The World Report on Disability
One of the most important findings of the report is the observation that at least 15% of the population of the world lives with disability, including an estimated 110 million with severe disability. Because of the well-known difficulties in defining disability and the challenges of collecting valid and reliable data across all nations, it is reasonable to speculate that these statistics underestimate the magnitude of the problem. Statistical concerns aside, it is notable that very few human conditions may have the same prevalence across all nations of the world (i.e., poverty). The general consequences of disability are sobering. According to the report, disability is associated with poorer health, lower educational achievement, less economic participation, higher rates of poverty, increased risk for abuse, increased dependency, reduced activity, and restricted participation, among others.
A report like the World Health Organization Report on Disability may be seen by busy clinicians and scientists as an intellectual and political effort that does not relate to the daily practice of physical medicine and rehabilitation (PM&R) or the conduct of rehabilitation research. However, before we come to that conclusion, we should consider more carefully the potential impact of this report on the medical specialty of PM&R and on rehabilitation in general. Disability, like other conditions in the modern world, is no longer geographically restricted, and its impact is not limited to selected ethnic or socioeconomic groups. We in PM&R should remember that all of our patients want to increase their level of independence, maintain a high degree of activity, and participate in family and social life. In other words, let us not forget that reducing disability is at the heart of the medical specialty of PM&R and is the ultimate goal of rehabilitation research. Moreover, the World Health Organization Report on Disability clearly identified education and research as important components of the solution to the problem. This is an opportunity for academic PM&R in the United States and other countries to contribute innovative solutions and strategies to address the problem.
There is no inherent conflict between the desire to focus on our very own professional and intellectual interests and participating in a discussion of the bigger picture of disability in the world and of a landmark report. On the contrary, this document presents a strong justification for what we do in our clinical practices and academic institutions. The World Health Organization Report on Disability provides a much needed framework for our activities and participation as members of the global PM&R community. We should read, understand, embrace, and adopt this landmark report.