The Construction of Disability & Health:

APHA Disability Section Chair’s Forum 2013

Integration vs. InclusionInstitutionalization and Isolation

Integration vs. Inclusion Mary Olson and Robert Liston

“…if the way that disabled people are expected to get into a building is round the back, past the bins and through the kitchens, what does that message communicate? How will it make a disabled person feel?” ~Napolitano, 1995

“Good inclusive design will send positive messages to disabled people, messages which tell them: ‘you are important’; ‘we want you here’; and ‘welcome’…”

~Napolitano, 1995

Integration• You can legislate integration and

accessibility- but not attitudes or inclusion

• Barriers to inclusion• Space is organized to perpetuate the

dominance of ‘able-bodied’ people

Inclusion• A belief that communities are better when

representing all people.

• Being in the community vs. being part of the community.

• Special Places

• Environments that exclude people with disabilities are constructed

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For Your Consideration• What would a world of inclusion vs. integration look

like? • How can we change landscape to facilitate

inclusion?

Institutionalization & Isolation

Mary Olson and Robert Liston

“An understanding of how disabled people become marginalized and excluded within society cannot be understood without an appreciation of the socio-spatial processes that reproduce social relations .”

~Kitchin, 1998

Institutions as Exclusionary Spaces

• As a way to separate those who are “deviant”

• Creation of institutions• Types of Institutions across time• Modern Definition: Places people live

without choice or as default

Socio-spatial IsolationHistorical interactions create culture

• Where do people belong?• Where can people’s needs be met?

What spaces teach us• Out of sight, out of mind• “Othering”, difference is “bad”• Culturally reinforcing

• Perceptions of where people with disabilities fit & how they belong

The Role of SystemsState Sponsored Isolations

• Institutional bias in Medicaid’s long-term care• Economic benefit to communities

Possibilities• Money Follows the Person• Community First Choice Option

For Your ConsiderationHow do isolation and institutionalization influence:

–How we perceive people with disabilities?–How we run our services? –How we build our environments?