Causes of Disability
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Transcript of Causes of Disability
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Patricia Lima Pereira
Student of Master in Public Health and Social Protection
Institute of Public Health- Jagiellonian University Medical College
15th, January 2010
Causes of disability: A challenge for research
in Latin America
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Wide range of definitions
Different types of classifications
Different methods used to measure the disability
Difficulties in comparing disability statistics
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Disability prevalence (%), by census data 14.4
6.4 5.3 4.7 4.6 3.92.6 2.2 1.8 1.8 1.1
HEALTH IN THE AMERICAS, 2007.VOLUME I–REGIONAL
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Disability prevalence (%) by household surveys
Uruguay Chile El Salvador
7.6
5.3
1.5
HEALTH IN THE AMERICAS, 2007.VOLUME I–REGIONAL
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Disability prevalence (%)by national studies using ICF-2001
HEALTH IN THE AMERICAS, 2007.VOLUME I–REGIONAL
Chile Ecuador Panamá Nicaragua
12.912.1 11.6
10.3
1
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Disability prevalence (%) in Chile,by different data sources
0
4
8
12
2.25.3
12.9
HEALTH IN THE AMERICAS, 2007.VOLUME I–REGIONAL
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Under-estimation of disability Core Impairment vs. Impairment
Continuum
BlindnessDeafnessMobilityMental retardation
All other impairments – moderate to mild
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Evolution of the definition of disability
From International Classification of Impairments, Disabilities and Handicaps (ICIDH)
1980
To International Classification of Functioning, Disability, and Health (ICF)
2001
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International Classification of Impairments, Disabilities and Handicaps (ICIDH) 1980
Impairment Disability Handicap
CAUSES
The “medical model of disability” regards disability only as an individual pathological problem, in need of cure, rehabilitation and adaptation to society.
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congenital
disease or infectioninjury or
trauma
Underlying causes of impairments3
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36%
34%
3%
27%
Vietnam
52%
21%
18%
9%
Uruguay
8%9%
67%
16%
Nicaragua
Illness
Birth
Aging
Acci-dents
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Adquired diseases
Traffic accidents
Occupational disease
Violence
Poverty
Problems at birth Aging
Main causes of disability in Latin America 3
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International Classification of Functioning, Disability, and Health (ICF) 2001
Dimensions of Functioning
Body Functions and Body Structures
Activities
Participation
Dimensions of Disability
Impairments
Activity limitations
Participation restrictions
The “social model of disability” does not deny medical & rehabilitativeneeds of persons with disabilities, but draws attentions to social, physical,informational and institutional barriers, which contribute disability.
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Body Functi
ons and
Structures
Activi- ties
Partici-pation
Health conditio
n
Personal
factors(gender,
age, socialbackground, education, profession,
etc.)
Environmental
factors (architectural characteristics, legal and
social structures,
ect.)
Contextual factors
Diseases,
disorders
injuries3
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Causes of disabilityUsing the approach of the ICF - 2001
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Diseases,
disorders
injuries
Health conditio
n
Personal
factors(gender,
age, socialbackground, education, profession,
etc.)
Environmental
factors (architectural characteristics, legal and
social structures,
ect.)
Contextual factors
Disability
CAUSES
CAUSES
CAUSES
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Diseases,
disorders
injuries
Health conditio
n
Disability
England Department of Health. Health Survey for England 2001
Headings of the International Classification of Diseases, 10th revision (ICD-10)
4
63 categories
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Diseases,
disorders
injuries
Health conditio
n
England Department of Health. Health Survey for England 2001
Headings of the International Classification of Diseases, 10th revision (ICD-10)
53%1
7%
11%
9%
9%
Musculoskele-tal system and connective tissue
Diseases of the circulatory system
Problems of old age
Diseases of the respiratory system
Ear and mas-toid processes
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Diseases,
disorders
injuries
Health conditio
n
Personal
factors(gender,
age, socialbackground, education, profession,
etc.)
Environmental
factors (architectural characteristics, legal and
social structures,
ect.)
Contextual factors
Disability
4
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Environmental
factors (architectural characteristics, legal and
social structures,
ect.)
Disability
4
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Diseases,
disorders
injuries
Health conditio
n
Environmental
factors (architectural characteristics, legal and
social structures,
ect.)
4
Personal
factors(gender,
age, socialbackground, education, profession,
etc.)Contextual factors
Disability
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Personal
factors(gender,
age, socialbackground, education, profession,
etc.)
Disability
4
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Poverty is both a cause and consequence of disability
Takamine, Yutaka (2003). Disability Issues in East Asia: Review and WaysForward.
Poor people
20 -30% Poor with disability
Disabled
persons
Poor disabled Persons (40%
more are poor) 4
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Limitations of the ICF approach
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Limitations of the ICF approach 5
Focus on disability experience and ignores etiology of health conditions
“In the ICF we would record the loss of limb as such, regardless of whether the loss was the result of a landmine, diabetes or a traffic accident. The impairment remains the same. Similarly, we would document the fact that a person was not working regardless of whether the underlying health condition was ‘flu, depression, or back pain”.
Training Manual on Disability Statistics (WHO/ ESCAP 2008)
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Focus on disability experience and ignores etiology of health conditions
Limitations of the ICF approach 5
IT MAY BE CONSIDERATE A LIMITATION?
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Identification of the cause of disability may assist policymakers to make decisions about the type of preventive programs appropriate for their country
5
COMPULSORY USE OF HELMETS
HEALTH CARESERVICES
ACCESS TO CLEAN WATER
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Could that create problems in the future?
Would it reduce the availability of data necessary to evaluate health prevention interventions at population levels?
Tendency focus in disability experience, neglecting the causes
Remaining questions 6
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CDC. Prevalence and Most Common Causes of Disability Among Adults in the United States. Morbidity and Mortility Weekly Report (MMWR), available on http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5816a2.htm#tab2. Retrieved on 04/01/10. 18:02, 2005.
DANE Colombia. Censo Nacional de Población. Informe preliminar cifras de población con discapacidad. Bogotá: Departamento Administrativo Nacional de Estadística, 2006.
DCDGRD Colombia. Información estadística de la discapacidad. Dirección de Censos y Demografía Grupo de Registros Demográficos. Colombia , 2004.
England Department of Health. Health Survey for England 2001. Available on: http://www.archive2.official-documents.co.uk/document/deps/doh/survey01/disa/disa01.htm. Retrieved on 03/01/2008. 21:20, 2001.
Hernandez Collado, Héctor. «Encuesta Nicaragüense para Personas con Discapacidad (ENDIS).» 2003. Murray, Christopher, and Alan López. The Global Burden of Diseases, Global Burden of Disease and Injury
Series. World Health Organization, Harvard School of Public Health, World Health, 1996. PAHO. La discapacidad en Nicaragua: situación actual y perspectivas. Panamerican Health Organization,
2005. Sánchez, S, M Sanabria, and N Medina. "Nutritional profile of indigenous children under five years old in
Paraguay. Indigenous Household Survey 2008." Pediatric Research, 2009: 65:4 (479). Takamine, Yutaka. «Disability Issues in East Asia: Review and Ways.» 2003. Vásquez, Armando. «La discapacidad en América Latina.» En Discapacidad: lo que todos debemos saber,
de Alicia Amate y Armando Vásquez, 9-24. Washington: OPS, 2006. WHO. «Health in the Americas 2007. Volume I Regional.» avalaible on www.who.int, 2007. WHO. International Classification of Functioning, Disability and Health. Geneva: World Health Organization,
2001. WHO/ ESCAP. Training Manual on Disability Statistics. World Health Organization / United Nations Economic
and Social Commission for Asia and the Pacific Region, 2008.
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