What does morbidity have to do with disability?

Abstract

This study compares and contrasts survey data on disablement from six countries according to their distributions and prevalence of causes and underlying medical conditions, using a framework proposed by the author that includes morbidity as one important determinant of disablement. The main thesis of this paper is that the study of disablement (that is impairments, disabilities and handicaps) should be conceptualized and classified independently of illness and poor health. Disablement, by definition, is not an illness. Using the World Health Organization global definitions of health it is possible to be both healthy and disabled. The assertion, however, that disability is not an illness does not preclude the joint study of morbidity and disablement; nor does it diminish the significance of disease and injury in the explanation of rates of disablement. Disablement is classified through the use of the WHO International Classification of Impairments, Disabilities, and Handicaps (ICIDH). The WHO International Statistical Classification of Diseases and Related Health Problems (ICD-10) is the primary classification used for the study of morbidity. This paper demonstrates that statistical guidelines and instructions on the use of the ICD and the ICIDH, including the development of appropriate short-listings of codes, are needed in order to increase data comparability and to further encourage sound research. National survey data examined are from the United Nations International Disability Statistics Data Base, DISTAT.