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What disables a person who uses a wheelchair — their inability to walk, or the building with steps and no ramp? The answer you give defines which model of disability you hold, and it is the single most important distinction in this field. For most of modern history, disability was understood through the medical model, as a defect or deficiency in the individual body to be cured, treated or rehabilitated. From the 1970s, disabled activists and sociologists mounted a radical challenge: the social model of disability, which argues that people are disabled not by their bodies but by a society organised in ways that exclude them. This lesson examines the sociology of disability and its central place in the sociology of health. It contrasts the medical and social models, traces the social model to the activism of UPIAS and to the foundational work of Mike Oliver and Colin Barnes, examines Tom Shakespeare's influential critique of the social model, and uses Erving Goffman's analysis of stigma to understand the everyday experience of disability. As throughout this option, the examinable skill is to weigh competing models and reach a judgement that respects both the social production of disability and the bodily reality of impairment.
Key Definition: The social model of disability draws a sharp distinction between impairment — a physical, sensory or cognitive difference or limitation of the body — and disability — the social disadvantage and exclusion imposed on people with impairments by a society organised around non-disabled norms. On this view, impairment is bodily, but disability is socially created: it is society, not the body, that "disables".
This lesson addresses a core bullet of the AQA A-Level Sociology (7192) specification, Paper 2 (Topics in Sociology), Section A — Health:
The specification expects you to describe (AO1) the medical and social models of disability, the impairment/disability distinction, key theorists (Oliver, Barnes, UPIAS, Shakespeare) and Goffman's stigma, apply (AO2) them to an Item, and evaluate (AO3) the social model against its critics. The vocabulary fixed here — impairment vs disability, the social model, disabling barriers, stigma — is central to the option.
The traditional and still-dominant framework is the medical model (sometimes called the individual model). It treats disability as a problem located in the individual body: a person is disabled by their impairment — their inability to walk, see, hear or process information — which is understood as a deficiency, abnormality or tragedy to be cured, treated, rehabilitated or cared for by medical and allied professionals. The disabled person is cast as a patient in need of expert intervention, and the goal is to make them as "normal" as possible or, failing that, to care for them.
Sociologists, following the social-model critique, identify several problems with this framework:
This is, in effect, the biomedical model (lesson 1) applied to disability, and it shares its individualism and its blindness to social conditions.
The medical model is not merely an abstract way of seeing; it has had concrete and often damaging consequences. Because it locates the problem in the individual, it has historically justified segregation — the removal of disabled people into separate institutions, "special" schools and sheltered settings, on the assumption that they cannot participate in mainstream life. This connects directly to Goffman's total institution (lesson 7): institutional "care" for disabled people, like the psychiatric asylum, could "mortify" the self and produce dependence. The medical model has also underpinned the framing of disabled people as objects of charity and pity — fundraising imagery that casts them as tragic and helpless — which disabled activists argue is itself demeaning and disempowering. The social model's insistence that the response to disability is a political choice, not a medical necessity, is therefore not academic hair-splitting: it challenges a whole history of segregation, institutionalisation and well-meaning but disabling benevolence.
The social model turns the medical model on its head, and it emerged not from academia alone but from the disabled people's movement itself. The pivotal moment was the work of the Union of the Physically Impaired Against Segregation (UPIAS) in Britain in the 1970s. UPIAS drew the foundational distinction that defines the field: between impairment (a feature of the body — lacking a limb, or having a limited bodily function) and disability (the disadvantage or restriction of activity imposed on people with impairments by a social organisation that takes little or no account of them). In UPIAS's formulation, disability is something done to impaired people by society.
This distinction was developed into a full sociological theory by Mike Oliver, who coined the term "the social model of disability" and whose The Politics of Disablement (1990) is the field's founding text. Oliver, himself a disabled sociologist, argued from a broadly Marxist standpoint that disability is socially produced: it is the product of a society — and especially an economy — organised around the capacities of the non-disabled body. Capitalism, he argued, with its demands for a particular kind of productive, flexible, standardised labour, created disability as a category of exclusion, casting those who could not meet its demands out of work and into dependency. Disability, on this view, is not a medical condition but a form of social oppression, comparable to racism or sexism. Colin Barnes, another central figure, documented the systematic discrimination and exclusion disabled people face across employment, education, transport, housing and the built environment, and argued these constitute disabling barriers that are the true cause of disability.
The shift from the medical to the social model transforms the entire question:
| Dimension | Medical (individual) model | Social model |
|---|---|---|
| What is the "problem"? | The individual's impaired body | A society organised around non-disabled norms |
| What disables the person? | Their impairment | Disabling barriers: physical, institutional, attitudinal |
| Who must change? | The individual (cure, rehabilitate) | Society (remove barriers, ensure accessibility) |
| How are disabled people cast? | Passive, dependent, tragic patients | Citizens with rights facing oppression |
| Who holds authority? | Professionals who define needs | Disabled people themselves (nothing about us without us) |
| Theoretical leaning | Functionalism; biomedical individualism | Marxism (Oliver); a model of social oppression |
The social model's political force is enormous: if disability is created by barriers, then the remedy is not to cure individuals but to remove the barriers — to build ramps, provide accessible information and transport, outlaw discrimination and redesign institutions. The slogan "nothing about us without us" captures the demand that disabled people define their own needs. The social model underpins the entire framework of accessibility and anti-discrimination policy.
graph TD
A["A person has an impairment (a bodily difference)"] --> B{"Which model?"}
B -->|"Medical model"| C["The impairment is the problem"]
C --> D["Cure, treat or rehabilitate the individual"]
B -->|"Social model"| E["Society's disabling barriers are the problem"]
E --> F["Physical, institutional and attitudinal barriers"]
F --> G["Remove the barriers: accessibility and rights"]
G --> H["Disability is social oppression (Oliver, Barnes, UPIAS)"]
Alongside the structural account of the social model sits an interactionist analysis of the everyday experience of disability, centred on Erving Goffman's (1963) concept of stigma (introduced in lesson 2). A stigma is a deeply discrediting attribute that reduces its bearer, in the eyes of others, "from a whole and usual person to a tainted, discounted one". Disability is a paradigm case. Goffman's analysis illuminates the micro-level dynamics that the structural social model can overlook:
Goffman's analysis connects to the social model because it shows that attitudinal barriers — prejudice, awkwardness, pity, the reduction of a person to their impairment — are as disabling as physical ones. It also connects to the labelling tradition (lessons 2 and 7): the "disabled" label, like the "mentally ill" label, can become a master status that shapes how the person is seen and how they come to see themselves.
It is worth spelling out the kinds of barrier the social model identifies, because a strong answer names them rather than gesturing vaguely at "society". Sociologists in the social-model tradition typically distinguish three interlocking types, each of which "disables" a person with an impairment over and above the impairment itself.
| Type of barrier | What it involves | Example |
|---|---|---|
| Physical / environmental | A built environment, transport system and set of products designed around the non-disabled body | Steps without ramps; inaccessible transport; signage unusable by people with sensory impairments |
| Institutional / structural | The rules, practices and organisation of institutions that exclude or disadvantage disabled people | Inaccessible workplaces and selection procedures; segregated "special" provision; benefits systems that assume dependence |
| Attitudinal / cultural | The prejudices, assumptions and representations that cast disabled people as pitiable, dependent or "other" | The reduction of a person to their impairment (Goffman's spoiled identity); media stereotypes of tragedy or heroism |
The point of the typology is that removing one barrier is not enough: a workplace with a ramp (physical) may still exclude through discriminatory recruitment (institutional) and the low expectations of colleagues (attitudinal). The social model's demand for accessibility is therefore comprehensive — it targets the whole organisation of society, not just the physical environment — and the persistence of disadvantage even where physical access has improved is itself evidence that institutional and attitudinal barriers are doing much of the disabling work.
A further sociological observation deepens this. Disabled activists pioneered the principle of emancipatory research — research conducted with and for disabled people, under their control, rather than on them by non-disabled experts. This is itself an application of the social model: if disability is socially produced, then disabled people, not professionals, are the authorities on their own oppression, and research should serve their self-determination. The slogan "nothing about us without us" thus extends from policy into the production of knowledge, challenging the professional monopoly over defining disabled people's needs (a direct link to medical power, lesson 10).
The social model did not arise in a seminar room; it was forged by the disabled people's movement as a tool of political mobilisation. Recognising this matters sociologically in three ways.
First, the model reframes disability as a question of citizenship and rights rather than care and charity. If disabled people are oppressed by barriers, then the appropriate response is the same as for other oppressed groups — civil rights, anti-discrimination law and the removal of exclusion — rather than pity or benevolence. The movement's achievements in shifting public policy towards accessibility and anti-discrimination are a practical vindication of the model's analytic claim.
Second, the model opened space for a positive disabled identity. Some theorists developed an affirmative model of disability, which goes beyond merely removing barriers to actively affirm disabled identity and experience as a valid and valuable way of being in the world, rejecting the assumption that impairment is inherently a tragedy or a deficit. This connects to the sociology of new social movements and identity politics, and it sharpens the contrast with the medical model's framing of disability as loss.
Third, the model insists that disability is a major axis of social inequality and intersects with the others studied in this option. Disabled people experience markedly higher rates of poverty, unemployment and exclusion, and disability cross-cuts class (disability and poverty reinforce one another), gender (disabled women may face compounded disadvantage), ethnicity and age (impairment becomes more common in later life, linking disability to the ageing body, lesson 8). Treating disability as a purely medical matter therefore obscures the fact that it is a stratifying social division — which is exactly the individualism the social model was built to reject.
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