Academic journal article American Journal of Pharmaceutical Education

Disability in Cultural Competency Pharmacy Education

Academic journal article American Journal of Pharmaceutical Education

Disability in Cultural Competency Pharmacy Education

Article excerpt


Persons with disabilities use disproportionately more health care resources than the non-disabled population. In spite of this, persons with disabilities generally experience poorer health outcomes, are significantly less satisfied with the quality of care provided to them, and have greater difficulty accessing health care goods and services compared to persons without disabilities. (1) These inequalities may be attributable to the limited knowledge and ability of health care professionals, including pharmacists, to provide competent care to this population, because disability is not usually included as a component of cultural competency education. This paper identifies persons with disabilities as a distinct community having a unique cultural identity. By defining disability as a culture, we seek to advocate for its position within cultural competence curricula in colleges and schools of pharmacy. The primary objectives of this paper are to define disability as a culture, and describe how the concept of disability as a culture can be incorporated into cultural competency education.

Disability Defined

Disability has been defined in medical, legal, and social terms. The most widely accepted definitions are by the World Health Organization (WHO) and the Americans with Disabilities Act (ADA). The WHO defines disabilities as "an umbrella term, covering impairments, activity limitations, and participation restrictions." (2)

Under the ADA, Congress determined that an individual is legally disabled, and therefore deserving of legal protection against discrimination if she or he: (1) has a physical or mental impairment that substantially limits a major life activity; (2) has a record of such an impairment; or (3) is regarded as having such an impairment. (3)

The medical model of disability views persons with disabilities as individuals with physiological problems who need either assistance (in terms of rehabilitation) to overcome the limitation placed by the condition or a curative solution to the problem. (4,5) While acknowledging the physiological aspect of impairment, the social model defines disability as a social construct. In contrast to the medical model which locates the problem as being in (and the responsibility of) the individual, the social model views the problem not so much as a deficiency of the individual but the disadvantages this group of individuals experience in society as a result of these disabilities. (4,5)

Establishing Disability as a Unique Culture

Culture is generally recognized in the literature as a shared way of life. Anthropologists Bates and Plog state that, "Culture is a system of shared beliefs, values, customs, behaviors, and artifacts that the members of a society use to cope with their world and with one another, and that are transmitted from generation to generation through learning." (6)

Drawing from various definitions of culture, people belonging to the same culture have: (1) a collective identity; (2) common history; (3) common experiences; (4) shared beliefs, values, and norms; and (5) distinctive material goods originating from a shared identity, like arts, music, etc. (6-9) Considering these components of culture, does disability meet the criteria to be classified as a culture?

Collective identity. There is a common sense of identity that unifies persons with disabilities and distinguishes them from people without disabilities. (7) This is evidenced by special or residential education, sheltered employment, disability allowances, privileged parking, distinctive language (eg, sign language for the deaf), etc. (7,9) Persons with disabilities have embraced a self-identity as shown in their ability to effectively put together organizations to advance their own good and in their celebration of themselves with self-affirming slogans such as "Disabled and Proud," "Deaf Pride," and "Disability Cool. …

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