Re-framing disability: Ethical underpinnings of community-centered practice

In public health curriculums, disability prevention is often highlighted as a hallmark of the field. The underlying assumption is that whenever possible, disability should be prevented. Consequently, health education and promotion efforts often overlook the importance of preventative care for people with disabilities or societal consequences of having a disability. With advances in medical technologies, morbidity is of growing public health significance. Disability Studies scholars challenge the focus on impairment and suggest that discrimination on the basis of impairment also should be mitigated. This project aims to provide a conceptual framework that unifies dominant public health and disability rights perspectives. By applying a public health framework to Disability Studies concepts, this project explores potential areas of shared interest between health professionals and people with disabilities. Specifically, we assess the International Classification of Functioning, Disability, and Health (ICF) model, models of disability, and quality of life. Through an iterative process that looked at both critiques and strengths of these concepts, the project identified three possible areas of congruency: disability as a social determinant of health, the experience of health inequities for people with disabilities, and a participatory approach to quality of life assessments. While these concepts reflect public health ideologies, they are inconsistent with the dominant public health model of disability prevention. In order to address expressed concerns of people with disabilities and provide a mechanism to include this often underrepresented and vulnerable community, schools of public health must re-frame the dominant understanding about disability prevention.