Disability and impairment

These words are sometimes used in relation to skin disease particularly to express a level of impact that the condition has on a person. Some of the outcome measures used to document the level of impact of the disease are expressed as a disability index, e.g. the Psoriasis Disability Index. The term ‘disability’ is an emotive word and different models view it in very different ways. For example, the medical model would define disability as a lack of ability as compared to a standard or norm. It may involve a physical, cognitive or intellectual impairment, mental disorder, or various types of chronic disease. This definition focuses on what the individual cannot do because of something that society might consider an impairment (Open University, 2006). A social model of disability takes a very different view labelling disability as a disadvantage or restriction on doing things that is the fault of society and the way that it is run. Thus the focus is on the way that society is set up and as such people become disabled because of the lack of preparedness of the society, rather than any personal intrinsic factor. (Open University, 2006) When considering the disability caused by skin disease, this definition is helpful as it is so often the responses from society at large that creates a disability for the individual sufferer. An impairment (that may have once been referred to as a handicap) is when a person has an injury or an illness for a long time that makes them different from other people. Impairment does not cause disability.

A piece of research carried out by Jowett and Ryan in 1985 looked at what they then labelled the handicapping impact of skin disease. This was early work looking at not only the physical, but also psychological and social burden of skin disease. Whilst the term handicap may no longer be used, this work clearly outlined how significant a range of skin conditions were on peoples’ psychological and social well-being (Jowett & Ryan, 1985).