Notes to Submission to the Productivity Commission Inquiry into the ...

etween activity restriction and disability has not been fully spelled out in the disabilityliterature, but in economic terms, the difference between them is one of cost incidence. Interms of outcome, both lead to less social participation and activity-restriction than wouldoccur if more resources were spent on technologies and design, but in terms of costincidence, it is useful to distinguish between participation-enhancing expendituresundertaken by the person with the impairment and participation-enhancing expendituresby other individuals and institutions. Thus, expenditure constraints on the part ofindividuals with impairment leads to activity-restriction and expenditure constraints onthe part of others leads to disability and conversely. In terms of the products themselves,it may be useful to see activity-restrictions as being overcome by assistive devices, anddisability as being overcome by public design features.Thus for example, an individual with impairment can overcome what would otherwise bean activity-restriction by the purchase of a wheelchair, a hearing aid, eyeglasses, acomputer or pharmaceutical drugs. In each of these cases, social participation can beenhanced by expenditure by the person with the impairment, and where it is notovercome because of a lack of resources, the person with impairment faces an activityrestriction.It is important to note that technological developments are dramatically expanding therange of available assistive devices, and in doing so, improve the potential participationprospects of people with impairments. But devices may be expensive and beyond thebudgets of many people with impairment, and that without increased incomes,technological possibilities do not translate into an actual reduction in activity restrictions.Similarly, businesses, government and households can ensure that building andequipment design is enabling rather than disabling; that information formats enablecommunication rather than filter it; and that schedules, policies and procedures aresufficiently flexible to enable greater participation by people who would otherwise beexcluded from participation.An increase in the number of people with impairments due to an ageing population andimproved mortality-decreasing medical technology increase the community’s awarenessof the numbers of people with impairment, and thereby also improve the prospects ofenabling social infrastructure. But impairment-oriented design involves re-directingresources from other uses, and there is nothing to ensure that such a re-direction is likelyto be supplied by either autonomous individual actors in a market setting, or bygovernment.The distinction between impairment, activity-restriction and disability shifts the focusfrom a medical outlook which allocates resources to minimise impairment by medicaltechnology to an economic outlook which allocates resources to minimising activityrestrictionand disability by enabling rather than disabling design in goods, services,procedures and policies.5