Disability in China

Disability in China involves a population of around 83 million facing significant challenges in inclusion, education, and employment despite government efforts and organizations like the CDPF. While there are legal frameworks and support systems, many people with disabilities, especially in rural areas, remain marginalized due to stigma, lack of accessible infrastructure, and underfunded social programs, with a greater focus needed on rights-based inclusion over welfare provision.

Demographics

Of the total number of disabled individuals, men account for 42.77 million and women account for 40.19 million, making the gender ratio 106.42 disabled men for every 100 disabled women. Furthermore, 20.71 million individuals of the disabled community reside in urban areas, whereas 62.25 million in rural areas.
According to the China Disabled Persons' Federation, approximately 12.33 million people have visual disabilities, 20.04 million have a hearing disability, 1.27 million have a speech disability, 24.12 million have a physical disability, 5.54 million have an intellectual disability, 6.14 million have a developmental disability, and 13.52 million have multiple disabilities.

Trends

Prevalence of disability

There are currently only two published national sample surveys on disability conducted in China. The First National Sample Survey on Disability was published in 1987, and the Second was published in 2006. Over the past 19 years, there has been an increase in the total number of disabled individuals and in the proportion of disabled people to the total population.
Using the data from the two surveys, researchers found that the crude disability rate increased 1.5% from 1987 to 2006. However, once the data was adjusted to accommodate modified age structures and the change in population pyramid with the higher proportion of elderly in 2006, the adjusted disability rate increased by 0.5% over the time period. Although the frequency of visual, hearing, speech, physical, and intellectual disabilities did not depend on sex or place of residence over time, there was an increase of mental disability across males, females, and rural residents that did not occur among urban inhabitants.

Language

There has been a shift in the language used to describe individuals with disabilities, reflecting a gradual increase in social acceptance of disabilities in China. Historically, the general term for people with disabilities was "can fei", which means "crippled and useless". Currently, the widely used term is "can ji", which means "deformed", although the China Disabled Persons' Federation is advocating the use of "can zhang", which means "incomplete and obstructed", as a more neutral term. However, many derogatory terms are still utilized in common vernacular to describe people with disabilities, such as "sha zi", which means idiot.

Law

Laws, regulations and policies

Definition

The Law of the People's Republic of China on the Protection of Disabled Persons states that "a disabled person refers to one who suffers from abnormalities or loss of a certain organ or function, psychologically or physiologically, or in anatomical structure and who has lost wholly or in part the ability to engage in activities in a normal way." This includes individuals with "visual, hearing, speech or physical disabilities, mental retardation, mental disorder, multiple disabilities and/or other disabilities." The Law of the People's Republic of China on the Protection of Disabled Persons upholds the rights of individuals with disabilities in regards to employment opportunities, educational access, legal liability, and sufficient care.
In 2011, the People's Republic of China published the Classification and Grading Criteria of Disability, as part of the National Standards of the People's Republic of China. This national standard is based on two published national sample surveys on disability conducted in China, adjusted according to international community and social development project. This national standard classify disability into six categories, which are visual disability, hearing disability, speech disability, physical disability, intellectual disability and mental disability. Some disabled factor such as visceral defects and irreversible chronic diseases are not included. This national standard not only classified disability categories, but also defines the disability definitions, terminology, disabled level and its grading criteria. The Classification and Grading Criteria of Disability was published January 14^th, 2011, and implemented on May 1^st, 2011.

Protection

Enacted in 1982, the Constitution of the People's Republic of China ensured protection for individuals with disabilities: "Citizens of the People's Republic of China have the right to material assistance from the State and society when they are old, ill or disabled. The State develops social insurance, social relief and medical and health services that are required for citizens this right... The State and society help make arrangement for the work, livelihood and education of the blind, deaf-mutes, and other handicapped citizens."
In 2008, the Regulations on the Employment of People with Disabilities promoted the employment of disabled individuals and safeguarded against their discrimination. It stated that the proportion of disabled employees should be at least 1.5%, although the number differed between provinces. Failure to meet this proportion would result in a fee to the employment security fund for disabled persons.

Education

In 1986, the Compulsory Education Law mandated that every child is given the right to nine years of free public education: six years of elementary school and three years of secondary school.
In 1994, the Regulations on the Education of Persons with Disabilities aimed to promote access to education for individuals with disabilities, although according to Human Rights Watch, it "failed to make adequate progress on mainstreaming children with disabilities into regular schools as required by international law."
In 2007, the United Nations Convention on the Rights of Persons with Disabilities was signed in China and outlined increased educational opportunity for children who had disabilities. The Convention emphasizes a human rights approach to disability and asserts that "inclusive education" is a fundamental human right.

Treatment

In 1990, the Law on the Protection of the Disabled Persons stated that families and the community share the responsibility for taking care of individuals with disabilities.
In 1999, the World Health Organization conducted an official mental health seminar with the Chinese government after which the government pledged to "improve their leadership for and support of mental health care, strengthen inter-sectoral collaboration and cooperation, establish a mental health strategy and action plan, facilitate the enactment of a national mental health law, and protect patients' rights."
In 2002, the first National Mental Health Plan establishing an effective system of mental health care led by the government with the participation and cooperation of other sectors; b) acceleration the process of mental health legislation development and implementation; c) improving the knowledge and raising the awareness of mental health among all citizens; d) strengthening mental health services to decrease burden and disability; and e) developing human resources for mental health services and enhancing the capacity of current psychiatric hospitals."
In 2004, the Proposal on Further Strengthening Mental Health Word was passed and it explicitly outlines means of intervention for psychological issues, treatment for mental disorders, and protecting the rights of disabled individuals. It currently serves as the "de facto Chinese mental health national policy."
In 2012, the Mental Health Law standardized mental health services, required hospitals to have services for counseling, and protected people from being treated against their will in psychiatric wards.

Accessibility

In 2005, the 5th National Five Year World Program for People with Disabilities aimed to improve the accessibility of the Olympic and Paralympic Games in Beijing and increase convenience for individuals with disabilities in "100 barrier free model cities".

Education

Since the establishment of the People's Republic of China in 1949, the government has provided special education services, and the first schools for the blind and deaf were founded at this time. In 1980, the first training for special education teachers was started. In the 1990s, courses on special education were mandatory offerings in teacher training schools.
The majority of individuals with disabilities live in rural areas and it is difficult to access funds for these areas. Thus, the "Learning in the Regular Classroom" model, which integrates children with disabilities in classroom with children without disabilities, has become more popular and in 2003, approximately 67% of individuals with disabilities are in such schools. However, students with disabilities have been "observed sitting alone, isolated from classroom activities, or have even remained at home, despite the fact that their names are on the registration list." Additionally, teachers in rural areas were not generally trained to teach students with disabilities. Vocational education for children with disabilities is limited to "painting for students with hearing impairment, massage and weaving for students with visual impairments, and sewing for those with mental retardation."
Presently, there are special schools set aside for children with disabilities. According to the China Disabled Persons' Federation, in 2009, there were 1,697 special schools for blind, deaf and intellectually disabled children. There were also 2,801 special classes in public schools. In total, 545,000 students are enrolled in special education.