Understanding the Link Between Health and Disability: A Holistic Perspective

Health and disability are deeply intertwined, yet they are often misunderstood as the same thing. A person with a disability is not necessarily unhealthy, and being healthy does not exclude living with a disability. To understand this link, we must move beyond seeing disability as merely a medical condition and recognise how bodies, minds, and the surrounding environment together shape a person’s wellbeing. This holistic view forms the foundation of modern disability studies and public health policy.

Defining health and disability 🔗

The World Health Organization defines health as a state of complete physical, mental, and social wellbeing, not merely the absence of disease. Disability fits within this broader definition because it touches every dimension of life, from biology to social participation.

According to the World Health Organization, disability is an umbrella term covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure. An activity limitation is a difficulty an individual faces in executing a task or action. A participation restriction is a problem a person experiences in being involved in life situations. This three-part framework comes from the WHO’s International Classification of Functioning, Disability and Health (ICF), which describes disability as a dynamic interaction between a person’s health condition and the personal and environmental factors around them.

An example to clarify the three components 🔗

Consider a young woman who has lost her vision. The loss of sight is the impairment. Her difficulty in reading printed text without assistance is the activity limitation. If her college does not provide screen readers or accessible study material, her inability to attend lectures on equal terms becomes a participation restriction. The first arises from her body, but the second and third are shaped just as much by what the world around her does or does not offer.

The medical model of disability 🔗

The medical model views disability as a problem located within the individual. Under this perspective, the person is seen as someone who needs to be diagnosed, treated, rehabilitated, or “fixed” through medical intervention. This model focuses on what is wrong with the person rather than what the person needs, which can lead to low expectations and a loss of independence.

While medical care is essential for managing many conditions, the medical model becomes limiting when it treats disability as solely a personal misfortune. It can encourage attitudes of pity or charity rather than rights and equality. It also tends to exclude people with disabilities from decisions about their own lives because professionals are seen as the experts on what they need.

The social model of disability 🔗

The social model offers a different lens. It argues that disability is caused by the way society is organised rather than by a person’s impairment or difference. People are disabled by physical barriers, inaccessible communication, and prejudiced attitudes, not by their bodies alone.

The classic illustration is a wheelchair user who cannot enter a building because of a step at the entrance. The medical model would say the person is disabled because they cannot walk. The social model would say the person is disabled because the building lacks a ramp. Remove the step, and the disability disappears in that situation.

This shift in thinking, largely shaped by the work of British sociologist Mike Oliver, has had a powerful influence on disability rights movements across the world. It reframes accessibility, inclusion, and dignity as social responsibilities rather than personal struggles.

A balanced view: the biopsychosocial approach 🔗

Most experts today recommend a balanced approach that combines both models. The ICF framework itself is biopsychosocial, recognising that biological factors, psychological wellbeing, and social environments all interact. A child with cerebral palsy benefits from physiotherapy and assistive devices, but she also needs ramps in her school, teachers trained in inclusive education, and classmates who treat her as an equal. Neither medicine nor social change alone is enough.

Types of disabilities 🔗

Disabilities are diverse, and grouping them helps in planning health services, education, and welfare. In India, the Rights of Persons with Disabilities Act, 2016 recognises 21 specified disabilities, an increase from the seven covered under the earlier 1995 law. These categories broadly fall under physical, mental, intellectual, and sensory impairments, along with chronic neurological and blood disorders.

Physical and locomotor disabilities 🔗

These affect movement and mobility. They include conditions such as cerebral palsy, leprosy-cured persons, muscular dystrophy, dwarfism, and acid attack survivors. People may use wheelchairs, crutches, or prosthetic limbs, and their everyday participation depends heavily on physical infrastructure such as ramps, lifts, accessible toilets, and adapted transport.

Sensory disabilities 🔗

Sensory disabilities involve impairments in vision or hearing. Blindness and low vision affect a person’s ability to read, navigate spaces, and access information. Deafness and hard of hearing affect communication and access to spoken language. Assistive tools such as braille, screen readers, sign language interpreters, and hearing aids help reduce activity limitations, but participation also depends on whether public services and workplaces actively accommodate these needs.

Intellectual disabilities 🔗

Intellectual disability involves significant limitations in intellectual functioning and adaptive behaviour, which affects learning, reasoning, and everyday social skills. Conditions such as Down syndrome and specific learning disabilities like dyslexia and dyscalculia fall here. With early intervention, supportive education, and family involvement, many people with intellectual disabilities lead full and meaningful lives.

Mental and psychosocial disabilities 🔗

Mental illness, including conditions such as schizophrenia, bipolar disorder, and severe depression, is recognised as a disability when it substantially affects a person’s daily functioning. Psychosocial disabilities are often invisible, which makes them especially vulnerable to stigma. People may face discrimination at workplaces, in educational institutions, and sometimes within their own families.

Neurological and blood disorders 🔗

The 2016 Act added conditions such as autism spectrum disorder, multiple sclerosis, Parkinson’s disease, thalassemia, haemophilia, and sickle cell disease. These often involve chronic management of symptoms and may fluctuate over time, which complicates how others perceive them. A person with multiple sclerosis may appear fine one day and struggle to walk the next.

How disability affects health and quality of life 🔗

Disability and health influence each other in both directions. A health condition can lead to impairment, but the experience of living with a disability also affects overall health. People with disabilities often have less education and live in more deprived conditions, including insufficient food, poor housing, and lack of access to safe water and sanitation, which raises their risk for many infectious and non-communicable diseases.

The most recent estimates from the National Family Health Survey-5 (2019-21) in India and earlier rounds suggest that disability prevalence is around 2.2 per cent, though many experts believe this is an undercount because of stigma, narrow definitions, and the invisibility of conditions such as mental illness and chronic pain. Globally, the WHO estimates that around 15 per cent of the population lives with some form of disability.

Persons with disabilities are also at greater risk of poverty, unemployment, and social isolation. The 2011 Census in India covered only seven broad categories of disability, primarily visible or physical impairments, which means people with invisible conditions like chronic fatigue, learning disabilities, or mental illness were largely missed from official data.

Societal barriers that shape the disability experience 🔗

The social model reminds us that the environment can either include or exclude people with disabilities. In practice, several types of barriers continue to limit participation.

Physical and infrastructural barriers 🔗

Many public buildings, schools, hospitals, and transport systems remain inaccessible. Footpaths without ramps, crowded buses with high steps, railway stations without lifts, and inaccessible toilets all reduce the freedom of movement that most people take for granted. A 2022 Parliament Standing Committee Report highlighted that the Accessible India Campaign, also known as Sugamya Bharat Abhiyan, had achieved less than 30 per cent of its accessibility targets, showing how far the gap between policy and ground reality can be.

Attitudinal barriers 🔗

Prejudice, stereotypes, and pity are often more disabling than physical barriers. Persons with disabilities are sometimes infantilised, treated as objects of charity, or assumed to be incapable of work, marriage, or independent decision-making. These attitudes can be internalised, eroding self-esteem and confidence. The shift in language from “handicapped” or “viklang” to Divyang, meaning “one with divine abilities”, reflects a deliberate attempt to change how society perceives disability, though critics point out that respectful terminology must be backed by structural change to have real meaning.

Communication barriers 🔗

The absence of sign language interpreters in hospitals, the lack of braille and audio formats for official information, and the rarity of plain-language materials all isolate people with sensory or cognitive disabilities. Even digital platforms, which can be enormously empowering, often fail to follow basic accessibility standards.

Economic and employment barriers 🔗

People with disabilities are far more likely to be unemployed or underemployed. Employers may hesitate to hire them due to misconceptions about productivity, even though research consistently shows that workers with disabilities are as capable as anyone when given the right environment. The 4 per cent reservation in government jobs for persons with benchmark disabilities under the RPwD Act is a step forward, but private sector inclusion remains limited.

Healthcare barriers 🔗

Ironically, healthcare itself can be inaccessible. Examination tables that cannot be lowered, doctors untrained in communicating with deaf patients, and a lack of rehabilitation centres in rural areas all create gaps in care. During the COVID-19 pandemic, the National Human Rights Commission noted that persons with disabilities faced disproportionate barriers in accessing vaccination and healthcare services, exposing fault lines that had existed long before the crisis.

Moving towards a holistic and inclusive approach 🔗

A holistic perspective on health and disability requires action on several fronts at once. Medical care must remain available and high quality, but it should be paired with universal design in buildings, inclusive education, sensitised workplaces, and accessible communication. Persons with disabilities must be involved as decision-makers, not just as beneficiaries, because nothing about them should be planned without them.

India’s adoption of the RPwD Act 2016, in line with the United Nations Convention on the Rights of Persons with Disabilities, signals a policy commitment to this holistic view. Implementation, however, depends on awareness at every level, from the family that supports a child with autism to the architect who designs an accessible metro station, to the employer who hires beyond quotas.

Health and disability are not opposites. They sit together within the broader story of human diversity. When we change buildings, attitudes, and systems, we expand what is possible for everyone, not just for persons with disabilities.

What do you think? If you observed your own college, neighbourhood, or workplace through the lens of the social model, how many barriers would you notice that you had previously overlooked? And what is one small change in your environment that could meaningfully improve participation for someone with a disability?

References

1. https://www.emro.who.int/violence-injuries-disabilities/strategy/disabilities.html
2. https://www.cdc.gov/nchs/data/icd/icfoverview_finalforwho10sept.pdf
3. https://www.disabilitynottinghamshire.org.uk/index.php/about/social-model-vs-medical-model-of-disability/
4. https://www.pib.gov.in/newsite/printrelease.aspx?relid=155592
5. https://www.afro.who.int/health-topics/disabilities
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC10009251/
7. https://idronline.org/article/diversity-inclusion/removing-barriers-for-persons-with-invisible-disabilities/
8. https://www.kamarajiasacademy.com/current-affairs/disabled-persons-and-their-vulnerability-in-india
9. https://en.wikipedia.org/wiki/Rights_of_Persons_with_Disabilities_Act,_2016