Disability Differential in India: A Critical Evaluation of Caste-Wise Disability

Abstract

The disabilities are deprived of all opportunities for social and economic development. The basic facilities like education, health and employment are denied to them. The State infrastructure is grossly inadequate and ill functioning where disabled are concerned. Therefore, the study have tried to see the state-wise change in disability, the prevalence of different types of disabilities and the caste-wise gap in disability by using Indian census 2001 and 2011 with the help of bi-variate and age-standardized methods. Movement, seeing and hearing impairment is more prevalent than the other disabilities. It is high in Uttar Pradesh and Maharashtra while lowest in seven sisters and the territories of India. Punjab, Jharkhand, Chhattisgarh, Maharashtra, Andhra Pradesh and Karnataka are the state where disability has increased over the period 2001 to 2011. Disabilities rate is high in the scheduled caste and males than the non-SCs/STs and females. Disability gap is increased after the age group 40-49 in both SCs/STs and rural setting. It concludes that there should be a separate policy for the 50 plus person that is mostly focused on vulnerable rural section (SCs/STs) irrespective for getting the better medical facility.

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International Journal of Science and Research (IJSR)
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Disability Differential in India: A Critical
Evaluation of Caste-Wise Disability
Jang Bahadur Prasad1, Kamalesh Kumar Patel2
1, 2International Institute for Population Sciences, Deonar, Govandi Station Road, Mumbai 400088, India
Abstract: The disabilities are deprived of all opportunities for social and economic development. The basic facilities like education,
health and employment are denied to them. The State infrastructure is grossly inadequate and ill functioning where disabled are
concerned. Therefore, the study have tried to see the state-wise change in disability, the prevalence of different types of disabilities and
the caste-wise gap in disability by using Indian census 2001 and 2011 with the help of bi-variate and age-standardized methods.
Movement, seeing and hearing impairment is more prevalent than the other disabilities. It is high in Uttar Pradesh and Maharashtra
while lowest in seven sisters and the territories of India. Punjab, Jharkhand, Chhattisgarh, Maharashtra, Andhra Pradesh and
Karnataka are the state where disability has increased over the period 2001 to 2011. Disabilities rate is high in the scheduled caste and
males than the non-SCs/STs and females. Disability gap is increased after the age group 40-49 in both SCs/STs and rural setting. It
concludes that there should be a separate policy for the 50 plus person that is mostly focused on vulnerable rural section (SCs/STs)
irrespective for getting the better medical facility.
Keywords: Disability, SCs, STs, Non-SCs/STs, males, females, rural, urban.
1. Introduction
Disabilities are an umbrella term, covering activity
limitations, impairments, and participation restrictions.
Impairment is a problem in body function or structure; an
activity limitation is a complexity encountered by an
individual in executing an action or task; while a
participation restriction is a problem practiced by an
individual in involvement in life situations (World Health
Organization).
Although disability can happen in any family, poverty and
disability are strongly interlinked. Poverty may enhance the
likelihood of disability and may also be a consequence of
disability [1]. Approximately 400 million disabled people
reside in the developing world. Often they are mostly from
poorest. According to World Health Organization (WHO)
estimates, 1.5 million blind children are primarily in Asia and
Africa. In the developing countries, up to 70 % of blindness
is either treatable or preventable. The WHO also estimates
that approximately 50% of disabling hearing impairment is
preventable. Globally, this affected a total of 120 million
people in 1995. According to the National Sample Survey
Organization (NSSO) 58th round survey in 2002, there are
18.49 million people in India who is disabled. This number
enlarged from 13.67 million in 1981 to 16.36 million in
1991. Out of the 18.49 million disabled inhabitants, 10.89
million are males and 7.56 million are females, which
constitutes around 59% and 49% males and females
respectively. These people are suffering from some form of
disability [2-3].
The 2001 Census covered five kinds of disabilities recorded
a prevalence rate of 2.13 percent, or 21.91 million
inhabitants with disabilities out of a whole population of
1028 million. The NSSO 58th round (July-December 2002)
survey reported that 1.8 percent of the population (18.5
million) was a disability. As 18-22 million people with
disabilities are a large number, this is still arguably a gross
under estimation, particularly when one considers that WHO
estimates a worldwide prevalence rate of 10 percent. The
leading Indian disability NGO, National Centre for
Promotion of Employment for Disabled People (NCPEDP)
indicates that 5-6 percent of the population has a disability
[3-4].
Disabled are not a homogenous group. There are different
types of disabilities, with different requirements. The
disabled are depressed of all opportunities for social and
economic development. The basic facilities like education,
health and employment are denied to them. The State
infrastructure is grossly insufficient and ill-functioning where
disabled are concerned [2]. Therefore in this paper, I begin
with an overview of different types of disability and state
wise disability change over the period 2001 to 2011. And the
prevalence of various kinds of disabilities as well as caste-
wise disability gap in the Indian context. In which study
undertake brief efforts to highlight the vulnerable section that
are back in getting a medical and another facility because of
the existents of discrimination and stigma in the Indian
society.
2. Material and Method
Data Source
The number of disabilities and population information
according to sex, place of residence and caste by the five
years age group has been taken from the Indian census-2001
and 2011. The total population of India in 2001 and 2011 is
1,02,86,10,328 and 1,21,08,54,977 respectively. Disability of
India was 26,810,557 in 2011 whereas it was 21,906,769 in
2001. Moreover, the Indian Census is a rich tradition. In
India, the first Census was conducted in the year 1872. It was
conducted at different points of time in different parts of the
country. In 1881, Census was taken in the whole country and
after its, Census has been conducted at every 10 years,
without a break. Therefore, the Census of India 2011 is the
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15th in unbroken series since 1872 and the 7th after
independence. Through, it is the missionary zeal and
dedication of Enumerators like that the great historical
custom of conducting the Census uninterruptedly has been
maintained in spite of several adversities like wars, natural
calamities, epidemics, political unrest, etc. Participation of
the people in India Census is an accurate reflection of the
national spirit of unity in diversity.
Methodology
Bi-variate analysis and age-standardized disability methods
are used with the help of Excel 2007 software. Bi-variate is
used for showing the simple contribution of different types of
disabilities, the prevalence of disabilities in SCs, STs, and
non-SCs/STs, and change in disability over the period 2001
to 2011. Elsewhere, age-standardized disability method has
also used for comparing the disability in between the caste
(SCs, STs and non-SCs/STs), place of residence (rural and
urban) and sex (male and females).
Age Standardized Disability Rate
The method of standardization is simple a preferred method
to measure age-adjusted disability rate for determining the
relative difference in disability situation between countries
and also within the same country over time. In the direct
approach, the age distribution is held constant, which refers
to that of the standard population. Thus, the standardized
disability rate is disability rate that will be experienced by the
standard population if it was exposed to the ASDR of the
reference population. Thus, if nPxis the number of persons
between age x to x+n in the standard population and nMxbe
age-specific disability of the study (reference) population,
then Age-standardized disability rate (ASDR) is given by,
Where, npx = Number of person between x to x+n of study
population
And = Total standard population
3. Results
Disability in India
India has highest movement disability (20 %) followed by
seeing and hearing (19 percent). However, only 3 percent of
people are suffering from mental illness (Figure 1). Figure 2
shows that the Uttar Pradesh (UP), Bihar, Maharashtra,
Andhra Pradesh, Madhya Pradesh, Rajasthan, Tamil Nadu,
Kerala, Karnataka, West Bengal, Gujarat, Punjab, Haryana,
Jharkhand, and Chhattisgarh state contributes the disabilities,
while remaining states contributions are negligible. Among
all these states, UP, Maharashtra, and West Bengal have
highest disability contribution and followed by other
contributing states. Three states Maharashtra, Andhra, and
Karnataka, are the states where disability growth is positive
over the year 2001 to 2011 whereas UP, Bihar, Orissa, and
Haryana have no change over the period. The overall, all the
states of Empowered Action Group (EAG) have a disabilities
contribution while in non-EAG states only a few states have
disability contribution.
Figure 1: Distribution of different type of disabilities in
India
Table 1 reveals the prevalence of different types of
disabilities according to the caste in India. Within the
country, the incidence of seeing, hearing and movement
disability is more in scheduled castes (SCs).
Table 1: Prevalence rate (per 1, 00,000 persons) of different
types of disability according to caste, India 2011
Disability
Total
SC
ST
Non-SC/ST
seeing
415.71
468.53
430.37
402.45
Hearing
418.89
427.80
415.81
417.26
speech
165.09
127.33
113.50
179.05
movement
449.09
502.75
483.24
433.53
Mental
Retardation
124.37
125.39
105.69
126.19
Mental Illness
59.71
58.39
56.68
60.33
Any other
407.00
562.58
354.70
378.36
Multiple
disability
174.83
179.25
192.48
171.94
Total Disabled
2214.71
2452.01
2152.46
2169.11
N
26,810,557
4,927,431
2,136,678
19,746,448
Note: N- Number of disabilities, SC –Schedule Castes, ST –
Schedule Tribes
However, in schedule tribes (STs), seeing, movement and
multiple disabilities is more than the non-schedule
caste/schedule tribe (non-SCs/STs). Moreover, speaking, and
mental retardation disabilities is more in non-SCs/STs than
the SCs and STs. The overall prevalence of disability is
highest in SCs (2452/100,000) followed by non-SCs/STs
(2169/100,000) and STs (2153/100,000) households. In
India, movement, seeing and hearing disabilities are more
prevalent (more than four hundred per 100,000 persons) than
the others. But the above discussion is unable to explain that
which group is more vulnerable. Now, for it, this paper tries
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to standardized age for getting standardized disabilities rate
in SCs, STs, and non-SCs/STs.
Figure 2: State-wise disability change in India
Table 2: Disability rate (per 1000) among Schedule castes
(SCs), Schedule Tribes (STs) and non-SCs/STs, India 2011
Status
Population
Disability
Rate per 1000
SCs
20,13,78,086
49,27,431
24.47
STs
10,42,81,034
21,36,678
20.49
non-SCs/STs
90,51,95,857
1,97,46,448
21.81
Total
1,21,08,54,977
2,68,10,557
22.14
Though, first of all, this paper tries to find out the disabilities
rate per thousands in a different caste group (table 2). Which
infers to the individuals who are in SCs are at a greater risk
of disability than those who are in STs and non-SCs/STs. So,
the problem is to examine the validity of the statements. For
this, there is need to adjust age because age is one of the
most important well-known confounders. For freezing, a
study has used a direct method of standardization. For it
firstly, authors have calculated total expected disability in
SCs, STs, and non-SCs/STs by freezing the age, which are in
table 3.
Table 3: Calculation of expected disabilities in SCs, STs and
non-SCs/STs by applying direct method of standardization,
India 2011
All ages
Total
Population
Scheduled Caste (SCs)
Expected
disability
Population
Disability
0-9
240627140
42683458
630856
3556440
10-19.
254178143
44519640
882533
5038687
20-29
213630320
35737596
791522
4731519
30-39
174382237
28056035
668903
4157564
40-49
135257970
21222571
561118
3576178
50-59
88543625
13377170
441557
2922672
60-69
64357324
10116354
495193
3150274
70-79
28547197
4120925
307287
2128696
80+
11331020
1544623
148462
1089081
Total
1210854977
201378372
4927431
30351111
Table 3:Continue…
Scheduled tribes (STs)
Expected
disability
Non-SCs/STs
Expected
disability
Population
Disability
Population
Disability
24363784
285089
2815661
173579898
2347699
3254524
23335380
382818
4169809
186323123
3374545
4603484
17813878
306755
3678717
160078846
3113206
4154673
14083769
257261
3185347
132242433
2728341
3597742
10961944
234594
2894624
103073455
2336034
3065457
6773427
199433
2607031
68393028
1864314
2413596
4711385
241536
3299372
49529586
1934680
2513867
1857943
156871
2410309
22568329
1314352
1662554
644205
72321
1272061
9142191
733277
908839
104545716
2136678
26332932
904930889
19746448
26174737
Then age-adjusted disability rate for
Schedule castes (SCs) [(30351111/1210854977)*1000] =
25.07
Schedule tribes (STs) [(26332932/1210854977)*1000] =
21.75
non-SCs/STs [(26174737/1210854977)*1000] = 21.62
However, after controlling the effect of age, the study gets
adjusted disability rate for the individuals. Now, the
individuals who are SCs have higher disability rate (25.1 per
1000) than the STs (21.8 per 1000) and non-SCs/STs (21.6
per 1000). One of the most important things is that STs is
also having higher disability rate than the non-SCs/STs.
However, Table 4 depicts that males are at a greater risk of
disability as compared to the females in India. But the
concert is that how much statement is valid. For it, there is a
need to calculate standardized disability rate. Therefore, for
calculation of the age-adjusted disability rate for both males
and females, firstly this study tried to estimate expected
disability which is in the table 5 and later on, age-adjusted
disability rate, which are just below the table 5. After
freezing the effect of age, it is clear that, the individual, who
are males (24.2 per 1000), is at a greater risk of disability
than those who are females (20 per 1000) i.e. men are more
disabled than the females.
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Table 4: Disabilities rate (per 1000) among Males and
Females, India 2011
Status
Population
Disability
Rate per 1000
Males
623270258
14,986,202
24.04
Females
587584719
11,824,355
20.12
Total
1210854977
26810557
22.14
Table 5: Calculation of expected disabilities in males and
females by applying direct method of standardization, India
2011
All ages
Total
Population
Males
Expected
disability
Population
Disability
00-09
240627140
125409994
1780999
3417246
10-19.
254178143
133911050
2623506
4979707
20-29
213630320
109345194
2431329
4750146
30-39
174382237
87914759
2123582
4212206
40-49
135257970
69949809
1861097
3598698
50-59
88543625
45472398
1438070
2800202
60-69
64357324
31767017
1401428
2839175
70-79
28547197
14196149
889391.6
1788488
80+
11331020
5303888
436799
933160
Total
1210854977
623270258
14986202
29319028
Table 5: Continue…
Females
Expected disability
Population
Disability
115217464
1482650
3096457
120267725
2016387
4261504
104284999
1780144
3646668
86467099
1530911
3087460
65308228
1270634
2631574
43071206
1067230
2193958
32590029
1269993
2507925
14350946
889133
1768681
6027024
517273
972492.3
587584719
11824355
24166718
Hence, the age standardized disability rate for males and
females is
Males [(29319028/1210854977)*1000] = 24.21
Females [(24166718/1210854977)*1000] = 19.96
Table 6 shows the disability rate, which is higher in rural
(22.4 per 1000) than the urban settings (21.7 per 1000). But
how much is it valid. For it, this paper have calculated the
standardize disability rate. For it firstly, expected disability
rate have been calculated for both rural and urban settings
that are in Table 7. Moreover, just below the table 7, the age-
standardized disability rate has been computed for the
individuals who are living either in rural and urban settings.
It concludes that those who are living in rural settings are at
higher risk of disability (22.4 per 1000) than those who are in
urban contexts.
Table 6: Disabilities rate (per 1000) among Rural and
Urban, India 2011
Status
Population
Disability
Rate per 1000
Rural
833748852
18,631,921
22.35
Urban
377106125
8,178,636
21.69
Total
1210854977
26,810,557
22.14
Table 7: Calculation of expected disabilities in rural and
urban settings by applying direct method of standardization,
India 2011
All age
Total
Population
Rural
Expected
disability
Population
Disability
0-9
240627139
177414228
2337005
3169683
10-19.
254178143
181340643
3279516
4596770
20-29
213630319
140393908
2748780
4182680
30-39
174382237
114374155
2388827
3642161
40-49
135257970
88578766
2066100
3154893
50-59
88543625
58096314
1693979
2581765
60-69
64357324
45366042
1999327
2836292
70-79
28547197
20262121
1380167
1944510
80+
11331019
7922675
738219
1055802
Total
1210854977
833748852
18631921
27164556
Table 7: Continue…
Urban
Expected disability
Population
Disability
63204836
926525
3527375
72833147
1360289
4747232
73241028
1462997
4267289
60012007
1265926
3678514
46682341
1065828
3088144
30449289
811404
2359484
18990558
671845
2276824
8284659
398105
1371787
3408262
215716
717163
377106125
8178636
26033811
Hence age adjusted disability rate for individuals who are
living in
Rural [(27164556/1210854977)*1000] =
22.43
Urban [(26033811/1210854977)*1000] =
21.50
Though, from above discussion it has been cleared that
SCs/STs, males, and rural people are more disabled
(vulnerable) than the non-SCs/STs, females and urban people
respectively. Moreover, the above discussion does not sure
that within the cohort which age group is more disabled. For
that figure 3, 4 and 5 tried to shows the disability gap within
the cohort accordance with caste, gender and place of
residence in India. From the figure 3, it is cleared that
disability between SCs/STs and non-SCs/STs are
approximately same till the age 40-49 and after that disability
gap is continuously increasing. It is also cleared that after the
age group of 30-39 disabilities rate increases in both SCs/STs
and non-SCs/STs.
Figure 3: Disability gap between SCs/STs and non-SCs/STs
over the ages in India, 2011
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However, the disability gap between males and females are
continuously steadily increasing from the 0-9 age group to till
the age group of 50-59 and after this, it has decreased. But
disability in both males and females is highly increased up to
the age group 70-79. Though the disability gap between rural
and urban settings are nearly 30 percent at the age group of
80+, while in the age group 70-79, it is almost 20 percent.
Moreover, disability is constant from the age group 10-19 to
30-39 and after the age group 40-49, it is highly increases up
to the age 80+ in both rural and urban settings.
Figure 4: Disability gap between males and females over the
ages in India, 2011
4. Discussion
Increasing the risk of disabilities shows the increasing the
health issues for the nation. In India, some of the states like
Maharashtra, Andhra Pradesh, Karnataka, Punjab,
Chhattisgarh, and Jharkhand, which increase the disability
over the years 2001 to 2011. The reason behind the
enhancing the disability is poverty in the particular states.
Since, India is still the home of villages. Currently, about 70
percent population is living in the rural areas [5]. Unsafe
working environments, poor living conditions, poor nutrition,
basic sanitation and nutritious food, lack of access to clean
water, health care, and education, all disproportionately
impact the poor and can outcome in disability. An individual
who is born with a disability or who becomes disabled are
often faces social marginalization. They have a significantly
less chance of accessing health care, education, or
employment leading to poverty, which in turn results in
limited access to safe housing and food, health care and so
forth [6-7].
However, the movement, seeing, and hearing disability
problem is more in the country. According to WHO estimates
50 percent hearing disability are preventable. Moreover, the
disability is highest in scheduled caste followed by scheduled
tribes. Why is it high in a vulnerable section (SCs and STs).
It may be because of discrimination and stigma. Since, the
SCs and STs, or Adivasis are economically and socially
deprive group in India. They comprise around 24% of India’s
population. OBCs and upper castes together consist of 76%
of India’s total population [8]. The deprivation of SCs and
STs Groups are associated with the historical processes of
economic and social exclusion, and discrimination based on
caste starts from Zamindari Pratha [9]. Still in many parts of
the country, these groups are suffering from economic
discrimination and society violence problems. It informs of
marginal farmers or landless labours by landlords by paying
minimum wages in cash or food or nothing. Which frequently
met by violence, sometimes resulting in deaths or injury of
the victim and sexual harassment also exist against the
SCs/STs women [10-11].
Figure 5: Disability gap between rural and urban over the
ages in India, 2011
Though, the disability among male is high during the period
2001 to 2011. It is fast paced in both males and females
almost after the age of 50 years. The gap and speed of
enhancement of disability in between SCs/STs and non-
SCs/STs is highly increases after the age 40-49. Mostly it
does exist in rural settings. It shows that there is still casteism
in the society. Which is somewhere on the paper has been
reduced and somewhere it is not but it exist in the real
situation. It is not only in the health system but also
everywhere either that may be government sector or private
sector. The gap between the caste groups will exist till the
existence of caste system in the Indian society.
5. Conclusion
The study demonstrates that movement, seeing and hearing
disabilities are more prevalent than the others. It is high in
states of Uttar Pradesh while lowest in the states of seven
sisters as well as the territory of India. Punjab, Jharkhand,
Chhattisgarh, Maharashtra, Andhra Pradesh and Karnataka
are the states where disability has increased over the period
2001 to 2011. But in EAG states, almost all the states (except
Jharkhand and Chhattisgarh) have no change over the period.
Disabilities rate are highest in the scheduled caste and males
whereas there are slightly high in the rural areas of India.
Disability gap is increased after the age group 40-49 in both
SCs/STs and rural setting. While it is slightly high in males
over the age 0-9 to 70-79 but overall disability in both males
and females are highly increased after the age group of 50-
59. It concludes that there is a need to be a separate policy
for the 50 plus person that might be mostly focused to
vulnerable rural section (rural-SCs/STs) irrespective for the
getting better medical facility.
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[10]India’s Prostitute Village (n.d.), Retrieved August 12,
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v=ma1Edum 46xE&feature=em-subs_digest-vrecs
[Accessed: August. 12, 2015]
[11]Lower Caste Hindu Dalits rolling over eaten food plates
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Author Profile
Jang Bahadur Prasad received the B.Sc (Mathematics and
Statistics). M.Sc. (in Health Statistics), Master in Population
Science (MPS) and M.Phil (in Population Science) degree
from Veer Bahadur Singh Purvanchal University, Jaunpur,
Banaras Hindu University (BHU), Varanasi and International
Institute for Population Sciences (IIPS), Mumbai in 2010,
2012, 2013 and 2014 respectively. Currently, he pursues
Ph.D from IIPS, Mumbai, India.
Kamalesh Kumar Patel MPS, M.Phil. and PhD from
International Institute for Population Sciences, Mumbai,
India.
Paper ID: SUB157573
1309