture is different between high- and low-income countries. In low-income countries, many more people are disabled due to preventable causes such as unintentional injury and infertility resulting from unsafe abortions and maternal sepsis. Also, in low-income countries, disability due to unintentional injuries among young people and cataracts among the elderly are much more common.
Table 3. Prevalence of moderate and severe disability (millions) for key disabling diseases by age for high-, middle- and low-income countries, Global Burden of Disease, 2004 estimate.
By age
Global aging has a significant impact on the development of disability. The higher rate of disability among older people reflects the fulfillment of accumulated health risks through injury and chronic disease.
Table 4. Age prevalence of disability by gross national product
Table 5. Age prevalence of disability by sex
The prevalence of disability among people aged 45 and over in low-income countries is higher than in high-income countries and is higher among women than among men.
Table 7. Distribution of the number of people with disabilities by age on the example of Australia, Canada, Germany, Ireland, New Zealand, South Africa, Sri Lanka, USA (%)
4. Financial situation and structure of payments
In Europe, social spending directed towards helping older people is designed to mitigate the risks that arise with the achievement of old age - lower income levels, lack of income, loss of independence in daily activities, reduced participation in social life, etc. At the same time, spending for medical care for the elderly should be attributed to another item of expenditure - in connection with illness and the need for treatment. However, it is not always easy to strictly distinguish between them. In most EU countries, social spending in three areas - in connection with old age, the death of a family member and disability - are highly interdependent. In order to ensure better comparability, the cost of assistance for old age and for the death of a family member is often combined, considering them together.
In 2007, social payments and benefits in the EU-27 amounted to 25.2% of GDP
In 2007, social payments and benefits (excluding administrative costs and other costs) in the EU-27 amounted to 25.2% of GDP. Most payments and benefits were directed to help in connection with old age and on the occasion of the death of a family member - 46.2% of all social benefits and payments, or 11.7% of GDP, as well as on the occasion of illness and the need for treatment - 29.1 % of total social transfers and benefits in the EU-27, or 7.4% of GDP. 6.1% of GDP was spent on all payments in other areas of social protection.
Figure 1. Social benefits and payments provided in the EU-27 in 2007, by purpose, %
Table 6. Amount and conditions of disability payments per person per month,,
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