Facts and figures

Introduction

It is often argued that it is not feasible to target people with disabilities in development projects, because even their number is not known. However, there is enough evidence to show that there are disabled people in every target population:

• Einar Helander has estimated that 7-10 % of the world's population have a disability[ 1]. The proportion varies between 4-20 % [2] depending largely on definitions and study methods used. Also age structure affects these figures.[3]
• The World Bank's estimates of the number of the world's population who have disabilities varies between 282 and 608 millions. The differences in the figures are mainly explained by the criteria and indicators used. Disability issues, trends and recommendations for the World Bank (PDF doc)

Estimates on the number and proportion of people with disabilities can be based on two rather different types of indicators:

1. indicators describing the number of people who have impairments i.e. loss or abnormality of body structure or functions. Sometimes such indicators are also called deficiency measures.
2. indicators describing the number of people who experience difficulties in seeing, hearing, moving or performing other activities of daily living. Such indicators reflect the functional definition of disability.

Impairment indicators give lower estimates on the extent of disability than those figures that are based on the functional definition. For instance, in Chile, a household survey that used functional indicators maintained that 21.7% of households had a member with a disability while a study using impairment indicators resulted in a figure of 5.3%.

Disability can be defined from many perspectives. It is thus important to know, in each context, what is the background philosophy and theory, what the word "disability" refers to and what is actually measured. Different perspectives result not only in different estimates but also in different understanding, different concepts and different policies regarding disability.

Disabled people belong to the poorest of the poor

They belong to those most vulnerable, poor and excluded; they also have less assets and means to escape from poverty:

• People with disabilities make up 15 - 20% of the poor in developing countries (The World Bank) [4]
• Out of the 1.3 billion people who are extremely poor and live for less than one US Dollar a day, approximately 260 million have disabilities[ 5]. This is about 43% of the world's population that have a disability.
• Causes of disability are often directly related to poverty: malnutrition causes 20% of disabilities [6], accidents/trauma/war 16%, infectious diseases 11 %, non-infectious diseases 20%, congenital diseases 20%, others (including ageing) 13% (United Nations)
• Some 25% of the entire population is directly or indirectly affected by disability (UN and World Bank)
• 1.71 - 2.23 trillion US $ are lost from of the global GPD because of disability, that is a rate of between 5.35% and 6.97% (The World Bank)

The attaining of poverty reduction goals, sustained economic growth and social development is not possible if the prevention of disabling living conditions and the participation of disabled people are not explicitly addressed in poverty reduction strategies.

Vicious circle of poverty

Most disabilities are strongly related to poor and unsafe living conditions. Lack of access to medical care and rehabilitation leads to worsening limitations on activity. These in turn, combined with social stigma, discrimination and physically inaccessible living environments tend to generate a process of exclusion from participating in social life, schooling, vocational training and employment. In the end, it results in a life-long exclusion from mainstream society. Disabling and excluding risks tend to accumulate. Disabled girls and women face multiple discrimination.

As a consequence of the cumulative effects of such risk factors, disabled people have generally a higher poverty rate than the rest of the population. World Bank studies show that they are poor by all dimensions of poverty: they lack access to income, work, education and other basic services, social security, personal safety, and participation. Disabled people are at the bottom by all Millennium Development Goals (MDG) indicators.

• World Bank: Poverty and Disability - A Survey of Literature (PDF)

End notes

[1] Einar Helander (1992): Prejustice and Dignity; an introducation to community based rehabilitation. UNDP

[2] Robert L. Metts (2004): Disability and Development. Background Paper prepared for the Disability and Development Research Agenda Meeting, November 16, 2004, World Bank Headquarters, Washington D.C

[3] Robert L. Metts (2000): Disability Issues, Trends and Recommandations for the World Bank (PDF); p. 4-5: "…WHO and the United Nations have long asserted that people with disabilities comprise approximately 10% of any national population. Recently, however, the author of the WHO estimate has suggested instead that the proportion is more likely to be about 4% of the population in developing countries and 7% in developed countries. The United Nations Development Program (UNDP) has also backed away from the 10% figure, and now estimates the global proportion to be 5.2%. Despite this international trend toward a lowering of previous estimates, some still estimate disabled proportions to be 10% or more. The United States Agency for International Development (USAID) estimates the disabled proportion of the global population to be 10% or more, and the Roeher Institute in Toronto Canada, estimates the global proportion to be 13% to 20%."

[4] Ann Elwan (1999):Poverty and Disability. A Survey of the Literature (PDF). Social Protection Discussion Paper Series. No. 9932. Social Protection Unit. Human Development Network. The World Bank.

[5] Inclusion International: Poverty and Disability (PDF doc), p.1.

[6] UNESCO (1995): Overcoming Obstacles to the Integration of Disabled People; cited in DFID (2000): Disabillity, Poverty and Development (PDF doc), p.3.