Recognising the ‘social’ in disability and health: the case of the Winter Paralympics.

CHPR blog, March 2018, Kris Southby

The 12th Winter Paralympic Games, which ended last week, was ten days of intense competition across six winter-sports events. Anyone watching on television – or who is familiar with para-sport – will have noticed that within each event, athletes are grouped to compete against each other based on their disability. The reason for this is so that athletes will not be unfairly advantaged or disadvantaged by coming up against competitors with different types of disability.

A quick Google brings up numerous guides and explanations about the classifications used (the International Paralympic Committee’s official guide to winter sport classification is here). However, less information is available about the thinking underpinning the classification system in general.

Within the field of disability studies, there are two opposing views – or models – about how to understand what a disability is. The ‘medical model’ supposes that disability is an individual pathology that people have. Someone is blind or may have no legs, for example. Conversely, the ‘social model’ of disability argues that disability is an experience that occurs at the interaction between individuals’ impairments and the way society is organised. So, for example, someone with a visual impairment is ‘disabled’ by a society that expects them to rely on visual information.

Para-sport is an interesting crossover of these two ideas. One the one hand, athletes are classified based on a purely medical perspective of their physical characteristics (literally) by a medical professional. On the other, the very notion of classifying participants introduces an egalitarian element that is reflective of the social model, recognising that athletes will be differently able to complete because of how their impairment interacts with the event.

The same dichotomy of perspectives – medical and social – are important in health. What it means to be healthy can be understood from an individual, medical perspective: do you have X disease? Is your weight under X? Is X chromosome defective? An alternative social perspective emphasises the social factors affecting the individual, such as housing, wealth, or social connectedness.

Thankfully, a social model of health is becoming increasingly recognised and influential with policy makers and practitioners. The rise of something like social prescribing shows how the need to affect people’s social situation rather than just deal with their symptoms (usually through medication) is becoming more accepted. However, whilst these developments are welcome, there is still a way to go before we have parity between the ‘medical’ and ‘social’. Para-sport has built a system that integrates individual impairment to ensure competition that is more equitable. I’m not sure if the same can be said for health.





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