1.What is disability and disabled person
Disability refers to a state in which a person loses the ability to live, work and study normally to varying degrees due to obvious physical and mental dysfunction caused by trauma, disease, developmental defects or mental factors.
A person with a disability is a person who has some kind of tissue loss, loss of function or abnormality in the psychological, physical, or human body structure, thus partially or completely losing the ability to engage in personal or social life in a normal way. This includes people with visual impairment (disability), hearing impairment (disability), speech impairment (disability), physical impairment (disability), mental impairment (disability), visceral impairment (disability), multiple impairments (disability), and other impairments (disability).
2. How many people with disabilities are there in the world today
According to the World Health Organization, people with disabilities currently account for about 10% of the world’s population, with a total of about 600 million people, including about 200 million children with disabilities, 80% of whom are in developing countries. According to the results of the second national sample survey of people with disabilities conducted in China on April 1, 2006, the total number of people with various types of disabilities in China is 82.96 million, accounting for about 6.34% of the total population. The number of persons with various types of disabilities and the proportion of the total number of persons with disabilities are: 12.33 million people with visual disability, accounting for 14.86%; 2004 million people with hearing disability, accounting for 24.16%; 1.27 million people with speech disability, accounting for 1.53%; 24.12 million people with physical disability, accounting for 29.07%; 5.54 million people with intellectual disability, accounting for 6.68%; 6.14 million people with mental disability, accounting for 7.40%; and 13.52 million people with multiple disabilities, accounting for 7.40%. The number of people with multiple disabilities is 13.52 million, accounting for 16.30 percent. Compared with the first national sample survey of disabled people in 1987, the total number of disabled people has increased, the proportion of disabled people has risen, and the structure of disability categories has also changed.
3.The main causes of disability
(1) Inbreeding.
Sexual diseases can lead to almost all categories of disability. According to a survey in six provinces in China, 80% of farmers intermarriage not out of the county, 50% not out of the township, 30% not out of the village, resulting in the occurrence of congenital disabilities more. A county in Sichuan inbreeding rate of 7%, their offspring intellectual disability of 20%. Malnutrition and diseases of pregnancy and childbirth, obstetric complications, abnormal delivery, etc. can cause fetal malformations, mental retardation and other disabilities. Because of the lack of folic acid in pregnant women, 80,000-100,000 children with anencephaly, spina bifida and other neural tube deformities are born in China every year. Most of the disabled children in China are congenitally disabled, and the proportion of congenital disability among all kinds of disabled children are: 68.7% for visual disability; 57.2% for intellectual disability; 47% for hearing and speech disability; and 35.4% for physical disability. According to statistics, more than 300,000 children with congenital disabilities are born in China every year, of which 60,000~80,000 are children with cerebral palsy.
(2) Diseases.
Diseases are the main factors causing disability, such as polio among infectious diseases, since 1995, no wild virus cases have been found in China, but the degree and consequences of physical disability caused by it are still very serious. The current rate of hypertension has reached 11% is an important cause of stroke and heart disease, and there are about 5 million patients with hemiplegia caused by hypertension in China.
①Infectious diseases: such as poliomyelitis, B encephalitis, spinal tuberculosis, etc;
② Pregnancy diseases: such as rubella, intrauterine infection, toxemia of pregnancy, syphilis, AIDS, etc.;
③ Chronic and geriatric diseases: such as cardiovascular diseases, chronic obstructive pulmonary diseases, diabetes, rheumatoid arthritis, tumors, etc. All of them can lead to different types of disabilities.
(3) Drug poisoning: drug poisoning can cause deafness, blindness, fetal malformation, etc., and there is a rising trend in recent years. At present, there are dozens of drugs known to cause deafness, such as streptomycin and gentamicin, etc. The proportion of drug deafness in patients with acquired deafness has increased from 5% in the 1950s to 40% in the 1990s. In addition, tetracycline, aspirin-like drugs, sex hormones, reaction stop, valproic acid, etc., can cause fetal physical disability, which is mainly related to the nature of the drug itself, the dose, the duration of medication and the gestational age at the time of medication. Generally speaking, the younger the gestational age, the higher the dose and the longer the duration of the drug, the greater the chance of disability. Therefore, pregnant women should consider the use of drugs carefully and should not abuse drugs.
(4) accidental injuries: accidents, such as enterprises, mines, traffic accidents and other casualties are increasing year by year, according to the 1994 statistics about 400,000. In addition, sports injuries, birth injuries, etc., can also cause cranio-cerebral injury, skeletal muscle system injury, etc. Children with physical disabilities caused by trauma account for 13.65%.
(5) Harmful environment and other factors: Harmful environment, such as endemic iodine deficiency, can lead to intellectual disability, congenital deafness and many other disabilities. There are 400 million people threatened by iodine deficiency in China, and the average IQ level of children in areas with severe iodine deficiency is 10-15 percentage points lower than that of other areas. Fluorosis caused by high environmental fluoride can lead to physical disability, and there are more than 300 million people threatened by it in China. Endemic macrosomia can also lead to physical disability, with a current population of nearly one million. Poor production environment, as well as industrial and agricultural production and transportation of exhaust gas, sewage, noise, solid waste caused by environmental pollution, can lead to occupational diseases and disabilities. According to the survey, about 85% or more children in industrial areas in China are harmed by lead poisoning, which seriously threatens their physical development and intellectual development. Malnutrition is also a factor leading to disability, such as serious lack of protein can cause mental retardation, serious lack of vitamin A can cause corneal softening and blindness, and serious lack of vitamin D can cause bone deformity. In addition, social and psychological factors can also cause disability. Human beings live in a society and face many common causes of disability, but in different communities, the causes of disability, the distribution of the population causing disability, and the degree of disability are different.
4.Prevention and rehabilitation of disability
In modern society, people with disabilities, like any able-bodied person, have the inherent right to live as human beings, but their rights, qualifications and dignity are compromised by physical and mental impairments. Rehabilitation is a prerequisite for people with disabilities to participate in social life. Most people with disabilities have the potential for rehabilitation and can recover and compensate for their functions and improve their ability to take care of themselves and adapt to society through practical rehabilitation training. The provision of local and practical rehabilitation training and services to people with disabilities is conducive to their health protection and quality of life improvement, and restores their rights as normal able-bodied people to acquire their gifts. However, many disabilities are difficult to achieve satisfactory results even after sustained rehabilitation or functional reconstruction, while the primary causes of disability can be prevented with low investment and high benefits. Specifically, it is to carry out disability prevention in the community, to organically combine the two efforts, to make full use of resources such as institutions, networks, facilities and professionals shared by the community, to focus on primary prevention, while strengthening secondary and tertiary prevention, so that disability prevention and community rehabilitation complement each other, promote each other and develop together.
Disability prevention should be carried out at different levels of national, local, community and family, and should be carried out at different periods of fetus, child, youth, adult and old age. And it needs the joint efforts of multiple departments of health, civil affairs, education, justice, and the Disabled Persons’ Federation to accomplish it.
Primary prevention is to reduce the occurrence of various disease losses. Primary prevention is the most effective and can reduce the incidence of disability by 70%. The measures taken include: eugenics, prohibition of marriage between close relatives, strengthening genetic counseling, prenatal, pregnancy and perinatal health care; vaccination, and active prevention and treatment of geriatric and chronic diseases; reasonable nutrition; reasonable use of drugs; prevention of accidents; strengthening health education, and paying attention to mental health. Among the 82.96 million disabled people nationwide, except for intellectual disability, which is mainly caused by congenital factors, most of the other types of disabilities are mainly caused by acquired factors, and the proportion is as high as 88.5%-98.6%, and the control of acquired factors can be achieved by taking effective measures to actively control them. For example, the prohibition of inbreeding can reduce the occurrence of congenital intellectual disability by about 13%. Early diagnosis and prevention of children with congenital defects can be effectively carried out through the application of pregnancy and prenatal diagnostic techniques and tools.
Secondary prevention is the limitation or reversal of disabilities caused by lesions. It can reduce the incidence of disability by 10-20%. The measures taken include: early detection and early treatment.
Treatment includes.
① Appropriate medication: e.g. treatment of tuberculosis, hypertension, etc. ;
② Basic surgical treatment: e.g. traumatic fracture, cataract surgery, etc.
Tertiary prevention is to prevent disabilities from turning into more serious disabilities. It can reduce the impact of disability on individuals, families and society. The measures used include: rehabilitation medical treatment, such as exercise therapy, occupational therapy, psychotherapy, speech therapy, and prosthesis, braces, aids, wheelchairs, etc.; educational rehabilitation; vocational rehabilitation; social rehabilitation; and also due social education.