The first comprehensive volume to integrate social-scientific literature on the origins and manifestations of prejudice against disabled people Ableism, prejudice against disabled people stereotyped as incompetent and dependent, can elicit a range of reactions that include fear, contempt, pity, and inspiration. Current literature--often narrowly focused on a specific aspect of the subject or limited in scope to psychoanalytic tradition--fails to examine the many origins and manifestations of Ableism. Filling a significant gap in the field, Ableism: The Causes and Consequences of Disability Prejudice is the first work to synthesize classic and contemporary studies on the evolutionary, ideological, and cognitive-emotional sources of Ableism. This comprehensive volume examines new manifestations of Ableism, summarizes the state of research on disability prejudice, and explores real-world personal accounts and interventions to illustrate the various forms and impacts of Ableism. This important contribution to the field combines evidence from multiple theoretical perspectives, including published and unpublished work from both disabled and nondisabled constituents, on the causes, consequences, and elimination of disability prejudice. Each chapter places findings in the context of contemporary theories--identifying methodological limits and suggesting alternative interpretations. Topics include the evolutionary and existential origins of disability prejudice, cultural and impairment-specific stereotypes, interventions to reduce prejudice, and how to effect social change through collective action and advocacy. Adopting a holistic approach to the study of disability prejudice, this accessibly-written volume: * Provides an inclusive, up-to-date exploration of the origins and expressions of Ableism * Addresses how to resist ableist practices, prioritize accessible policies, and create more equitable social relations with pages earmarked for activists and allies * Focuses on interpersonal and intergroup analysis from a social-psychological perspective * Integrates research from multiple disciplines to illustrate critical cognitive, affective and behavioral mechanisms and manifestations of Ableism * Suggests future research directions based on topics covered in each chapter Ableism: The Causes and Consequences of Disability Prejudice is an important resource for social, community and rehabilitation psychologists, scholars and researchers of disability studies, and students, activists, and academics across political, sociological, and humanistic disciplines.
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1 Introduction: Defining Ableism
The Largest Minority Group: Who Qualifies?
Ongoing Disparities: Institutionalized Ableism
Historical Approaches to the Study of Disability Prejudice
Chapter 2. The Evolutionary and Existential Origins of Ableism
Chapter 3. Justifying Ableism: Ideologies and Language
Chapter 4. Cultural and Impairment‐Specific Stereotypes
Chapter 5. Hostile, Ambivalent, and Paternalistic Attitudes and Interactions
Chapter 6. Contending with Ableism from Internalized Ableism to Collective Action
Chapter 7. Interventions to Reduce Prejudice
Chapter 8. Beyond Contact: Promoting Social Change and Disability Justice
Identifying Assumptions and Calling for Action
2 The Evolutionary and Existential Origins of Ableism
The Basics of Evolutionary Theory
Evolutionary Origins of Prejudice: Disease Avoidance
Evidence of Disease Avoidance as a Primary Determinant of Disability Prejudice
Critique of Evolutionary Accounts of Disability Prejudice
Existential Fears of Becoming Disabled
Disabled People Violate Dominant Cultural Beliefs
Terror Management Theory
3 Justifying Ableism: Ideologies and Language
The Ideological Construction of Disability
Language: Communicating and Maintaining System‐Justifying Ideologies
4 Cultural and Impairment‐Specific Stereotypes
The Origins of Cultural Stereotypes About Disability
Preliminary Evidence for Global Disability Stereotypes
Evidence for Cross‐Impairment/GlobalDisability Stereotypes
Disability Stereotypes as Diagnostic Tools
Implications for the Use of Disability Stereotypes
Implicit Stereotyping: The Automatic Operation of Disability Stereotypes
Stereotype Preservation: Biases that Maintain Overgeneralized Beliefs
5 Hostile, Ambivalent, and Paternalistic Attitudes and Interactions
Historical Approaches to Capturing Attitudes about Disability
Theoretical Approaches to Ambivalent or Mixed Attitudes About Disability
The Stereotype Content Model: Implications of Competency and Warmth
Modern Approaches to Measuring Disability Prejudice
Implications for Social Interaction: Manifestations of Ableism
6 Contending with Ableism from Internalized Ableism to Collective Action
Discrimination's Toll on Well‐Being
How Does Ableism Affect Disabled People?
Coping with Ableism: The Central Role of Disability Identity
Who Uses Which Coping Strategies?
Consequences of Coping Strategies
Directions for Future Research
7 Interventions to Reduce Prejudice
Part I. Reducing Prejudice Through Direct and Indirect Contact
Part II. Categorical Framing Approaches
Part III. Empathy Inductions and Experiential Simulations
Summarizing and Comparing Prejudice‐Reduction Interventions
8 Beyond Contact: Promoting Social Change and Disability Justice
The Disability Rights Movement Actions and Accomplishments
Changing the Normative Landscape Through Confrontation: Allies in the Fight for Change
Disability and Disability‐Directed Advocacy
Conclusions, Implications, and Recommendations
Appendix: Summary of Future Research Questions
Chapter 2: The Evolutionary and Existential Origins of Ableism
Chapter 3: Justifying Ableism: Ideologies and Language
Chapter 4: Cultural and Impairment‐Specific Stereotypes
Chapter 5: Hostile, Ambivalent, and Paternalistic Attitudes and Interactions
Chapter 6: Contending with Ableism from Internalized Ableism to Collective Action
Chapter 7: Interventions to Reduce Prejudice
Chapter 8: Beyond Contact: Promoting Social Change and Disability Justice
End User License Agreement
Table 4.1 Frequencies and percentages of the top 10 themes used for each targ...
Table 6.1 Strategies for maintaining positive social identities in the presen...
Table 6.2 Predictors of social mobility, social creativity, and social change...
Table 6.3 Index items and reliability coefficients for measures of disability...
Table 7.1 Sample of prejudice reduction indicators.
Figure 4.1 Frequencies by target group of the themes diagnostic of each grou...
Figure 4.2 Conceptual depiction of the disability stereotype as an associati...
Figure 5.1 The Stereotype Content Model (SCM). Status and competitiveness di...
Table of Contents
Contemporary Social Issues, a book series authored by leading experts in the field, focuses on psychological inquiry and research relevant to social issues facing individuals, groups, communities, and society at large. Each volume is written for scholars, students, practitioners, and policy‐makers.
Series Editor: Daniel Perlman
Multiculturalism and Diversity: A Social Psychological PerspectiveBernice Lott
The Psychological Wealth of Nations: Do Happy People Make a Happy Society?Shigehiro Oishi
Women and Poverty: Psychology, Public Policy, and Social JusticeHeather Bullock
Ableism: The Causes and Consequences of Disability PrejudiceMichelle R. Nario‐Redmond
Stalking and the Cultural Construction of RomanceH. Colleen Sinclair
Taking Moral ActionChuck Huff
The Psychology of Helping RelationsArie Nadler
Michelle R. Nario‐Redmond
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For Ceara Grace whose name means woman wielding a sword. You are the reason I came to disability studies and became a warrior for disability culture and justice. I love you my girl.
For Peter James, my rock who envisioned this long before I did. Thank you for your music, meals, and for nurturing these pursuits.
For Ethan Joseph – steadfast and loyal ally. Thank you for coming to our family and for your deep well of empathy for others.
For my parents’ never‐ending love and support and for all the Beachwood kids who gave me kisses as I worked.
For Dr. Arielle Silverman. Your collaboration on insider perspectives has been invaluable. And to the best developmental editor a gal could ever ask for. I am so grateful to Dr. Dan Perlman.
Finally, to my disabled students and allies: Alexia Kemerling, Nina Lester, and Zoe Sajen. I am especially thankful to you and to the many students who contributed to the Activist pages with news, scholarship, theme analyses, and polling data. Thank you for making sure I did not miss key implications for social change: Brianne Goodrich, Angela Cobb‐Munez, Megan Schaefer, Vaal Ngalla, and Jacob Marvin. I appreciate your dedication to changing the world.
Think for a moment: how many immediate family members, relatives, friends, and/or other significant people in your life – including yourself – have a disability; that is, who “happen to be blind, deaf, or living with chronic physical, intellectual, or mental health conditions”? How many close friends and relatives with such conditions can you think of? One, two, three, four, five …?
Given that a Gallup poll found most Americans have nine close friends, not counting relatives, let us say there are 20 people with whom you interact in important ways – working with them, attending parties with them, helping or being helped by them, etc. According to the US census, 19% of Americans or 56.7 of roughly 322 million are identified as disabled. Approximately one in five Americans have a disability; in your network of your 20 most important relationships, four members are likely to have a disability. Can you think of those members? I can.
In my own family network, three members have disabilities (autism, manic depression, and dementia) such that they need assisted living or social benefits for individuals with disabilities. One of my most important former mentors has congestive heart disease. I myself am sufficiently hearing impaired that I often ask my wife and others “What did you say?” and use various strategies at work and in noisy social situations to hear people. My point is that most of us, ourselves, have – or at some point in our lives will have – a disability.
Michelle Nario‐Redmond's tour de force book is about ableism, aka disability prejudice, and the experiences of individuals with disability. It builds on decades of social science literature, integrating it in a comprehensive, fresh way. In addition to considering how individuals and macro forces contribute to ableism, Michelle emphasizes a previously neglected intergroup perspective. She writes: “An intergroup perspective on ableism recognizes that while prejudice often occurs between individuals interacting at the interpersonal level, prejudice also represents beliefs and motivations that derive from belonging to particular groups – groups of “us” and “them” – groups often motivated to maintain their status differences.”
The book progresses in three logically organized sections. The first section examines the causes of disability prejudice, starting with evolutionary explanations. Is prejudice against disabled individuals something innate in human nature designed to foster reproduction and the species' successful perpetuation? Another explanation for disability prejudice is rooted in our ideologies such as individualism or the Protestant ethic that get transmitted to us through social influences (e.g. the media, the stories we tell). An analysis of how stereotypes, the thoughts we have in our heads, contribute to our disability prejudices rounds out this section of the book.
The middle section of the book deals with the consequences of disability prejudice. One focus in this section is the emotional reactions, attitudes, and interaction patterns others have with and toward people with disabilities. These can be benevolent and caring, paternalistic, pitying, or hostile. Often they are an ambivalent mixture. Michelle illuminates when various reactions are most likely. The second focus of this section, written with disabled social scientist Arielle Silverman, is how people with disabilities respond, either individually or collectively, to the ableism they experience. Possible reactions include trying to conceal one's disability or endeavoring to improve the status of disabled people. Both approaches have risks and rewards.
The final section of the book introduces interventions to reduce ableism and promote social change. This section opens with three common approaches: encouraging contact between disabled and nondisabled people, various types of training, and the problem with simulations (e.g. using a wheelchair) designed to create aspects of the experience of having a disability. Contact under the right conditions arguably has the strongest record of effectiveness. The final segment of the book considers evidence on the success of the disability rights movement. Michelle writes that “Arguably, among the most enduring, positive impacts on ableist practices have been policy‐based, including structural changes for inclusive integration at school and work, access to the built environment, and anti‐discrimination legislation.” Allies and group coalitions are helpful in bringing about these impacts.
There are many features that make this book special for me, among them are the following:
It captures the complexity of disability: its varieties, causes, its challenges, the responses it elicits, and how society might combat ableism (aka disability prejudice).
The attention to both disabled and nondisabled people in the analysis.
The multiple conceptual perspectives including one's crossing disciplinary boundaries and the impressive body of evidence the author brings to bear on ableism.
The author's bringing to the fore an intergroup perspective.
The rich set of research ideas for scholars and students to pursue.
My favorite, reader‐friendly feature is Michelle's including a set of Activist pages in the book. As their name implies, they offer ideas about ways people can address and resist ableism. They provide concrete cases and problems found in everyday life, fascinating topics (e.g. inspirational porn), getting below the surface (implicit ableism), cartoons, the views of individuals with disabilities, informational leads on disability resources and advocacy bodies, and so on. They add richness and immediacy to the phenomena of ableism.
It is the Society for the Psychological Study of Social Issues' (SPSSI's) honor and privilege to sponsor this volume as part of the Society's Contemporary Social Issues series. Reflecting the Society's traditions and values as a social justice organization, the series consists of authored books addressing a diverse array of social concerns that are amenable to psychological analysis. Grounded in its author's expertise, each volume focuses on an area of psychological inquiry relevant to social issues facing individuals, groups, communities, and/or society at large. Each volume is written for a diverse audience of scholars, students, practitioners, and policy‐makers. Without any doubt, anyone who wants a scholarly informed analysis of a social issue in which they are interested should find the books in this series of interest. This volume will be of particular value to social science and disability scholars as well as professionals occupying various roles. Indeed, despite the sometimes distant or contentious relations between psychologists and disability study scholars, one of the Michelle's goals is to encourage more multidisciplinary cross‐fertilization between camps and within the subdisciplines of social, rehabilitation, and community psychology. I am rooting that it will!
I started with a question. I will end with one. Do you want your family members or friends to be the targets of ableism – a phenomena that assumes the superiority of nondisabled individuals and perpetuates false perceptions of people with disabilities and discrimination against them? My answer is “No!” In its place, I want a socially just society that respects and fosters the well‐being of all its members.
Dan PerlmanEditor (2013–2019)SPSSI's Contemporary Social Issues Series
Carroll, J. (2004).
Americans satisfied with number of friends, closeness of friendships
. Gallup News Service. Retrieved from
Erickson, W., Lee, C., and von Schrader, S. (2017). Disability Statistics from the American Community Survey (ACS). Ithaca, NY: Cornell University Yang‐Tan Institute (YTI). Retrieved from Cornell University Disability Statistics website:
Ableism is when you say that I don't act disabled and expect me to take that as a compliment …
Ableism is when “whole” is a word reserved for the able‐bodied, or when you say that I'm beautiful despite my differences, and fail to recognize that I'm beautiful because of them …
Ableism is when you leave us to ripen and rot hanging from the vine because you refuse to bite into our fruit. Ableism is the fruit of your fears …
Ableism is when you assume I'm single … when you assume I'm a virgin, when you assume I hate my body because in your narrow mind how could I not? …
Ableism is when parents yank their kids away and tell them not to stare, automatically teaching them that disability is a dirty word …
Ableism is when you make plans that do not include accessible venues, accessible spaces, so it becomes easier to erase me from your list …
Ableism is when disabled parents are told they should not be parents …
Ableism is making heroes out of people who take disabled kids to the prom and never talk to them again because that one “good deed” is good for at least 10 years, if not a lifetime …
Ableism is a lifetime of isolation, a lifetime of segregation, a lifetime of untold stories of “Once upon a time there was a cripple who could” and for every cripple that could there was and is an able‐bodied person who should but doesn't …
Ableism is the fact that we can embarrass you just by sitting in the same room and breathing the same air …
Ableism is the way media portrays us as either objects of pity or inspiration …
Ableism is how you want to lock us in the closet and how you believe that giving us new labels like physically challenged and differently abled is no longer labeling us …
Ableism is making buses accessible but not the streets leading to the bus stop …
Ableism is when you say that if God hasn't healed me, it is only because I don't have enough faith …
Ableism is how your faith considers me a punishment from God, or how you try to pray my differences away as if they were demons …
Ableism is your ability to find reasons to push us aside to keeps us in cages, leave our struggles out of the history pages … pretend we never existed …
Ableism is when you think I don't have a disability because you can't see it …
Ableism is asking my friends what I would like to order because you fear not being able to communicate with me. Ableism is the fact that you don't even try …
Ableism is calling my needs “special” and then ignoring them …
Ableism is believing I need to be fixed. Ableism is you refusing to fix what's really broken …
Ableism is painting our lives like a tragic story …
Ableism is our story told by nondisabled voices captured through a nondisabled lens …
Ableism is you feeling like I should be grateful for the ramps and the parking spaces as if access was not a basic right …
Ableism is when you force unsolicited help upon me because, to you, it seemed like I needed it …
Ableism is you thinking that my asking for help gives you the right to decide for me …
Ableism is when you wish for a world without disabled people, and you say that to me and expect me to agree with you …
Ableism is when you say that if you became disabled, you would want to die …
Ableism is wishing you could help us die, or wishing you didn't have to help us live …
Ableism is believing disabled people are better off dead …
(Selections from “Naming Ableism” byMaria Palacios 2017. Full poem)
While research on ageism, heterosexism, and anti‐fat attitudes has been steadily increasing, the study of ableism or disability prejudice is still in its infancy (Corrigan 2014). First referenced over 35 years ago in the women's news journal Off Our Backs (House 1981), ableism is an uncomfortable subject, a difficult dialogue, and not just because people feel bad for those who happen to be blind, deaf, or living with chronic physical, intellectual, or mental health conditions. Disappointment, disregard, discomfort, and distain are provoked, in part, because disability is a group that anyone can join – at any time. This can be scary, especially for those less familiar with diverse disabled people.
However, this book was designed to provoke difficult dialogues about disability – a social status that incites both hostile and benevolent forms of prejudice – and a group that provokes stereotypes of incompetence and dependency, and behaviors that range from staring and unwanted assistance to abandonment, dehumanization, and hate crimes. As illustrated in the opening poem by educator, author, and activist Maria Palacios, sometimes these prejudices are motivated by fear and contempt – at other times pity, inspiration, and compassion are involved as well. Extending the multitude of volumes on racism, sexism, and intergroup prejudice more generally, this book is among the first to integrate the social scientific literature on the origins and manifestations of prejudice against disabled people as a social group writ large – a group that confronts pervasive discrimination for the right to live independently, to work, and to parent.
More than one billion people in the world live with some form of disability, of whom nearly 200 million experience considerable difficulties in functioning. In the years ahead, disability will be an even greater concern because its prevalence is on the rise. This is due to ageing populations and the higher risk of disability in older people as well as the global increase in chronic health conditions such as diabetes, cardiovascular disease, cancer and mental health disorders.
World Health Organization (WHO 2011, p. 5)
Disability is a membership status on the rise both globally and in the United States (WHO 2011). One in five people currently qualify as living with disability,1 and many more will acquire the status on either a permanent or temporary basis, the longer they live (Fujiura and Rutkowski‐Kmitta 2001). Yet, for reasons this book will tackle head on, disability is a status that seems avoidable – even preventable – unlike old age and the inevitability of death. People don't like to think about disability. Some even characterize it as a fate worse than death: “I'd rather be dead than disabled,” is a comment that continues to resonate in popular discourse (Reynolds 2017).
Though surprising to some, disabled people make up the largest minority group in the United States, with 19% of the population or 56.7 million disabled people identified by the US Census (Brault 2012). But the census underestimates the population since it does not count institutionalized people with disabilities incarcerated in prisons or in nursing homes.2 Some people are born into disability with conditions like Down syndrome, dwarfism, or other congenital impairments.3 The vast majority of impairments, however (e.g. cerebral palsy, amputation, brain injury, multiple sclerosis), occur after birth, through accidental injury or the progression of disease (Vos et al. 2016). Furthermore, fractured limbs, concussions, low vision, hearing loss, and depression are quite common throughout the lifecycle, and many people experience multiple disabling conditions that vary in appearance and severity (Centers for Disease Control and Prevention 2013). According to US projections, given a 75‐year life expectancy, newborns will average 11 years with disabilities that limit their activities, and those who live past 75 can expect an additional four to five years of disability (Melzer et al. 2000; Zola 1993). When it comes to disability – it's more a question of when it will happen – not if. I've often wondered whether the open‐enrollment nature of disability is part of the reason ableism has been such a contentious topic, even among the experts who study stereotyping and prejudice.
In 2003, there were no fewer than 67 US federal statutory definitions of disability.
(Krahn et al. 2015, p. S199)
The concept of disability itself is highly contested (McDermott and Turk 2011). Who qualifies as disabled (and who doesn't) continues to be a moving target since defining characteristics change depending on the source, setting, and historical time period. For example, the same person who is considered disabled at school may not qualify as disabled at work. Different organizations have different inclusion criteria. Some people qualify as disabled if diagnosed with a specific impairment (e.g. autism, spina bifida, depression). Yet, a diagnosis alone does not predict a person's ability to function in different settings or with particular accommodations. People with the same exact diagnoses can differ widely in terms of their functional abilities, prognosis, and predictability of symptoms.
Not only can the same impairment result in very different limitations for different people, but very different impairments can produce similar limitations: both heart and back problems can reduce mobility. For this reason, many definitions of disability focus on age‐specific activity restrictions related to self‐care (e.g. bathing, dressing) and other activities of daily living (e.g. managing money, shopping). Questions about activity restrictions typically focus on what people cannot do (e.g. “Can you get outside the home?”), which fail to account for the use of technologies and other modifications like the availability of ramps to and from a wheelchair user's destination. Finally, some disabling conditions like facial scars, HIV/AIDS, or a record of “mental illness” are not associated with any physical limitations; yet, people still experience barriers that restrict their participation in a variety of settings. To address these complexities, the International Classification of Functioning, Disability and Health (ICF) defines disability as an umbrella term that incorporates impairments, activity limitations, and participation restrictions (Jelsma 2009).
The Americans with Disabilities Act (ADA1990) also includes a three‐pronged definition of disability to protect citizens against discrimination or unfair treatment on the basis of disability: “A person with a disability is defined as a person with a physical or mental impairment that substantially limits one or more major life activities; or a person with a record of such a physical or mental impairment; or a person who is regarded as having such an impairment.” However, before the 2008 amendments, the ADA excluded protection for those with medically correctable conditions (e.g. hearing aids) and those treatable with drugs (e.g. bipolar disorder, epilepsy). This lack of consensus about disability status is also reflected in recent public opinion polls.
According to nationally representative surveys, Americans still do not agree on what conditions should qualify as disabilities, particularly when it comes to mental “illnesses” like schizophrenia, depression, and addiction (Shannon‐Missal 2015). Agreement is even lower among older adults, Republicans, and those without disabled people in their household. In 2015, less than 58% of Americans believed that speech, language, and learning disabilities should qualify as disabilities under the ADA. Yet, in 2015, most (39%) students (ages 6–21) receiving special education services in the United States experienced specific learning disabilities, followed by those with speech‐language disabilities (17%) (Lauer and Houtenville 2018). The disconnect between public perceptions and reality makes the study of disability and disability prejudice ripe for investigation.
As I see it, the theoretical framework and analytical lens of Ableism is a gift from the disabled people rights movement [sic] and disability studies to the social sciences and humanities.
The term ableism emerged out of the disability rights movements in the United States and Britain to serve as an analytical parallel to sexism and racism for those studying disability as social creation (Wolbring 2012). With interdisciplinary origins, ableism has been defined as “ideas, practices, institutions, and social relations that presume able‐bodiedness, and by so doing, construct persons with disabilities as marginalized … and largely invisible ‘others’” (Chouinard 1997, p. 380). Yet ableism affects the “able‐bodied” too, as many impairments are not physically apparent in, or on, the body. Alternative definitions describe ableism as “a doctrine that falsely treats impairments as inherently and naturally horrible and blames the impairments themselves for the problems experienced by the people who have them” (Amundson and Taira 2005, p. 54). According to Hehir (2002), ableism is “the devaluation of disability that results in societal attitudes that uncritically assert that it is better for a child to walk than roll, speak than sign, read print than read Braille, spell independently than use a spell‐check, and hang out with nondisabled kids as opposed to other disabled kids” (p. 2). Sometimes referred to as disablism (Miller et al. 2004) or disability oppression, ableism privileges a nondisabled perspective and promotes the inferior and unequal treatment of disabled people (Campbell 2009).
While multiple definitions help frame the scope of the concept, in the present volume, ableism is simply defined as prejudice and discrimination toward individuals simply because they are classified as disabled – regardless of whether their impairments are physical or mental, visible or invisible. In the field of social psychology, prejudice is traditionally conceptualized in terms of three related components. These are the A, B, Cs of ableism:
Affective emotions or attitudinal reactions,
Behavioral actions/practices, and
Cognitive beliefs/stereotypes that go beyond general negativity.
To illustrate how this works at the interpersonal level, imagine meeting someone with a disability: if feelings of disgust or pity emerge (affect), one may offer to help or simply avoid interacting (behavior) – especially if one believes the person with a disability needs assistance or can't think clearly (cognition). Ableism can operate at multiple levels affecting personal self‐perceptions, interpersonal interactions, and intergroup relations. Like other prejudices, there are both individual and institutionalized forms of ableism and discrimination as well.
Based on the most recent US Census and nationally representative surveys, large disparities remain between disabled and nondisabled people in terms of educational attainment, employment status, healthcare, and other indicators of societal participation (Erickson et al. 2017; Kraus et al. 2018). In terms of educational attainment, in 2015, students with disabilities were twice as likely to have earned less than a high school education by age 25 compared to nondisabled peers. Furthermore, by age 25, only 10.3% of disabled students had earned a four‐year college degree compared to 21.4% of nondisabled students, who were twice as likely to have achieved more than a four‐year degree (Lauer and Houtenville 2018). Although the percentage of students with disabilities who pursue higher education has steadily increased (National Council on Disability 2014), some argue that the special education system itself contributes directly to the problem of underachievement. Special education, as a segregated system, can become a dumping ground for students with disabilities, especially for those with multiple minority statutes (Ferri and Connor 2005). In the United States, Black students make up 17% of total school enrollments but 33% of those labeled “mentally retarded,” which is nearly three times higher than the figure for white children. Black students are also twice as likely to be labeled emotionally disturbed compared to White students (Macedo and Marti 2010). In fact, a disability diagnosis has been deployed as a nonracial basis for expulsion from school – contributing to the school‐to‐prison pipeline (Reid and Knight 2006; Redfield and Nance 2016).
The legacy of marginalization and segregation is not limited to the special education “short bus,” as ableism is reflected in employment and healthcare disparities as well. For example, based on representative survey samples, compared to nondisabled people (12%) more than twice as many people with disabilities (27%) said they needed to see a doctor but did not because of cost (Krahn et al. 2015); and inadequate transportation was cited as a significant barrier to healthcare twice as often by people with disabilities compared to those without.
Accessible transportation is a basic necessity for many Americans to secure and maintain employment. Regardless of the number or effectiveness of programs and incentives designed to promote job opportunities for people with disabilities, in most instances, workers cannot secure and maintain a job if they do not have accessible transportation to get to it.
(National Council on Disability 2014, p. 28)
In 2016, 76.8% of people (18–64 years old) without disabilities were employed compared to only 35.9% of people with disabilities; and only 23% of these disabled people worked full‐time, year round (Lauer and Houtenville 2018). This 40% employment gap has remained constant for the past 10 years across economic downturn and recovery (Kraus et al. 2018). In 2016, median work earnings were over $10 000 lower for those with disabilities while their poverty rate was more than twice as high (26.7%) as those without disabilities (11.6%).4
Moreover, ableism pervades many other “major life activities” including participation in political, parental, and romantic arenas. Disabled people are less likely to marry, and if they do are more likely to get divorced. The rate for first marriages for people from 18 to 49 years of age is 71.8 per 1000 but only 41.1 per 1000 for people with disabilities – significantly lower than the general population (Cohen 2014). These rates vary widely for different ethnic groups: African Americans with disabilities have among the lowest marriage rates. Furthermore, while divorce rates in the United States have increased in general over the past 25 years, if a spouse becomes disabled, the likelihood of divorce is much higher, particularly among young, educated men with acquired disabilities that prevent them from working (Singleton 2012). Based on analyses of the American Community Survey, Cohen (2014) found that people with disabilities are up to twice as likely to get divorced compared to those without disabilities. Similarly, parents with disabled children are also up to two times more likely to divorce than those in the general population (Hartley et al. 2010; Wymbs et al. 2008).
Finally, disabled people are at much higher risk for secondary health conditions like obesity and heart disease, and are at greater risk of both unintentional injury and intentional victimization and violent crime (see Chapter 2). Specifically, disabled people are “more than twice as likely to report rape or sexual assault compared to people without disability. Women are victimized more often than men … [and] both men and women with disabilities are at significantly increased risk for intimate partner violence” (Krahn et al. 2015, p. S201–S202).
Since its inception in the mid‐1980s, the field of Disability Studies, like Black Studies and Women's Studies, has underscored the importance of disability as a social construction – a concept created to provide some basis for shared ideas about reality. In the case of concepts like race, gender, and disability, the reality that is created (and perpetuated) is often hierarchical: Some groups are positioned with more privilege and power over other groups who remain disadvantaged. Because they are social creations, these concepts mean different things in different places, and change with time as societies evolve and regress. For example, some still consider homosexuality a lifestyle choice; yet, increasingly science has documented its biological bases (Mustanski et al. 2002). Likewise, disability has seen many alternative constructions throughout history, equating it with the supernatural, the animalistic, the biological, and most recently, the socio‐political (Burch and Rembis 2014; Wendell 1996).
Some scholars who have taken up the issue of ableism focus on large‐scale political, economic, and structural issues that systematically oppress those who differ from the norm (Charlton 1998; Hollomotz 2013). Others have written from a humanities perspective to theorize the philosophical contours of ableism, and challenge the concept of normalcy (Campbell 2009; Scuro 2017). Within the field of psychology, psychoanalytic critiques have been applied to explain how ableist beliefs can affect the socialization of self through discourses about trauma and control, projection, and the rationalization of bias (Goodley 2011; Watermeyer 2012). Rehabilitation psychologists have also expanded their research on personal adaptation to disability to examine the interpersonal and environmental factors affecting the attitudes of nondisabled people toward disabled people – a topic that has dominated the study of disability prejudice for many years (Dunn 2010).
A review of textbooks on the psychology of prejudice and discrimination, however, revealed very few, and mostly brief, sections on disability prejudice as a category of study (Chin 2010; Nelson 2006; Whitley and Kite 2009). As a consequence, most students of psychology, like the public more generally, continue to assume that disability has more to do with people's biological impairments (e.g. blindness, deafness, or spinal cord injury) than with their socially disadvantaged status, and they are not alone. My own field of social psychology has been slow to recognize disabled people as a social group (see Nario‐Redmond 2010). This is unfortunate considering that the study of disability as a social creation began in the 1940s with Beatrice Wright, an early pioneer of disability studies and a student of Kurt Lewin. Lewin is recognized as the founder of social psychology, the man who championed the idea of: “No action without research. No research without action” (Adelman 1993, p. 8). Lewin's work inspired one of the most influential papers in my development as a social psychologist doing disability studies: “Disability Beyond Stigma: Social Interaction, Discrimination, and Activism.” In this paper, Fine and Asch (1988) called for a return to Lewinian principles and a minority‐group approach to disability prejudice. This was 30 years ago when these authors challenged the individualistic assumptions driving the study of disability in social psychology; yet, few have taken up that call for intergroup theorizing and action‐based research, until recently (see Dirth and Branscombe 2018).
Instead, social psychological research has focused almost exclusively on the stigma and anxiety associated with specific impairment conditions like paralysis, autism, and schizophrenia. In fact, this focus on the stigma of individual impairments has influenced the questions researchers have asked, and the methods they have used for the past five decades. To illustrate, one very popular method for assessing disability attitudes asks people about the closest relationships they are willing to have with those who experienced any number of conditions, including mental illnesses, blindness, deafness, dwarfism, missing limbs, etc. The approach resulted in a rank ordering of those impairment groups that people would: institutionalize, live next to, or accept as co‐workers, friends, or romantic partners (see Chapter 5). Studies using these “preference hierarchies” proliferated, although some have called for the permanent halting of this approach to measuring disability prejudice which can neither explain why some conditions rank higher than others nor predict prejudicial treatment more broadly (Olkin and Howson 1994).
By failing to conceptualize disability as a social category, a group membership, questions about ableism as a more global set of reactions toward disabled people as a whole (regardless of impairment) cannot be considered. This is changing as scholars begin to recognize that the study of stigma and attitudes is incomplete without an analysis of the experiences of disabled people as a group in order to uncover the broader social and political implications of ableism and its effects on the participation and well‐being of current and future citizens with disabilities.
The subject of ableism is now being explored descriptively through personal narratives, and discourse analyses, at both micro and macro levels. What remains lacking is a distinctly intergroup perspective that incorporates contemporary theory and research on the psychology of prejudice, mindful of recent critiques and new interdisciplinary approaches (Dixon and Levine 2012). An intergroup perspective on ableism recognizes that while prejudice often occurs between individuals interacting at the interpersonal level, prejudice also represents beliefs and motivations that derive from belonging to particular groups – groups of “us” and “them” – groups often motivated to maintain their status differences (Tajfel and Turner 1979). Until very recently, the discipline of social psychology had not articulated disability as a socially contingent category, a disadvantaged minority status influenced by intergroup power dynamics and the material environment in ways that shape ableist attitudes, stereotypic beliefs, and discriminatory behaviors (Nario‐Redmond 2010).
Therefore, the ground is extremely fertile for new research at the intersections of disability studies, social, and community psychology. There has been growing recognition that traditional approaches focused only on “what's wrong” with the individual are not sufficient because they don't account for persistent inequalities, prejudice, and discrimination experienced by this marginalized group. A social psychology of disability is needed to explore the mechanisms, myths, values, attributions, and emotional reactions that lead to biased intergroup judgments, group identify formation, self‐stereotyping, and the tensions between interpersonal liking and collective action for change.
Among contemporary prejudice researchers, a self‐critical approach has been gaining traction that recognizes how changing historical policies (e.g. ADA) have shifted the dynamics between disabled and nondisabled groups, altering the forms that ableism can take. Increasingly, prejudice is recognized as a complex manifestation of beliefs, mixed emotions, and behaviors that transcend expressions of general negativity (Glick and Fiske 2001). Prejudice, and disability prejudice in particular, can be benevolent and kind, paternalistic, pitying, and inspired by charitable intentions that nevertheless allow for the justification of control, restricted rights, and dehumanizing actions. For example, as more disabled people are gaining employment and access to higher education, ableism in the form of jealousy can emerge, especially when accommodations are framed as “special privileges,” like extra time on tests, books on tape, and the ever coveted disability parking placard.
The changing socio‐political landscape is also directing the focus of scholarly research to explore the shifting power dynamics of interpersonal and intergroup life for disabled and nondisabled people alike. This emerging multi‐disciplinary scholarship remains somewhat marginalized itself as it is fragmented across many fields of study, appearing in the journals of psychology, sociology, rehabilitation medicine, social work, political science, and disability studies. One of the goals of the present volume is to translate across these disparate literatures on disability attitudes, stigma, stereotypes, prejudice, and discrimination to uncover convergent trends and theoretical advancements, and to call for future research on a myriad of questions yet unanswered. This volume aims to address five key questions:
What does ableism look like? What are its common manifestations?
What are the causes of ableism against disabled people, and how are these perpetuated?
How do disabled people respond to ableism, and how do responses affect well‐being?
What works to reduce ableism, promote understanding, and increase equality?
What research questions remain unanswered for a future research agenda?
The following section summarizes each of the chapters to follow, which are based on a thorough review of the contemporary and classic research on disability prejudice, and critiques of the prejudice problematic – the approaches that have driven research on stereotyping, prejudice, and stigma for the past 50 years. Each chapter situates findings within the context of intergroup relations theories, identifying methodological limits, and suggesting contingent interpretations along with next steps. The chapters are organized into three parts: the origins of ableism (Chapters 2, 3, and 4); its consequences for targets' interpersonal and social relationships (Chapters 5 and 6); and advances from interventions to reduce ableism and activism to promote equality and social change (Chapters 7 and 8).
Specifically, following this introductory chapter, I review research testing the various theoretical origins associated with disability prejudice, beginning with the most distal or remote explanations about our evolutionary predispositions and universal motives. This is followed by more midrange explanations focused on ideologies, media portrayals, and language. I then review the more proximal explanations for ableism and its impact on disabled people, including the cognitive‐affective mechanisms and contextual factors that sustain, qualify, and alter its expression. The final chapters examine the impact of interventions that have been effective in reducing prejudice and ableism more specifically, and the disability rights advocacy and collective action efforts that have resulted in specific social changes, followed by an agenda for future research.
The evolutionary and existential origins of ableism are among the more distal explanations for prejudice, less accessible to awareness. They focus on the relatively universal and unconscious tendencies that humans from around the world demonstrate, revealing some of our most basic needs for safety, belonging, and significance. This chapter first describes the basic premises of evolutionary theory, and its implications for disability prejudice. According to evolutionary theory, one of the root causes of prejudice derives from biological predispositions that were adaptive in early hunter‐gatherer societies – where communal living offered safety, and attention to potential threats helped protect the group (Kurzban and Leary 2001). The idea is that human ancestors who inherited the tendency to be watchful and wary of danger were more likely to survive, reproduce, and pass on these same traits to their children. This evolved capacity for watchfulness is considered to be threat specific, which may help to explain why prejudice comes in a variety of forms. For example, if a stranger acted in ways that signaled competition, the most adaptive response might be anger (and beliefs that justified retaliation). However, if a stranger or even someone from within the group acted in ways suggestive of illness or disease, the most adaptive response might be avoidance (and beliefs that justified the elimination of this threat).
Some disability prejudice, therefore, might be an evolutionary holdover from those who inherited a disease‐avoidance system that became overly sensitive to people whose appearance or behavior signaled poor health – even if they were not infectious. If some people inherited an overactive disease‐detection mechanism, they might stare and respond fearfully to others with disease cues like open sores, spasms, or missing limbs, which tend to characterize some of the world's deadliest infections (Oaten et al. 2011). As a consequence, those who limp, tremor, or have uneven arms or eyes may trigger a false alarm in people who express discomfort and avoid contact even with objects touched by people with certain disabilities (Maguire and Haddad 1990). Some evidence in support of these ideas comes from tests of the disease‐avoidance model of disability prejudice. Park et al. (2003) found that some people do overgeneralize their adaptive fear and disgust toward pathogens by avoiding those with disabilities who are not contagious. These evolved tendencies are even more likely when people feel vulnerable to disease, like when pregnant or in hospital settings.
People don't usually catch disability like the flu despite that fact that around the world disabled people provoke repulsion and are treated as if they are contagious. They are isolated and shunned from public venues. People with cancer, cleft palates, birthmarks, and burns report being treated as if they were contagious, and responded to with gestures of disgust. Such “germaphobic” tendencies have important implications for interventions designed to promote inclusion and physical connection. If some people have a predisposition to avoid those who trigger contagion fears, interventions that put people into close contact to reduce disability prejudice might actually increase anxiety. Alternatively, with increasing exposure, such fears might become obsolete over time. Unfortunately, by assuming prejudice is primarily learned (and therefore can be unlearned), prejudice researchers have focused less on the challenges from evolutionary (Neuberg and Cottrell 2006) and existential psychology (Pyszczynski et al. 2015), which both focus on more deep‐seated and unconscious fears.
The second half of Chapter 2 summarizes theory and research on the existential fears associated with disability prejudice, dehumanization, and hate crimes. According to Terror Management Theory (TMT), some people are avoided because they remind others of their vulnerability to deterioration and death. Disability prejudice therefore, may be used as a way to escape awareness of our own frailty, which can be threatening to those who would rather not think about the prospect of acquiring a disability (or a disabled family member). Disability reminds people that strength, intellect, and language are neither guaranteed nor permanent. Like all animals, humans break. We all have accidents, and someday we will die. Research in over 25 countries has shown that fears of death are linked to prejudice against Jews, Muslims, immigrants, and disabled people (Pyszczynski et al. 2015). Although many cultures promote the superiority of humankind, evidence shows that viewing humans as superior to animals is another strong predictor of intergroup prejudice. If disabled people serve as unwanted reminders that life is not predictable, they may not only be excluded, they may also become the targets of violent crimes.
Ableism may also stem, in part, from a need to feel distinct from other animals. TMT lays the groundwork to examine how fears of death and the need for a meaningful, uniquely human existence can underlie prejudicial reactions – especially toward those who threaten beliefs about what it means to be human (Goldenberg et al. 2000). People work very hard to keep reminders of their animal natures at bay: we cover up blemishes, perfume body odors, and make private and sanitary the elimination of wastes. Enter people with disabilities who may crawl, shake, and drool. They can be blatant reminders that we, as animals, are made of flesh and blood. Research has yet to test whether making people aware of their animal natures increases ableist attitudes, but evidence shows these reminders do increase thoughts of death. Perhaps this is why birth control regulations are imposed on those whose human status continues to be questioned. People with disabilities are frequently denied personhood, and have a long history of dehumanizing treatments (Braddock and Parish 2001). People whose bodies or bodily fluids signal our essential creatureliness (and vulnerability to disability) may become targets of condescending but taming forms of social control, or animalistic hate crimes involving urination and defecation (Haslam and Loughnan 2012). Others, whose prosthetics and assistive devices appear machine‐like, may become the targets of mechanistic forms of dehumanization: disabled residents in institutional settings have been deprived of medication and heat in the winter justified on the basis that they are unfeeling machines that do not feel pain (Bryen et al. 2003).
Critiques of both evolutionary and existential approaches, alternative interpretations, and next steps needed to corroborate the evidence to date will also be discussed. As long as disabled people are conceptualized as less than fully human, they will be treated in ways that benefit those whose lives are considered more valuable.
Where else do such ideas about disability as a fate worse than death originate? From childhood on, people are exposed to many stories about human variability, the causes of disability, and why some people are more deserving of opportunity than others. In contrast to the universal origins of prejudice, this chapter focuses on the intermediate origins of ableism reflected in the complex belief systems used to justify and perpetuate both privilege and oppression. The chapter begins with a review of how ideologies like Social Darwinism, Individualism, Meritocracy, and the Protestant Work Ethic provide handy explanations that can be used to make sense of status differences and discriminatory practices.
Disabled people have endured a long history of persecution, from institutionalization and forced sterilization to medical experimentation and systematic extermination (Morris 1991). How are such practices that result in persecution, economic exploitation, and hate crimes justified? Across most forms of victimization, ideological beliefs about disabled people's deservingness of specific treatments can be found (Sherry 2016). Few people know that before World War II, over 240 000 disabled people were starved, gassed, and poisoned. Yet, these actions were not considered war crimes. Instead, they were rationalized as mercy killings intended to free families from “a lifetime of sacrifice” (Gallagher 1990). Ableist beliefs that cast disability as burdensome may be even more common when resources are scarce, or when disabled people are described as taking opportunities away from those benefiting from the way things are (Sidanius et al. 1994). Idealistic beliefs about improving society through human enhancements, designer babies, and selective abortions in the case of disability still persist today as part of the New Eugenics movement (Allen 2001).
Several contemporary and clashing ideologies underscore competing definitions of disability itself, which have significant consequences for social policy. The moral, medical, and social models of disability are analyzed in relation to theories of system justification and social dominance. This work examines how different explanatory frameworks about disability can either fortify or weaken unequal status relationships that keep some groups at the top of the social hierarchy and others at the bottom. The disability models provide for very different explanations about where the problems of disability are located, and therefore dictate very different ideas about where solutions should be sought (Altman 2001). For example, when disability is attributed to supernatural forces, people may be more likely to endorse the need for divine intervention. Whether exorcism or other religious rituals are sought may depend on whether disability is attributed to demon possession or to the workings of a merciful God whose power is revealed through prayer (Braddock and Parish 2001).
Ideological beliefs are often transmitted through popular discourse and other forms of social influence. Chapter 3 goes on to review how language and media portrayals are both used to maintain social inequalities and to challenge the status quo. For example, talk is a form of action that both reflects and creates reality. The phrase “wheelchair bound” is a violation of journalistic guidelines that caution against describing disabled people as passive and imprisoned when mobility devices could also be described as liberating. Unwanted forms of helping can result from repeatedly hearing that people are “confined to wheelchairs” (Linton 1998). Simply overhearing someone use derogatory slurs leads people to devalue those described (Blanchard et al. 1994). Similarly, if the media consistently describes people as “suffering from” disability, viewers are more likely to reflect these restricted accounts. For example, those labeled as a danger to themselves are still forcibly medicated and committed to institutions in the name of protection; an entire “tragic persons' industry” exists for those with “special needs.” When ramps and audio captions are characterized as “special needs,” people may not identify them as civil rights. It wasn't until disabled people started describing their problems in terms of discrimination that disability rights activism became possible (Chapter 8).
Finally, Chapter 3 highlights the shifting nature of disability descriptions and media portrayals, particularly in everyday conversations where people often gesture toward prejudice through jokes, memes, and other humorous quips. What qualifies as ableist speech is hotly debated and changes with the times. What was previously considered acceptable may later be contested as prejudicial and vice versa. For example, previously stigmatized terms like freak, gimp, mad, and crip have been reclaimed as positive expressions of pride within the disability community. Furthermore, public expressions are not always managed to avoid prejudicial talk, especially when people are motivated to verify their biased allegiances. Many people remain unclear about what counts as offensive or funny when it comes to disability, but as minority groups gain power, humor may be used to relieve tension and help people process new social arrangements. The power of disability humor can also raise awareness of the everyday insults and microaggressions disabled people confront (e.g. the YouTube trend “Sh*t people say to … disabled people”). Bridging the gulf between curious inquiry and offensive probes is a topic in desperate need of research informed by the experiences of disabled people who should not have to conform to normal standards or disclose their conditions just to put nondisabled people at ease. Future research is also suggested on the process by which popular discourse shifts between what was formerly considered acceptable, and what is increasingly recognized as ableist.
When language and media portrayals consistently associate certain characteristics with disability (e.g. helplessness, dependence, asexuality) while failing to link the group with other roles and capabilities (parenthood, independence, competence), cultural stereotypes become engrained in memory, shaping what people notice and fail to notice about others. Novels, movies, and cartoons are full of examples that perpetuate stereotypes by portraying disabled people as tragic victims, angry villains, and incompetent dupes (Haller 2010). Even contemporary, award‐winning films (e.g. Million Dollar Baby; Me Before You) reinforce stereotypes whenever the disabled character chooses to die so as not to be a burden to loved ones (Dolmage and DeGenaro 2005). As noted in Chapter 3, the removal of life‐sustaining food and breathing tubes can be justified as mercy killing as long as disabled people are characterized as suffering burdens.
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