Chapter 5: Physical Disability

INTRODUCTION

Physical disability is often the most visible type of disability. It is difficult not to see when someone uses a wheelchair or a mobility aid such as a cane, walker, or crutches, or to notice that someone is missing one or more extremities.

Just as different federal and state agencies define the general term disability in different ways, the term physical disability has different definitions. One definition, developed by the Independence Care System (2016) based on the Americans with Disabilities Act of 1990, and published in A Blueprint for Improving Access to Primary Care for Adults with Physical Disabilities, describes physical disability as a functional limitation (specifically, in mobility) that affects one or more activities of daily living—for example, bathing, toileting, cooking, walking, transferring, or dressing.

Another way of defining or describing disability is by function or functional type based on self-reported difficulties (Centers for Disease Prevention and Control [n.d.-a). Using this approach, physical disability can be equated to some degree with the following categories (with the first category most closely aligned):

• Mobility limitations: Serious difficulty walking or climbing stairs

• Independent living limitations: Difficulty doing errands such as shopping or visiting a physician’s office alone

• Self-care limitations: Difficulty dressing or bathing

In its Survey of Income and Program Participation (SIPP), the US Census Bureau (2014) defined physical disability as follows:

• Requiring the use of a wheelchair, a cane, crutches, or a walker

• Difficulty performing one or more of the following functional activities: seeing, hearing, speaking, lifting/carrying, using stairs, walking, or grasping small objects

• Difficulty with one or more activities of daily living (getting around inside the home, getting in or out of bed or a chair, bathing, dressing, eating, and toileting)

• Difficulty with one or more instrumental activities of daily living (going outside the home, keeping track of money and bills, preparing meals, doing light housework, taking prescription medicines in the right amount at the right time, and using the telephone)

Finally, the terminology used by the Centers for Disease Control and Prevention (CDC) in the National Health Interview Survey (NHIS) demonstrates the complexity of definitions of disability in general and physical disability specifically (CDC, n.d.-b):

• Has limitation of activity (e.g., personal care needs, routine needs, inability to work, limited work, walking, remembering; other physical, mental, or emotional limitations)

• Requires use of special equipment (e.g., cane, wheelchair, special bed, special telephone)