Social Structures
Author: Dr. Emma M. Smith, Postdoctoral Researcher, AT2030, ALL Institute, Department of Psychology, Maynooth University
This week, like many of our colleagues who work in the areas of disability and inclusion, we are anticipating the start of the Paralympic Games. Aligned with this, we are also celebrating the launch of #WeThe15, a global campaign to promote inclusion of persons with disabilities through engagement in sport. Participation in culture, including sport, is enshrined in Article 30 of the UN Convention on the Rights of Persons with Disabilities. We also have research which supports the concept that sports promote health and wellbeing through social inclusion, access to the community, and opportunities for physical activity.
We wrote in a recent blog post about our research highlighting the importance of every-day assistive technologies, in addition to sport-specific technologies to facilitate sport engagement. This recent research supports a more holistic approach to sports engagement – understanding that assistive technologies are needed for people with disabilities across all types of sport engagement, and along a pathway of sport participation that includes pre, during, and post-sport performance.
Despite a growing understanding of the critical need for assistive technologies to facilitate participation and social inclusion, both in sport and in the community, the World Health Organization estimates less than 1 in 10 have access to the technologies they need. These are technologies which allow people to maintain or improve their independence, and support the realization of a wide range of rights.
Cost is one of the primary reasons people have difficulty accessing the assistive technologies they need. Even in countries with universal health care systems, assistive technologies are often not included in health insurance schemes or have significant limits placed on them. One example we see frequently is access to wheelchairs. While research in Canada has shown that nearly 20% of wheelchair users actively use more than one type of wheelchair or scooter, most funding schemes in Canada do not have a provision for multiple devices. Nearly all universal health systems also place limits on the technologies which are provided, and those which are not used for daily mobility (sometimes only mobility inside the home) are outside the scope of these funding schemes. In lower and middle-income countries, lack of funding often means access to one appropriate wheelchair (not to mention two) is impossible. Reliance on donors for access to assistive technologies, and a lack of appropriate personnel with training to provide skilled fitting and training, means many people never have access to the assistive technologies they need.
Access to sport for people with disabilities, particularly those sports which require access to assistive technology, is even more constrained. Research shows that people with disabilities, worldwide, are more likely to live in poverty than people who do not have disabilities. Furthermore, the cost of disability is high – people with disability also face disproportionally higher health care costs than people without disabilities, even in countries with universal health care systems.
This, combined with the high cost to acquire the right assistive technologies for participation means that cost can be a barrier to entry, and therefore a barrier to sport participation. For those living in poverty, participating in sport, therefore, becomes impossible. This is shown across all levels of sport. Consider the example of powerchair football, a sport that is played at both the recreational and elite level. Players can participate in their every-day wheelchairs (which are already prohibitively expensive for many), however, to get the full benefits of participation, or to compete on an international level, they need access to specialized wheelchairs – the most commonly used called the Strike Force wheelchair. Even the most basic of these wheelchairs, without any adjustments or changes commonly required by people who play powerchair football costs nearly $18,000 USD. Additional modifications which may be required to make it possible for a person to use the wheelchair independently can cost an additional $10,000 or more.
The same is true for many other adaptive sports. The cost of an entry-level sit-ski, which is used by people who are unable to ski standing up, ranges from $3,000 USD to $5,000 USD, far exceeding the cost of entry-level ski equipment for people who ski in a standing position. Furthermore, while many who are learning to ski would hire ski equipment during the learning process, this is nearly impossible for adaptive equipment, as most facilities simply don’t have the equipment available for hire, nor the expertise to appropriately fit the equipment.
Community organizations who provide access to adaptive sport do an incredible job of finding the funds to provide the best possible experience – with the best possible equipment. They have trained staff and volunteers who are skilled in providing adaptive sports instruction. Many try to operate at similar costs to comparable programs for people without disabilities. However, these programs are often reliant on donations and volunteer time to operate, and therefore have to limit the number of individuals who can take part.
Even athletes in those sports which do not require assistive technologies, like seated volleyball, may still rely on day-to-day assistive technologies – to get them to training, to ensure they are positioned well for sleep at night, or to be able to bathe after a sporting event. Each of these technologies comes at a cost and increases the cost-based barrier to entry to sport.
In the coming weeks, we will see amazing athletes competing at the Paralympic level from countries all over the world. If you watch carefully, you will likely notice that there are many more athletes from high-income countries. In those sports which require assistive technology use, you may notice this gap growing even wider. This is not just a guess – the research to demonstrate this gap is forthcoming and shows what will be quite obvious: low and middle-income countries have lower rates of participation and achievement in all sports, but particularly in sports requiring assistive technologies, than higher-income countries.
We have an opportunity to use the Paralympic games, and movements like #WeThe15 to highlight these disparities. To consider how we can be more inclusive as a society, and break down the barriers to achievement of rights, including the right to participation in culture and sport.