Multiculturalism, chronic illness, and disability.

To gain at least an initial understanding of the underlying beliefs and attitudes in a cross-cultural situation, we believe that the three key points discussed in this paper should prove a significant point of departure: 1. Traditional beliefs about the cause of chronic illness or disability will play a significant role in determining family and community attitudes toward individuals with a disability and will influence when, how, and why medical input is sought. 2. The expectation of survival on the part of parents and community will have an effect on the amount of time, energy, and cooperation shown by family and community for the individual who has an impairment. 3. The expectations by family and community for the social role(s) and individual with a chronic illness or disability will hold will affect a broad range of issues, including education, social integration, and independence. Furthermore, although chronic illness and disability are often considered as issues distinct from the full range of problems encountered in society for immigrant and minority groups, in fact, these issues could not be more closely tied. The frequently discussed concerns within the ethnic and minority community about the role of the family, integration and acculturation, social articulation with the greater American society, stress, cross-cultural misunderstanding, and outright prejudice can all compound the problems encountered for the chronically ill or disabled individual in a multicultural society.

Self, identity and the naming question: reflections on the language of disability.

With all the emphasis on 'political correctness', it is especially important to delineate the functions of naming. People with disabilities are facing issues quite similar to minority groups which have preceded them in attempting to enter 'mainstream' America. Their similarities and differences with these groups are traced as well as their own unique path (with all its implications) and some possible analytic and political solutions.

Bringing our bodies and ourselves back in: reflections on a past, present, and future "medical sociology".

This paper is a revision of an address given upon receipt of the Leo G. Reeder Award for Distinguished Scholarship in Medical Sociology. It was presented on August 14, 1990 to The Medical Sociology Section of the American Sociological Association during its annual meetings, held in Washington, DC. Herein I reflect on the structured silence of personal bodily experience and on the unfinished paradigmatic challenge of feminism as a way of leading to a new praxis in medical sociology.

Toward the necessary universalizing of a disability policy.

Issues confronting people with disabilities do not result solely from physical or mental impairment, but from the fit between impairments and practically every feature of the social, economic, physical, and political environment. Changes in housing, transportation, and employment policies would augment the quality of daily living for those with disabilities today and in the future. With the entire population facing chronic illness and activity limitations, a universal approach to disability is virtually required, rather than policies focusing exclusively on a person's special needs. The absence of such a universal perspective will lead to the expansion and perpetuation of the segregated and unequal society visible at present.

Social and cultural disincentives to independent living.

More than 30 million Americans have some disability or chronic condition that prevents their full participation in social living, according to the Department of Health and Human Services, yet their rehabilitation as well as integration into the mainstream of American life has been slow. The causes of this paradox are to be found in the contradictory implications of certain American values, our overreliance on technologic solutions to personal and social problems, and our continuing reluctance to fully admit patient-consumers as partners in their own rehabilitation.

Denial of emotional needs to people with handicaps.

Much work today focuses on the issue of accessibility for those with a physical handicap of chronic disease. While this is necessary and just, its solution only makes more visible what society as a whole has done and needs to correct, in its dealing with people who have handicaps. As a result of our collective past, those of us with a disability spend much of our time in a continuing effort to reclaim what we have lost - the right to act sexy, get angry, be vulnerable, and have possibilities. While these do not seem like the kinds of things that one person can give to another, they are needs whose satisfaction the rest of society has helped impede and deny.

Communication barriers between 'the able-bodied' and 'the handicapped'.

The specific details and hardships of having a handicap or chronic disease vary from person to person. But not the core problem. The story is inevitably difficult both to hear and to tell. The hearing brings up many basic fears of personal and social failure to the listener. The telling confronts the individual who has a handicap with the depressing realities to be faced every day. Moreover, the problems that both "the able-bodied" and "the handicapped" have in communicating with one another are rooted deep in Western culture.

Helping one another: a speculative history of the self-help movement.

The Independent Living Movement represents a direct challenge to current notions of rehabilitation (see the article by Gerben DeJong in this issue). It is a unique challenge, spearheaded not by new technical advances but by a new social awareness, and not from within by medical personnel but from without by lay groups. In another sense, however, it is but the latest evolution of an old theme in American life--the notion of self-help. This paper traces the history of self-help, to illuminate the problems and prospects of the Independent Living Movement.