DIVERSITY & INCLUSION
Intersection of Disability and Race or Gender (Then and Now): A Disproportionate Effect By Anika Backster, MD; Wendy Coates, MD; Jeff Siegelman, MD; and Jason Rotoli, MD, on behalf of the Accommodations Committee Subgroup of the SAEM Academy for Diversity & Inclusion in Emergency Medicine
SAEM PULSE | JULY-AUGUST 2022
Introduction
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People with disabilities represent the largest minority group in the United States (U.S). Native Americans and African Americans stand out as the U.S. groups with the highest prevalence of disability. Both racial minorities and people with disabilities experience marginalization — but what happens when you identify with both groups? In 1989, Kimberle Crenshaw introduced the concept of intersectionality as the complex interaction between social forces, social identities, and ideological instruments through which power and disadvantage are expressed and legitimized. She discussed how singleaxis analyses (i.e. viewing only one’s race or gender or ability but not any combination of them) of a person often fails to capture the complexity of one’s lived experience. Are there compounded socioeconomic, educational, or health effects
of being a member of more than one minority group? There may be challenges to finding such information because the traditional medical perspective of disability pervades our culture and scholarly research, often dismissing disability as a natural consequence of biological deficiency or aging and conflating disability with poor health.
Historical Perspective
Use of disability to justify slavery was common in U.S. history. Both sides in the U.S. civil war promoted the idea of slaves having intellectual disability. The antislave movement expressed the horrors of intellectually impaired slaves being mistreated, and the pro-slavery side expressed the need for continued slavery to “protect the weak.”(Forret). Such is our history, that the entanglement or intersection of race and disability should not be overlooked, much less ignored. Marginalization from society and the sustaining of cultural normalcy was
often accomplished using oppressive discourses. These took place between the majority and minority groups and often between different minority groups to pit the oppressed groups against each other. Thus, groups felt the need to stress being “abled” and a woman, or “abled” and black as a reason for their equality. For example, ableism was sometimes used to advocate for a marginalized group’s rights. If a marginalized group was “able” then they could and should be equal. The 1848 Declarations of Sentiments and Resolutions (the Seneca Falls Women's Rights Convention) states: "the equality of human rights results necessarily from the fact of the identity of the race in capabilities and responsibilities.” Here we see, ableism prevails, and disability is seen as being less than. Another example is seen in the case of Sojorner Truth (a women’s rights activist and abolitionist). If you look, her
