Cultural Status of People with Intellectual Disabilities in the UK and China
Introduction
The American Association of Intellectual and Developmental Disabilities or AAIDD, describes that an individual can be considered to have an intellectual disability based on the three important criteria: intellectual functioning level or IQ is below 70 – 75; significant limitations exists in two or even more adaptive skill areas; and the condition manifests itself before the age of 18 ( 2008). In addition the Centers of Disease Control and Prevention explained that intellectual disability can be defined as both by a vital below-average score in mental ability and intelligence test, and limitations in the different abilities that can help to functions in different areas of daily life such as communication, self-care and other social situation such as making friends and joining different school activities (2005).
The World Health Organization or WHO reported that there was about 1% to 2% occurrence of intellectual disability of the global population in 2001 (2005). While, in 2006, the Inclusion International reported that there are about 130 million of people in the world that are suffering from intellectual disabilities ( 2006).
In 2007, the WHO reported that the number of percentage of people with intellectual disabilities had increased to 3% of the entire population of the world or more or less 200 million people ( 2008). Thus, intellectual disabilities know no borders, and it is present in all countries, communities, races as well as social classes, and using the word retard to describe people with the said disabilities is considered as hate speech (2008).
Persons with intellectual disabilities are commonly the most vulnerable group, and on most of the time, they are exposed to the human rights violations and deprived of minimum service as well as dignity. In addition those persons are also most commonly to be secluded in the large institutions, unable to access different basic health and educational services and they are being excluded from the ordinary social relations. Even though, intellectual disability is considered as a neglected are, essential and vital information regarding its presence of resources and services for this population does not even exist in most of the countries in the world ( 2007).
Rationale
This paper will focus on the different aspects and issues that are related with the cases, programs and policies regarding intellectual disabilities of two countries, the UK and China. It will tackle and analyze the different important factors such as causes, measures of socioeconomic disadvantage, health services, diagnosis system and prevalence. It will also focus on the demographics, environment, care system, education, laws, housing and even issues regarding employment, religion, relationship and sexuality.
It is important to consider that the UK and China will have entirely different perspective in the issues regarding intellectual disabilities that can be seen in their legislation and laws that are currently implemented. This is due to the fact that UK has been a developed and open region compare to China.
Causes of Intellectual Disabilities
It is not always possible to explain why a person has an intellectual disability because its causes are commonly unknown. In the UK, there are three categories that have been showed as the major causes of intellectual disability in the country. The first category is the before birth factors like chromosome abnormalities particularly Down’s Syndrome, Tuberous Sclerosis Infection. It is also associated with the lack of oxygen to the fetus, trauma in accidents and injuries, vaccine damage and poison like drugs, alcohol, cigarette and lead. It is important to consider that there are abut 600 babies in the country that are born with the Down’s Syndrome every year due to the fact that most of the mother are having their babies in the later age ( 2008). In addition, there are about 13 million of adults in the UK who smoke cigarettes where in 29% are men, and 25% are women ( 2008). Furthermore it is also important to consider the increasing alcohol deaths of the UK, showing 12.9 deaths per 100,000 populations ( 2008). The said statistics shows that problem with lifestyle is considered as one of the most common causes of intellectual disabilities in the country.
The second category is the birth complication that includes asphyxia and anoxia, obstructed birth and extended labor, instrument birth and brain damage as well as extreme case of premature and very low birth weight ( 2008).
The last category is the postnatal factors like infections, injury and child abuse, metabolic or lack of nutrition and growth and social deprivation ( 2008). In the UK, it is important to consider that malnutrition is affecting 10-55% of ill adults in the hospital and community and 16% of the hospitalized children, while 20% are at risk of malnutrition ( 2007).
On the other hand, although the causes of intellectual disabilities in China are just the same as the categories that have been mentioned for the UK, it can be altered due to the different environmental and lifestyle aspect. According to the estimate of WD, there are about 1,623,559 people that are suffering from intellectual disabilities out of 1,298,847,642 ( 2008). This shows that both countries show a high rate of Down syndrome which is considered as a major cause of intellectual disability. On the other hand, unlike the UK, Chinese are not that into smoking, as a matter of fact, according to the 2003 data, there were about 320 million people who smoked, and only 10% of the entire population was women ( 2008). Thus, it can be said that most of the mothers do not smoke. However, it is important to consider the growing number of people who are becoming smokers. In addition, it will be impossible not to connect Chinese with alcohol because the said country is considered as one of the oldest brewing countries in the world and drinking alcohol is considered as an important factor of the Chinese culture. It shows that the drinking frequency of Chinese in once a day is about 26.7% male drinkers, while 5.4% female drinkers ( 2008). Thus, it has a great impact over the health of the women, especially during pregnancy.
In terms of malnutrition, China is also facing dilemma like UK and other countries in the world. The estimate shows that there is about 10 – 15% of Chinese population that is not receiving adequate nutrition, particularly those from rural a less industrialized place ( 2008).
Above all, the most important cause of intellectual disabilities lies on the environment. It is important to consider that China is considered as one of the most polluted country in the world. And lead pollution is a vital aspect. According to the study of People’s Daily in 2000, there are about 83.2% out of 14,400 children in the southern city of Guangzhou that carry lead to their body that is higher than the normal standard ( 2000).
Measures of Socioeconomic Disadvantages
There have been many studies that show high rates of mortality and morbidity among the people with intellectual disabilities, however, virtually there are no researches that address the potential social determinants of health status within the said vulnerable population (2007).
If we are going to analyze the history, people with intellectual disabilities have been excluded from education and workforce participation. Thus, due to the perspective that they are dependent and in a great need of care, they had to rely on the state in order to obtain resources and continue living. Thus, the said exclusion from workforce participation enables to cut them off from both the economic and non-economic benefits of work, therefore deny their status as full citizens ( 1999).
It is important to consider the living condition of the family where in the person with intellectual disabilities live in. Mostly, people with intellectual disabilities are raised with parents that have poor physical health that lead to poverty, unemployment, inadequate housing and unsafe neighborhoods that can result to difficulties in relationship, high stress, poor treatment throughout the life, depression and then low self-esteem. In addition, due to the said social condition, people with intellectual disabilities will have a little exposure towards positive parenthood ( 2007).
Another important factor is the culture that focuses on the traditional beliefs where in intellectual disabilities can be seen as a curse or sign of sin and disgrace. That’s why in some place, intellectual disability was considered as a severe stigma. When an intellectually disabled child was born, there is a big chance that his or her parent will reject him or her, and will later on be rejected by the entire community ( 2007).
The said situation may lead to inequality and unfairness that can be observed in the sector of education as well as employment. More often than not, businesses are employing those disabled people, but not those who are considered as intellectually disabled people.
The UK Health Services for People with Intellectual Disabilities
Over the past two decades, healthcare provision for those people with intellectual disabilities has undergone a significant change in the UK. Historically, services for the said group were mainly provided by the specialist intellectual disability professionals within the segregated settings like the long-stay hospital. After that, there has been different development in the model of care that focuses on integration of the intellectual disabled people within the society. In 1990, the Community Care Act was implemented that focuses on the mixed economy of care, where in the healthcare provision for the said group had become the responsibility of the mainstream healthcare providers, however, there are some distinct and vital set of specialist intellectual disability services that cater for those health care needs fall outside the remit of the ordinary service like those people with profound intellectual disabilities (2006).
Currently, most of the health services of the country regarding intellectual disabilities focus on the health facilitation where in it involves the participation of the health professionals, the family member and the person with intellectual disability him- or her-self. The main aim of the said health service is to promote access to the mainstream service for people with those intellectually disabled, at the same time, aiding them the same services in order to develop the vital skills in order to accommodate the needs of each and every individual in the said group. The said health services are divided into two important levels: self-development work; and person to person work with people with learning disabilities. Aside from that the country is also focusing on dissemination of information regarding the different aspects that are related with intellectual disabilities that can aid and notify those people who are suffering with the said disabilities, the family as well as the entire society. The said action was done with the help of health promotion and health education by using education and informative leaflets (, 2006).
China’s Health Services for People with Intellectual Disabilities
Just like the UK, the history of the health care provision for intellectually disabled people had been affected by the traditional and ignorance of the people regarding the said group. As a result, they are excluded fro the health care system, due to the fact that normal people tend to see them as family-dependent, or in harsh term, burden.
Currently, China is taking the opportunity of the Special Olympics in order to improve the welfare of the intellectually disabled people and take more efficient measures in order to help them ( 2007). Due to the fact that China has a very different culture and traditions compare with the UK and other western countries, China has its own way of handling and implementing different health services towards the aspect of intellectual disabilities. The entire health care provision of China focuses on the better integration of tradition with the modern health care, thus it is also related with the social reform and strengthening of the primary care sector ( 2002).
Classification
In the UK, the Royal College of Psychiatrists in 2001 published a classification system that provides operationalized diagnostic criteria for different psychiatric disorders that are intended to use for those adults with the moderate up to profound intellectual disability. The said classification is use and available for the adult population with the intellectual disabilities. In addition, the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation or Intellectual Disability of DC-LD was also designed in order be used with accordance to the ICD-10 and DSM-IVTR manuals in order to asses the people with mild disability ( 2006). On the other hand, China is using the DSM-IV that was developed and published by the American Psychiatric Association or APA and focuses on the vitality of the 5-axis diagnostic system ().
The Prevalence of People with Intellectual Disabilities
In the UK, it was calculated that there are about 3 – 4 persons in every 1000 population that are suffering from intellectual disabilities. Thus, there are about 30% of the said population have severe or profound learning disabilities ( 2006). Because of the different changes in the demographic aspect of the UK, the population of the intellectually disabled people have increased by 53% from 1960 – 1995 ( 2004 ). stated that in 2007, there will be 1,465,000 people out of 58.6 million population who will suffer in the said disorder and about 175,000 cases of sever and profound disability ( 2005).
On the other hand, the prevalence of intellectual disabilities in China was 1% out of the entire population in 1997, and the highest prevalence was among age group of 25 – 29 ( 2002). Recently, the CDPF Facts and Progress on Disability in China 2008, reported that intellectually disabled people are 6.68% of the entire disabled population or a total of 5.54 million people (I2008).
Discussion
Based on the statistics and information that have showed in the first parts of the paper, it can be said that the population of those intellectually disabled population are growing. This is due to the different changes in lifestyle, demographics as well as economic conditions. In terms of social factor, it can be said that both of the country showed reluctance the communities’ reluctance to accept intellectually disabled people in different important field such as education, health system and even business and works. This is the result of the different wrong believes due to traditions and culture. However, as times goes by, both of the country realize that equality and fairness is considered as an important factors in terms of law and policy making. ‘
On the other hand, the UK is considered as one of those countries that are always involved in policy making that involves inclusion of different vulnerable groups, particularly intellectually disabled people. The said situation is already rising in China, due to the fact that China is considered as one of the fastest developed country, since it had opened its gate for global trade and relationship. Thus, China had been able to focus on the different rules and policies that will improve the lives of those people with intellectual disabilities.
In the UK, its legislation focuses on the education of the children with intellectual disabilities by the aid of the Special Education Needs and Disability Act 2001 or the SENDA 2001 that enables to extend the rights of the children with intellectual disabilities to be educated in the mainstream schools. The country firmly believed that their education must be provided in the mainstream school, except if the family or the child itself does not agree about it due to incompatibility. The said provision also offers protection for the children against any means of discrimination in the sector of education ( 2005). On the other hand, in China, the government paid a great attention to the special education with the guidance of different laws and regulation in order to ensure the rights of education for those people with disabilities, such as: The Compulsory Education Law in 1986; the Protection of Disabled Persons Law in 1990; and the Regulations for Disabled Person’s Education ( 2007 ).
Employment is considered as the most critical aspect for the entire population of intellectually disabled people. In the UK, the numbers of people with intellectual disabilities that are employed are low. The statistic shows that intellectually disabled people got the 11% population of the entire paid employment for people with disabilities ( 2005). The government is focusing also on the different laws and regulation that will support the said population to enter the workforce. With the assistance of the Disability Rights Commission or DRC framework in England, Wales and Scotland as well as the support of the Equality Commission in Northern Ireland, people in the said group can pursue their complain regarding work-related discrimination ( 2005 ). In addition to that, the UK is also executing and putting into practice the different programs that will encourage the employment of the said group and provide different sources for development fund that will support different employment agencies (2005). It can be seen that the government is doing their best in order to encourage the population into the workforce; however, the effort is not that effective due to the fact that there are only few people with the said disabilities that are accessing the different mainstream programs that are related with training (2005).
In China, the Employment Regulation and the Education Regulation for people with disabilities was adopted in 2007 that will help to encourage and endorse equality, participation and sharing that will later on help to prohibit discrimination (2008).
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