1.1. THE CONCEPT OF DISABILITY AND ITS TYPES.

The UN Declaration on the Rights of Persons with Disabilities, adopted in December 1971 and ratified by most countries of the world, gives the following definition of the concept of “disabled person”: this is any person who cannot independently provide fully or partially his needs for a normal social and personal life due to a disability physical or mental capabilities. This definition can be considered as a basic one, which is the basis for developing those ideas about people with disabilities and disability that are inherent in specific states and societies.

In modern Russian legislation, the following definition of the concept “disabled person” has been adopted - this is a person who, due to limited life activity, due to physical and mental disabilities, needs social assistance and protection. Thus, according to the legislation of the Russian Federation, the basis for providing a disabled person with a certain amount of social assistance is the restriction of his life activity system, i.e., the complete or partial loss of a person’s ability to self-service, move, orientate, control his behavior and engage in work.

The concept of disability is defined differently by a number of authors, as defined by L.P. Khrapylina. “disability is a disharmony of a person’s relationship with the environment, manifested as a result of health problems in a persistent limitation of his life activity.”

According to the definition of Russian sociologist E.R. Yarskaya-Smirnova: “disability is the result of social agreements, and the meaning of this concept changes depending on cultural traditions, social conditions and other status differences.”

The international movement for the rights of persons with disabilities considers the following concept of disability to be the most correct: “Disability is an obstacle or limitation in the activities of a person with physical, mental, sensory and mental disabilities caused by conditions existing in society under which people are excluded from active life.”

People with disabilities have functional difficulties as a result of illness, deviations or deficiencies in development, health, appearance, due to the inability of the external environment to their special needs, as well as because of society’s prejudices towards themselves. To reduce the impact of such restrictions, a system of state guarantees for social protection of people with disabilities has been developed.

Social protection of disabled people is a system of state-guaranteed economic, social and legal measures that provide disabled people with conditions for overcoming, replacing (compensating) disabilities and aimed at creating opportunities for them to participate in the life of society equal to other citizens.

The term “disabled person” goes back to the Latin root (volid – “effective, full-fledged, powerful”) and literally translated can mean “unfit”, “inferior”. In Russian usage, starting from the time of Peter I, this name was given to military personnel who, due to illness, injury or injury, were unable to perform military service and who were sent for further service to civilian positions.

It is characteristic that in Western Europe this word had the same connotation, that is, it referred primarily to crippled soldiers. From the second half of the nineteenth century. the term also applies to civilians who also became victims of war - the development of weapons and the expansion of the scale of wars increasingly exposed the civilian population to all the dangers of military conflicts. Finally, after the Second World War, in line with the general movement to formulate and protect human rights in general and certain categories of the population in particular, the concept of “disabled person” was formed, referring to all persons with physical, mental or intellectual disabilities.

Today, people with disabilities belong to the most socially vulnerable category of the population. Their income is well below average and their health and social care needs are much higher. They have less opportunity to receive an education and are often unable to work. Most of them have no family and do not want to participate in public life. All this suggests that people with disabilities in our society are a discriminated and segregated minority.

An analysis of the history of the development of the problem of disability indicates that, having gone from the ideas of physical destruction, isolation of “inferior” members of society to the concepts of attracting them to work, humanity has come to understand the need for the reintegration of persons with physical defects, pathophysiological syndromes, and psychosocial disorders.

In this regard, there is a need to reject the classical approach to the problem of disability as a problem of “inferior people” and present it as a problem affecting society as a whole.

In other words, disability is not a problem of one person, or even a part of society, but of the whole society as a whole. Its essence lies in the legal, economic, production, communication, and psychological characteristics of the interaction of disabled people with the outside world.

This genesis of social thought is explained by the corresponding development of economic opportunities and the level of social maturity of various historical eras.

“A disabled person,” says the Law “On Social Protection of Disabled Persons in the Russian Federation,” is a person who has a health disorder with a persistent disorder of body functions, caused by illness, consequences of injuries or defects, leading to limited life activity and necessitating his social protection.”

“Limitation of life activity,” the same law explains, “is a complete or partial loss of a person’s ability or ability to provide self-care, move independently, navigate, communicate, control one’s behavior, study and engage in work.”

Currently, there is a debate taking place at the international level, initiated by organizations of disabled people who advocate an interpretation of disability that would not be discriminatory. The Dictionary of Social Work defines a person with a disability as one "who is unable to perform specified duties or functions because of a special physical or mental condition or infirmity. Such a condition may be temporary or chronic, general or partial."

Blind, deaf, dumb, people with impaired coordination of movement, completely or partially paralyzed, etc. are recognized as disabled due to obvious deviations from the normal physical condition of a person. Persons who have no external differences from ordinary people, but suffer from diseases that do not allow them to work in various fields as healthy people do, are also recognized as disabled. For example, a person suffering from coronary heart disease is not able to perform heavy physical work, but he is quite capable of mental activity.

All disabled people are divided into several groups for various reasons:

1. By age - disabled children, disabled adults.

2. By origin of disability: disabled since childhood, war disabled, labor disabled, disabled from general illness.

3. By degree of ability to work: disabled people able to work and incapacitated, disabled people of group I (incapacitated), disabled people of group II (temporarily disabled or able to work in limited areas), disabled people of group II (able to work in benign working conditions).

4. Based on the nature of the disease, people with disabilities can belong to the mobile, low-mobility or immobile groups.

Depending on membership in a particular group, issues of employment and organization of life for disabled people are resolved. Low mobility disabled people (able to move only with the help of wheelchairs or crutches) can work from home or have them transported to their place of work. The situation is even more complicated with immobile disabled people who are bedridden. They cannot move without assistance, but are able to work mentally: analyze socio-political, economic, environmental and other situations; write articles, works of art, create paintings, engage in accounting activities, etc.

If such a disabled person lives in a family, many problems can be solved relatively simply. What if he's lonely? Special workers will be required who would find such disabled people, identify their abilities, help receive orders, conclude contracts, purchase the necessary materials and tools, organize the sale of products, etc. It is clear that such a disabled person also needs everyday care, starting with the morning toilet and ending with the provision of products. In all these cases, disabled people are helped by special social workers who receive wages for caring for them. Blind but mobile disabled people are also assigned workers paid by the state or charitable organizations.

The population of the planet must realize the presence of people with disabilities and the need to create normal living conditions for them. According to the UN, one in ten people on the planet has a disability, one in 10 suffers from physical, mental or sensory impairments, and at least 25% of the total population suffers from health disorders. According to the Social Information Agency, there are at least 15 million of them. Among the current disabled people there are many young people and children.

In the general contingent of disabled people, men make up more than 50%, women - more than 44%, 65-80% are elderly people. Along with the growth in the number of disabled people, there are trends in qualitative changes in their composition. Society is concerned about the increase in the number of disabled people among people of working age; they make up 45% of the number of citizens initially recognized as people with disabilities. Over the past decade, the number of disabled children has increased at an accelerated pace: if in the RSFSR in 1990. While 155,100 such children were registered with the social protection authorities, in the Russian Federation in 1995. this figure increased to 453,700, and in 1999 to 592,300 children. It is also alarming that, according to the Ministry of Health of the Russian Federation, every year in our country 50,000 children are born who are recognized as disabled from childhood.

In recent years, the number of people with disabilities due to war trauma has also been growing. Now their number is almost 42,200 people. Persons of retirement age account for 80% of the total number of disabled people; disabled people of the Great Patriotic War - more than 15%, group I - 12.7%, group II - 58%, group III - 29.3%.

The structure of the distribution of disability due to general disease in Russia is as follows: in the first place are diseases of the cardiovascular system (22.6%), followed by malignant neoplasms (20.5%), then injuries (12.6%), diseases of the respiratory system and tuberculosis (8.06%), in fifth place are mental disorders (2.7%). The prevalence of disability is generally higher among urban populations compared to rural residents.

The dynamics of disability growth in Russia is characterized by the following indicators:

 the age structure is dominated by disabled people of retirement age;

 according to nosology - most often disability is associated with diseases of the circulatory system;

 in terms of severity - disabled people of group II predominate.

The availability of statistical data on the number of disabled people in the country, forecasting and identifying the dynamics of growth in the number of disabled people, the causes of disability, developing a system of measures to prevent it, and determining the possible costs of the state for these purposes is important. The forecasts for the growth dynamics of the number of disabled people in the world, especially those of active working age, are alarming.

The growth of people with disabilities on an international scale is explained both by the growth of the indicator itself, indicating the deterioration of the health of the planet’s inhabitants, and by the expansion of the criteria for defining disability, primarily in relation to the elderly and especially children. The increase in the total number of disabled people in all developed countries of the world and, especially, the number of disabled children has made the problem of preventing disability and preventing childhood disability among the national priorities of these countries.

1.2. CURRENT PROBLEMS OF INTERACTION OF DISABLED PEOPLE AND SOCIETY.

The problem of socio-psychological adaptation of disabled people to living conditions in society is one of the most important facets of the general integration problem. Recently, this issue has acquired additional importance and urgency due to major changes in approaches to people who are disabled. Despite this, the process of adaptation of this category of citizens to the basics of society remains practically unstudied, and it is this process that decisively determines the effectiveness of those corrective measures taken by specialists working with people with disabilities.

The time has come to present disability not as a problem of a certain circle of “inferior people”, but as a problem of the entire society as a whole. Its essence is determined by the legal, economic, production, communication, and psychological characteristics of the interaction of disabled people with the surrounding reality. The most serious aspects of the disability problem are associated with the emergence of numerous social barriers that do not allow disabled people and people with chronic diseases, as well as children with social behavior disorders, to actively participate in the life of society. This situation is a consequence of incorrect social policy, which is focused only on part of the “healthy” population and expresses the interests of this category of citizens. That is why the structure of production and life, culture and leisure, social services remains unadapted to the needs of sick people.

The needs of disabled people can be divided into two groups: – general, i.e. similar to the needs of other citizens and special, i.e. needs caused by a particular illness.

The most typical of the “special” needs of people with disabilities are the following:

 in restoration (compensation) of impaired abilities for various types of activities;

 in movement;

 in communication;

 free access to social, cultural and other objects;

 the opportunity to gain knowledge;

 in employment;

 in comfortable living conditions;

 in socio-psychological adaptation;

 in material support.

Satisfying the listed needs is an indispensable condition for the success of all integration activities regarding people with disabilities. In socio-psychological terms, disability poses many problems for a person, so it is necessary to especially highlight the socio-psychological aspects of persons with disabilities.

The relationship between disabled people and healthy people is a powerful factor in the adaptation process. As foreign and domestic experience shows, disabled people often, even having all the potential opportunities to actively participate in the life of society, cannot realize them because other fellow citizens do not want to communicate with them; entrepreneurs are afraid to hire a disabled person, often simply due to established negative stereotypes. Therefore, organizational measures for social adaptation that are not prepared psychologically may be ineffective. The few studies devoted to this issue have revealed the following: representatives of various segments of the population generally admit (97%) that there are weak and vulnerable groups that need help from society, and only 3% of respondents said that preference should not be given to anyone when providing social assistance . On the issue of the priority of assistance to certain groups of people, opinions were distributed as follows: more than 50% of citizens believe that disabled children are most in need of it, followed by elderly people living in nursing homes (47.3% of respondents), orphans (46 .4%), disabled adults (26.3%), Chernobyl survivors (20.9%), single mothers (18.2%), large families (15.5%), refugees, alcoholics, homeless people, drug addicts (according to 10%), WWII veterans (6.4%).

The idea of ​​social integration of disabled people into society is verbally supported by the majority, but in-depth studies have revealed the complexity and ambiguity of the attitude of the healthy towards the sick. This attitude can be called ambivalent: on the one hand, people with disabilities are perceived as different for the worse, on the other, as deprived of many opportunities. This gives rise to both rejection of unhealthy fellow citizens by other members of society and sympathy towards them, but in general there is an unpreparedness of many healthy people for close contact with disabled people and for situations that allow disabled people to realize their capabilities on an equal basis with everyone else. The relationship between disabled people and healthy people implies responsibility for these relationships on both sides. Therefore, it should be noted that disabled people in these relationships do not occupy an entirely acceptable position. Many of them lack social skills, the ability to express themselves in communication with colleagues, acquaintances, administration, and employers. Disabled people are not always able to grasp the nuances of human relationships; they perceive other people somewhat generally, evaluating them on the basis of only some moral qualities: kindness, responsiveness, etc.

Relationships between disabled people are also not entirely harmonious. Belonging to a group of people with disabilities does not mean that other members of this group will be treated accordingly.

The experience of public organizations of disabled people shows that disabled people prefer to unite with people who have identical diseases and have a negative attitude towards others. One of the main indicators of socio-psychological adaptation of persons with disabilities is their attitude towards their own lives. Almost half of disabled people (according to the results of special sociological studies) assess the quality of their life as unsatisfactory (mostly these are disabled people of group 1). About a third of disabled people (mainly groups 2 and 3) characterize their life as quite acceptable. Moreover, the concept of “satisfaction-dissatisfaction with life” often comes down to the poor or stable financial situation of a disabled person. The lower the income of a disabled person, the more pessimistic his views on one’s existence. One of the factors in one’s attitude towards life is the self-assessment of the disabled person’s state of health. According to research results, among those who define the quality of their existence as low, only 3.8% rated their well-being as good.

An important element of the psychological well-being and social adaptation of persons with disabilities is their self-perception. Surveys have shown that only every tenth disabled person considers himself happy. A third of disabled people considered themselves passive. Every third person admitted to being unsociable. A quarter of disabled people consider themselves sad. Data on the psychological characteristics of people with disabilities vary significantly in groups with different incomes. The number of “happy”, “kind”, “active”, “sociable” people was greater among those whose budget was stable, while the number of “unhappy”, “angry”, “passive”, “uncommunicative” people was greater among those constantly in need. Psychological self-assessments are similar in groups of disabled people of different severity. Self-esteem is most favorable among disabled people of group 1. Among them there are more “kind”, “sociable”, “cheerful”. The situation is worse among disabled people of group 2. It is noteworthy that among disabled people of group 3 there are fewer “unhappy” and “sad”, but significantly more “angry”, which characterizes disadvantage in socio-psychological terms.

This is confirmed by a number of deeper individual psychological experiments that reveal psychological disadaptation, a sense of inferiority, and great difficulties in interpersonal contacts among disabled people of group 3. There was also a difference in self-esteem between men and women: 7.4% of men and 14.3% of women consider themselves “lucky”, 38.4% and 62.8%, respectively, “kind”, 18.8% – “cheerful” and 21.2%, which indicates the high adaptive capabilities of women.

A difference has been noticed in the self-esteem of employed and unemployed disabled people: for the latter it is significantly lower. This is partly due to the financial situation of workers and their greater social adaptation compared to non-workers. The latter are withdrawn from this sphere of social relations, which is one of the reasons for extremely unfavorable personal self-esteem. Lonely disabled people are the least adapted. Despite the fact that their financial situation does not differ fundamentally for the worse, they represent a risk group in terms of social adaptation. Thus, they are more likely than others to negatively assess their financial situation (31.4% and on average for disabled people 26.4%). They consider themselves more “unhappy” (62.5%, and on average among disabled people 44.1%), “passive” (57.2% and 28.5%, respectively), “sad” (40.9% and 29 %), among these people there are few people who are satisfied with life. Traits of socio-psychological maladaptation of single disabled people exist, despite the fact that they have a certain priority in social protection measures. But, apparently, psychological and pedagogical assistance is needed for these people first. people. The deterioration of the moral and psychological state of people with disabilities is also explained by the difficult economic and political conditions in the country. Like all people, people with disabilities experience fear of the future, anxiety and uncertainty about the future, a feeling of tension and discomfort. for today's political, economic and socio-psychological conditions, along with material disadvantage, this leads to the fact that the slightest difficulties cause panic and severe stress among disabled people.

So, we can state that currently the process of social adaptation of disabled people is difficult because:

 life satisfaction among disabled people is low;

 self-esteem also has negative dynamics;

 significant problems face disabled people in the area of ​​relationships with others;

 the emotional state of disabled people is characterized by anxiety and uncertainty about the future, pessimism.

The most unfavorable group in the socio-psychological sense is the one where there is a combination of various unfavorable indicators (low self-esteem, wariness of others, dissatisfaction with life, etc.). This group includes people with poor financial situation and living conditions, single disabled people, disabled people of group 3, especially the unemployed, disabled people since childhood (in particular, patients with cerebral palsy).

In people with cerebral palsy, along with impaired motor functions, deviations in the emotional-volitional sphere, behavior, and intellect are observed. Emotional-volitional disorders are revealed in increased excitability, excessive sensitivity, anxiety (or lethargy), fussiness (or passivity), excessive disinhibition (or lack of initiative). Patients with cerebral palsy have been disabled since childhood, which means that they have not had the opportunity for full social development, since their contacts with the outside world are extremely limited.

Typically, a child with infantile paralysis does not have the opportunity to go through all the cycles of socialization, and his maturation is delayed. All this happens because adults do not provide proper socio-psychological adaptation to such a child. As a result, for the rest of his life he remains infantile, dependent on others, passive, feeling comfortable only with close people. The social consequences of this situation are manifested in the fact that these disabled people become a special socio-demographic group, separated from society. Research has found that people suffering from cerebral palsy most feel a sense of self-doubt and realize that they are useless to society. Their income level is lower than that of people with other diseases, and their educational opportunities are lower. A small number of these people are employed; among patients with infantile paralysis, there are significantly fewer people who have their own families; the majority have no desire to engage in any useful activity. As the so far limited domestic experience shows, disabled people with cerebral palsy, even having the desire and opportunity to participate in the life of society, cannot realize them due to the negative attitude of others towards them, while young people are the most negatively inclined (for this category of young disabled people with a visible defect, contact with healthy peers is especially difficult). It is impossible not to say how young disabled people suffering from infantile paralysis themselves relate to the possibility of personal active participation in public life. To the question of the questionnaire, “In your opinion, should disabled people live, study and work among healthy people, or should they live separately, in special institutions?” All respondents answered, which indicates its relevance. Among those who oppose integration (43%) are those young people who often met with the disdain of others. Their opinion is: “Healthy people still won’t understand people with disabilities.” As a result of our research, it also turned out that disabled people living in rural areas are more often supporters of integration than young people living in large cities in the region. An interesting fact is that older disabled people (25-30 years old) have a positive attitude towards active and personal participation in life around them. Among young people aged 14-24 there are significantly fewer such people. The greater the degree of damage in patients with cerebral palsy, the less socially active they are. We also noticed that young disabled people, whose families have a low material level and poor living conditions, also turned out to be among the opponents of the idea of ​​integration. This is probably due to the fact that people who have already failed in some way do not hope that life will be better under other conditions. Often, young people with cerebral palsy do not always have stable relationships with loved ones. Many prefer to communicate with peers by sitting “within four walls” under parental care. Approximately 30% of the surveyed young disabled people with cerebral palsy generally refuse contact with anyone (mainly girls aged 18-28 years with severe form of infantile paralysis). During the observation process, it was noticed that in the families of these young people, psychological problems of this kind arise: most parents have various negative feelings, they begin to feel awkward and ashamed in front of others for their disabled child and therefore narrow their social circle. contacts. It is important to dwell on the reason for the occurrence of such situations in more detail. When a child with disabilities appears in a family, it experiences, as it were, two crises: the birth of a child itself is a crisis in the life cycle of the family, since it sometimes leads to a rethinking of social roles and functions. At the same time, conflicting moments arise. When a child has signs of disability, then this crisis occurs with double severity. This extremely dramatically changes the socio-economic status of the family and disrupts social ties. Moral and psychological problems are becoming extremely acute. The vast majority of parents have a feeling of guilt, which is accompanied by a feeling of their own inferiority. Family life begins to take place in a psychotraumatic situation, when parents not only hide their sick child from others, but also try to isolate themselves from the world. Often these families break up, and the child, as a rule, remains with the mother. The family, which is one of the main guarantors of a child’s social adaptation, does not always retain the ability to perform this function. Relatives often lose self-confidence, are unable to properly organize communication and upbringing of the child, do not notice his real needs, and cannot correctly assess his capabilities. Therefore, it is quite reasonable that many young disabled people with cerebral palsy complain about parental overprotection, which suppresses any independence. This sharply reduces the ability of such disabled people to adapt. The majority of the young disabled people we surveyed - “oporniks” (56.7%) need to eliminate conflict situations in the family.

However, the current socio-economic situation is gradually forcing some young disabled people to change their lives. At the moment, their number is still small, but we can expect a further increase in the number of such people, and therefore, there is a need to think in advance about ways to realize their potential for social integration and the desire to independently improve their lives.

Our own observations and analysis of the socio-psychological characteristics of young people with cerebral palsy allowed us to identify four main types of adaptation of these disabled people to society:

The active-positive type is characterized by the desire to find an independent way out of negative life situations. Young disabled people belonging to this type have a favorable internal mood, fairly high self-esteem, optimism that infects others, energy and independence of judgment and action.

The passive-positive type is characterized by low self-esteem among young disabled people. With a passive-positive type of adaptation, the current situation in which the disabled person finds himself (for example, constant care of loved ones) suits him, so there is a lack of desire for change.

Passive-negative type. Young people are dissatisfied with their situation and at the same time lack the desire to improve it on their own. All this is accompanied by low self-esteem, psychological discomfort, a wary attitude towards others, and the expectation of global catastrophic consequences even from minor everyday troubles.

Active negative type. The psychological discomfort and dissatisfaction with one’s own life present here do not deny the desire to change the situation for the better, but this does not have real practical consequences due to the influence of various objective and subjective factors..

Unfortunately, among young people with the consequences of infantile paralysis, people with an active and positive life position are extremely rare. There are only a few of them, but they are the most socially active (including in terms of creating public organizations for people with disabilities). Most young disabled people with cerebral palsy either do not feel the desire to somehow change their lives, or consider themselves incapable of taking such an important step. As a rule, they are at the mercy of certain circumstances. Therefore, these individuals are especially in need of a clearly planned and scientifically based system of socio-pedagogical and psychological measures aimed at developing their independence of judgment and action, work skills and culture of behavior, a worthy spiritual and moral character, and the ability to live in society.

People with disabilities are not a homogeneous group; each person is an individual, different from everyone else. Features of communication and the degree of freedom of movement play an important role, because this group is differentiated by gender and age, social status and type of disability, education, and geography of residence.

As experience shows, disabled people living in cities and regional centers have more opportunities for integration into society, while disabled people from villages and small villages sometimes do not use the services intended for them at all and, apart from pensions, do not know anything. However, in large populated areas and metropolitan areas, people with disabilities are more likely to experience harassment and resentment in their everyday interactions with society.

The process of social rehabilitation is two-way and reciprocal. Society must meet people with disabilities halfway, adapting their living environment and motivating them to integrate into society. On the other hand, which is very important, people with disabilities should themselves strive to become equal members of society.

Integral factors of any normally functioning social system are social protection and socio-economic support of the population.

Social assistance in maintaining the physical life of people and satisfying their social needs existed already in the initial period of human development and was carried out on the basis of customs, norms, traditions, and rituals.

With the development of civilization, technological progress and culture, the disintegration of family, kinship and community ties, the state increasingly actively assumed the function of a guarantor of human social security. The formation and development of a market economy led to the separation of social protection of the population into an independent type of activity, which acquired a new meaning.

The social protection system, as practice shows, is involved in the market system and is its integral element. Through it the principle of social justice is realized. Social support for those who objectively do not have the opportunity to provide themselves with a decent standard of living is, in essence, a necessary payment for the opportunity to do business and generate income in a stable society.

Objective reality, conditioned by the logic of the development of market relations, brings to the fore the formation of a scientifically based system of social protection and social support of the population and its most vulnerable layers. The need to create this system is due to a number of factors. One of the fundamental factors operating within society and determining the content of social support for the population is “a certain system of relations of property and law.” It is private property that, according to Hegel, determines the independence of civil society from the state, makes a person a full-fledged subject and guarantees the necessary conditions for his social life.

With the change in forms of ownership, the dismantling of the system of distribution of material goods and services begins. New relationships are formed between members of society, into which they enter in the process of appropriation. Relations of appropriation in the narrow sense should be understood as the relations of people to the conditions of production and material goods.

The emergence of new forms of ownership of the means of production leads to the problem of their alienation. This problem is directly related to the category of satisfying human needs (material, social, economic, spiritual, cultural, etc.), to expressing the interests of the individual. Here we are talking primarily about wages, the level of which must be sufficient to ensure the reproduction of the labor force.

In market conditions, a person can ensure the satisfaction of his needs only by receiving income from property or in the form of wages for his labor.

However, in every society there is a certain part of the population that does not have property and is not able to work due to objective reasons: illness, disability due to old age or age that does not allow a person to enter the sphere of production relations (children), consequences of environmental, economic, national, political and military conflicts, natural disasters, obvious demographic changes, etc. These categories of the population will not survive without the protection and social assistance of the state, when capital is increasingly becoming the main factor of production and distribution.

“The state is objectively interested in supporting socially vulnerable segments of the population for several reasons:

• 1) a state that has declared itself civilized is guided by the idea of ​​humanism and is obliged, according to the Universal Declaration of Human Rights, to “provide the population with a decent standard of living”;
• 2) every state is interested in the expanded reproduction of qualified labor;
• 3) socio-economic support for the poor levels the economic condition of various groups and segments of the population, thereby reducing social tension in society” Karelova G.N., Katulsky E.D., Gorkin A.P. and others. Social encyclopedia. - M: Bolii. Ross. Enz-ya, 2000. - P. 148..

That is why market relations inevitably give rise to their opposite - a specialized institution for social protection of the population. The social protection system primarily involves the protection of constitutional human rights.

The development of a civilized market can only be carried out normally together with the expansion and deepening of social protection.

“In a broad sense, social protection is the policy of the state to ensure constitutional rights and minimum guarantees to a person, regardless of his place of residence, nationality, gender, age, otherwise all constitutional rights and freedoms of the individual need social protection - from the right to property and freedom of enterprise to personal integrity and environmental safety" Dictionary-reference book on social work / Ed. E.I. Single. - M.: Lawyer, 2004. - P. 212..

A narrower concept of social protection is that “this is the appropriate state policy to ensure rights and guarantees in the field of living standards, satisfaction of human needs: the right to minimally sufficient means of subsistence, to work and rest, protection from unemployment, protection of health and housing, for social security in old age, illness and in case of loss of a breadwinner, for raising children, etc.” Dictionary-reference book for social work / Ed. E.I. Single. - M.: Lawyer, 2004. - P. 145.

The main goal of social protection is to provide the necessary assistance to a specific person in a difficult life situation.

Life requires new economic approaches in order to strengthen the social security of citizens. It is necessary to create legal and economic conditions for:

• - ensuring a decent standard of living through your work;
• - use of new incentives for work and economic activity: entrepreneurship, self-employment, ownership of property, land, etc.;
• - creation of civilized mechanisms for income distribution (joint stock and other forms of population participation in the distribution of profits, social partnership, non-state social insurance, etc.);
• - formation of an economic system of self-defense and equalization of starting opportunities for this on the basis of civil legislation.

The state participates in the mechanism of free enterprise through its economic policies. The economic policy of the state is part of its general policy, a set of principles, decisions and actions aimed at ensuring the optimal functioning of the market mechanism with the greatest economic efficiency.

At the same time, the state is called upon to influence the competitive market system using economic methods. At the same time, economic regulators themselves should be used very carefully, without replacing or weakening market incentives.

The social orientation of the economy is expressed, first of all, in the subordination of production to the consumer, satisfying the social needs of the population and stimulating these needs. At the same time, it presupposes the necessary redistribution of income between the more affluent and less affluent segments of the population, the accumulation in budgets of different levels and various funds of funds for the provision of social services to the population and the provision of social guarantees.

The influence of economic factors on social well-being and meeting the needs of members of society in the context of the transition to market relations is increasing enormously. The degree of satisfaction of the needs of a person and various segments of society, as is known, is the main criterion for the economic efficiency of social work.

Social needs are influenced by the volume and structure of production, the size and age and sex composition of the population; its social structure and cultural level; climatic, geographical and national-historical living conditions; changes in human physiological characteristics.

The effective demand of the population depends on the size of the distribution of national income, the monetary income of the population and their distribution between social groups, prices for goods and services, commodity funds, and the size of public consumption funds.

Analysis of changes in these factors reveals the reasons for the increase in social tension: a fall in production in general and consumer goods especially; unfavorable demographic situation and aging society as a consequence; structural changes in the economy and military cuts leading to a widening base of unemployment; inflation and depreciation of savings of the population; an increase in the cost of energy resources, causing an increase in the cost of utilities, transport, etc.

It is important to note that capitalism has learned to combine the market and social protection through the development and implementation of economic policies, going through several stages of this interaction.

The period of classical liberalism is characterized by the dominance of free competition. The main goal of production during this period was to obtain maximum profit, and the individual was viewed as an “economic man.” The state pursued a policy of non-interference in the economy.

This was the heyday of entrepreneurship and rejection of political reforms, the heyday of the bourgeois-parliamentary system and bourgeois “freedoms” in the economic sphere. Charity (and this was the basis of social work) was carried out mainly by pious people, guided by the ideas of altruism and philanthropy.

“The idea of ​​economic liberalism as a consistent and comprehensive political-economic concept was developed by A. Smith. He actively supported the put forward slogan “Laisser faire” - “don’t interfere with action”: full scope for private initiative, liberation of economic activity from the tutelage of the state, ensuring conditions for free enterprise and trade. “Equality of opportunity” for agents of commodity-capitalist production was proclaimed” Karelova G.N., Katulsky E.D., Gorkin A.P. and others. Social encyclopedia. - M: Bolii. Ross. Enz-ya, 2000. - P. 320..

The consumer has sovereign power; the demand that he places on the market, like a ballot dropped into a ballot box, forces the entrepreneur to take into account his desires.

The function of the state was limited to protecting the private property of citizens and establishing a general framework for free competition between individual producers.

In the 20th century, with the entry of capitalism into the monopoly stage, the concept of “neoliberalism” arose: the mechanism of one market creates the most favorable preconditions for effective economic activity, regulation of economic and social processes, rational distribution of economic resources and satisfaction of consumer demands.

Like A. Smith, the “neoliberalists” believed that free economic policy should be regulated by moral standards of personal and public responsibility in traditional religious concepts of charity. But assistance must be rational, with clearly defined goals and expected results.

By the 30s of the XX century. It became clear that it was necessary to introduce some restrictions on personal freedoms and abandon the policy of free competition.

After the crisis of the 30s, the so-called “Keynesian” period began, when society recognized the need for government intervention in the market economy, the need for social protection of the poor: the state has the right and must intervene in the redistribution of income towards the social protection of the poor.

The influence of J.M. Keynes on public opinion turned out to be the strongest. His main work is “The General Theory of Employment; percent of money" (1936) showed that to meet the modern needs of society, government measures are necessary: ​​a satisfactory level of prices and employment must be established through government regulation and public policy.

Thus, the period of Keynesianism is characterized by the fact that the state takes responsibility for providing social assistance, although it is of a bureaucratic nature.

The post-Keynesian stage came after the Second World War and was characterized by the concept of a “social market economy”. One of its authors, L. Erhard, put forward a model of social protection of the population based on a strong social policy.

Unlike Keynesianism, social protection is implemented not by state-bureaucratic methods, but through policies aimed at creating conditions that allow a person to earn his own living and, moreover, aimed at increasing the number of owners.

The process of recognizing the fact that the state must level out the unfair market regulation of income ended with the expansion of the economic functions of the state, which was actively involved in the redistribution of income.

In the mid-70s, a new stage began, characterized by an aging population in developed countries.

The idea of ​​the welfare state was a resounding success as a means of social planning and innovation in the 1950s and 1960s. But this idea did not allow solving many economic and social problems that arose acutely in the 70-80s, namely:

• - constantly high level of unemployment in many countries of the world;
• - strengthening of migration processes;
• - serious changes in the social stratification of society;
• - falling birth rates, aging population and much more.

This led to the need to review the entire system of protecting the population, adopting the concept of social innovation, which is based on joint actions of the central government, local authorities, and the public.

Thus, in a society of market relations, there is objectively a part of the population that is not able to provide itself with a decent life. The main prerequisites for the need for social protection of the population in a market economy society are dictated by the laws of the market, stem from its essence and determine the formation of a social protection system as a specialized public institution. Social protection of the population is becoming an important component of the economic and social policy of the state.

The term “disabled person” goes back to the Latin root (“valid” - effective, full-fledged, powerful) and literally translated can mean “unsuitable”, “inferior”. In Russian usage, starting from the time of Peter I, this name was given to military personnel who, due to illness, injury or injury, were unable to perform military service and who were sent for further service to civilian positions. Peter tried to rationally use the potential of retired military personnel - in the public administration system, city security, etc.

It is characteristic that in Western Europe this word had the same connotation, i.e. applied primarily to crippled warriors. From the second half of the 19th century. the term also applies to civilians who also became victims of war - the development of weapons and the expansion of the scale of wars increasingly exposed the civilian population to all the dangers of military conflicts. Finally, after the Second World War, in line with the general movement to formulate and protect human rights in general and certain categories of the population in particular, the concept of “disabled person” is being rethought, referring to all persons with physical, mental or intellectual disabilities.

Today, according to various estimates, on average, almost every tenth resident in developed countries has some kind of health limitation. The classification of specific types of limitations or impairments as persons with disabilities depends on national legislation; Consequently, the number of disabled people and their share in the population of each specific country may differ significantly, despite the fact that the level of morbidity and loss of certain functions in countries that have reached a certain level of development is quite comparable.

The Federal Law of November 24, 1995 No. 181-FZ “On the social protection of disabled people in the Russian Federation” provides a detailed definition of disability.

Disabled person- this is a person who has a health disorder with a persistent disorder of body functions, caused by diseases, consequences of injuries or defects, leading to limited life activity and necessitating his social protection.

Limitation of life activity is expressed in the complete or partial loss of a person’s ability or ability to carry out self-care, move independently, navigate, communicate, control one’s behavior, study and engage in work activities.

Thus, according to internationally recognized criteria, disability is defined by abnormalities or impairments in the following areas.

Blind, deaf, dumb, people with limb defects, impaired coordination of movement, completely or partially paralyzed are recognized as disabled due to obvious deviations from the normal physical condition of a person. Disabled persons are also recognized as persons who have no external differences from ordinary people, but suffer from diseases that do not allow them to function in various spheres of life in the same way as healthy people do. For example, a person suffering from coronary heart disease is unable to perform heavy physical work, but he may be quite capable of mental activity. A patient with schizophrenia may be physically healthy, in many cases he is also able to perform work associated with mental stress, but during an exacerbation he is not able to control his behavior and communication with other people.

At the same time, the majority of disabled people do not need isolation, they are able to independently (or with some help) lead an independent life, many of them work in regular or adapted jobs, have families and support them independently.

Social changes that are objectively occurring in modern society and reflected in people’s consciousness are expressed in the desire to expand the content of the terms “disabled person” and “disability”.

Thus, WHO has adopted the following characteristics of the concept of “disability” as standards for the world community:

• any loss or impairment of psychological, physiological or anatomical structure or function;
• limited or absent (due to the above defects) ability to perform functions in a manner considered normal for the average person;
• a difficulty arising from the above-mentioned disadvantages, which completely or partially prevents a person from performing a role (taking into account the influence of age, gender and cultural background).

At the same time, taking into account the complexity and inconsistency of the understanding and definition of such concepts as “health”, “standard of health”, “deviation”, functionalist concepts of the interpretation of disability, based on the assessment of deviations and defects in several scales related to biophysical, mental , social and professional aspects of the life of a disabled person.

At the same time, the importance of developing valid criteria and methods for assessing and regulating the status of a disabled person is determined by the fact that in a society in which the principle of equal rights is fundamental, disability is one of the mechanisms that predetermine inequality and can become a source of marginalization of people with disabilities and families, in which they live.

The World Health Organization has developed the International Classification of Impairments, Disabilities and Handicaps, in which the starting point for defining disability is an impairment, a defect, which is understood as a mental, physiological and (or) anatomical deficiency in the structure of the body. Losses can be global (universal) or partial; the impairment may vary in level and depth, may be permanent or curable, congenital or acquired, stable or progressive (in which the person's condition worsens).

Handicap, which is a consequence of injury (mutilation) and disability, determines less favorable social conditions for a person, since the ability to perform standard functions for a given society and role identification in it is either completely blocked or significantly limited. It also becomes difficult to achieve one’s own life goals that are related to age, gender and cultural traditions.”

The degree of role impairment may manifest itself in difficulties in fulfilling social roles; in the constraints that arise (not all desired roles can be performed at a satisfactory level); in the complete absence of opportunities for adequate role behavior.

The systemic understanding of disability presented by WHO departs from its narrow interpretation, which emphasized occupational limitations and the ability (inability) to work. The presence of disability and the degree of impairment is considered as an indicator of disorders in regulating the relationship of a disabled person with his social environment. At the same time, an analysis of social practice shows that there are people who have disorders of communication and social behavior, maladaptation and social marginalization that are not associated with health problems. Such individuals (deviant behavior) also need social rehabilitation, however, in order to organize specialized assistance, it is necessary to distinguish between marginalized people who have difficulties in the field of social adaptation, based on sociopathy or behavioral disorders, and people with psychosomatic abnormalities.

Multifactor analysis of the social status of disability allows us to conclude that:

• from an economic point of view - this is limitation and dependence arising from poor ability to work or from incapacity for work;
• medical point of view - a long-term condition of the body that limits or blocks its normal functions;
• legal point of view - status giving the right to compensation payments and other social support measures regulated by national or regional legislation;
• professional point of view - a state of difficult, limited employment opportunities (or a state of complete disability);
• psychological point of view - this is, on the one hand, a behavioral syndrome, and on the other, a state of emotional stress;
• sociological point of view - loss of previous social roles, inability to participate in the implementation of a standard set of social roles for a given society, as well as stigmatization, labeling that prescribes a certain, limited social functioning to the disabled person.

If we pay attention to the last two provisions, we can conclude that social restrictions and barriers for persons with disabilities are partly formed not only by physical barriers, but also by subjective social restrictions and self-limitations. Thus, the stigmatization of disabled people in the public consciousness prescribes for them the role of unfortunate people, worthy of pity, in need of constant protection, although many self-sufficient disabled people emphasize their equal subjectivity to all other people. At the same time, some people with disabilities acquire the mentality and behavioral standards of a victim, unable to independently resolve at least part of their own problems, and place responsibility for their fate on others - relatives, employees of medical and social institutions, and the state as a whole.

This approach, reflecting the specifics of the social position of people with disabilities in various spheres, allows us to formulate a new idea: person with disabilities - This is an individual who has all human rights, who is in a position of inequality, formed by barrier restrictions of the environment, which he cannot overcome due to the limited capabilities of his health.

At a conference organized by the UN Secretariat in 2006 and dedicated to the problems of disability, it was noted that the UN Convention on the Rights of Persons with Disabilities recognizes the dynamic development of the concept of disability along with the development of public ideology, which necessitates regular and timely adaptation of instruments for social protection of persons with disabilities. Currently, the following markers of disability are recognized: biological (organismal defects due to diseases, injuries or their consequences, persistent functional impairment); social (violation of interaction between an individual and society, special social needs, limitation of freedom of choice, special social status, need for social protection); psychological (special collective personal attitudes, special behavior in the social environment, special relationships within the population and with other social groups of the population); economic (restriction of freedom of economic behavior, economic dependence); physical (accessibility barriers). All these markers, or factors, form the social specificity of the state of disability, which prevents what is normal for a given environment, i.e. socially recognized set of models of functioning.

All disabled people, but for different reasons, are divided into several groups:

• by age - disabled children, disabled adults;
• origin of disability - disabled people from childhood, disabled people from war, disabled people from labor, disabled people with general illness;
• general condition - disabled people of mobile, low-mobility and immobile groups;
• degree of ability to work - disabled people able to work and incapable of work, disabled people of group I (unable to work), disabled people of group II (temporarily disabled or able to work in limited areas), disabled people of group III (able to work in benign working conditions).

Criteria for determining first disability group is a social disability that requires social protection or assistance due to a health disorder with a persistent, significant disorder of body functions caused by diseases, consequences of injuries or defects leading to a pronounced limitation of any category of life activity or a combination thereof.

The criterion for establishing second disability group is a social disability that requires social protection or assistance due to a health disorder with a persistent severe disorder of body functions caused by diseases, consequences of injuries or defects leading to a pronounced limitation of any category of life activity or a combination thereof.

Criteria for determining third disability group is a social disability that requires social protection or assistance due to a health disorder with a persistent, slightly or moderately expressed disorder of body functions, caused by diseases, consequences of injuries or defects leading to a mild or moderately pronounced limitation of any category of life activity or a combination thereof.

• self-care ability - the ability to independently satisfy basic physiological needs, perform daily household activities and personal hygiene skills;
• ability to move - the ability to independently move in space, overcome obstacles, maintain body balance within the framework of everyday, social, and professional activities;
• ability to work - ability to carry out activities in accordance with the requirements for the content, volume and conditions of work;
• orientation ability - ability to be determined in time and space;
• communication ability - the ability to establish contacts between people by perceiving, processing and transmitting information;
• ability to control one's behavior - the ability to self-awareness and adequate behavior taking into account social and legal norms.

Also distinguished ability to learn, the limitation of which may be the basis for establishing a second disability group, when combined with one or more other categories of life activity. The ability to learn is the ability to perceive and reproduce knowledge (general education, professional and others), mastery of skills and abilities (social, cultural and everyday).

When considering childhood disabilities, there are usually 10 categories of children with developmental disabilities. These include children with disorders of one of the analyzers: with complete (total) or partial (partial) loss of hearing or vision; deaf (deaf), hard of hearing or with specific speech disorders; with musculoskeletal disorders (cerebral palsy, consequences of spinal injuries or polio); with mental retardation and with varying degrees of mental retardation (various forms of mental underdevelopment with predominant immaturity of intellectual activity); with complex disabilities (blind, mentally retarded, deaf-blind, deaf-blind with mental retardation, blind with speech impairment); autistic (having a painful communication disorder and avoiding communication with other people).

Despite the increasingly impressive successes of medicine, the number of disabled people not only is not decreasing, but is steadily growing, and in almost all types of societies and all social categories of the population.

There are many different reasons behind the occurrence of disability.

Depending on the cause Three groups can be roughly distinguished:

• 1) hereditary forms:
• 2) forms associated with the intrauterine position of the fetus, damage to the fetus during childbirth and in the earliest stages of the child’s life;
• 3) forms acquired during the development of a disabled person as a result of diseases, injuries, and other events that resulted in a persistent health disorder. Acquired disability is divided into the following forms:
  • a) disability due to a general illness;
  • b) disability acquired during work - due to a work injury or occupational disease;
  • c) disability due to war injury;
  • d) disability associated with natural and man-made emergencies - radiation exposure, earthquakes and other disasters.

There are forms of disability, in the origin of which hereditary and other (infectious, traumatic) factors interact. In addition, what often makes a person disabled is not so much the objective state of his health as the inability (for various reasons) of himself and society as a whole to organize full development and social functioning in the conditions of precisely this state of health.

Considering disorders of the musculoskeletal system, it should be noted that pathology of the musculoskeletal system can be a consequence of a congenital defect, the consequences of injuries, degenerative-dystrophic changes in the musculoskeletal system.

In accordance with the International Nomenclature of Impairments, Disabilities and Social Disabilities, movement disorders are presented in a fairly differentiated manner. Movement disorders are classified as follows:

• due to the complete or partial absence of one or more limbs, including amputations;
• due to the absence of one or more distal parts of the limbs (finger, hand, foot);
• due to the absence or impairment of voluntary mobility of four limbs (quadriplegia, tetraparesis);
• due to the absence or impairment of mobility of the lower extremities (paraplegia, paraparesis);
• due to impaired voluntary mobility of the upper and lower limbs on one side (hemiplegia);
• due to impaired muscle strength of the lower extremities;
• due to impaired motor functions of one or both lower extremities.

The consequence of these violations is restrictions on life activity in the sphere of self-care and movement.

All causes of disability (both congenital and acquired) can be divided into medical-biological, socio-psychological, economic and legal.

Medical and biological reasons consist in the formation of pathologies. Among them the main places are occupied by:

• pathology of pregnancy;
• consequences of injuries (including birth);
• poisoning;
• accidents;
• hereditary diseases.

The reasons for the formation of pathologies also include poor organization of medical care:

• irregularity of examinations by specialists;
• most often disabled people due to mental and nervous diseases are not covered by medical examination;
• there is no systematic observation by doctors;
• there are no specialized medical institutions - rehabilitation treatment departments, rehabilitation centers;
• severity of the pathology.

Among biological reasons, the age of the parents, especially the mother, at the birth of the child is primarily important. Among the socio-psychological causes of disability are:

• a) low educational level of parents, their low literacy in matters of education and training;
• b) poor living conditions (lack of sufficient communal amenities in everyday life, poor sanitary and hygienic conditions).

Social and psychological reasons can be family, pedagogical, household, etc.

Among economic and legal reasons disability, the low material income of the family, ignorance and practical non-use of their rights to receive one or another type of benefits, allowances, and the provision by health and social protection institutions of the population of the required amount of medical and social assistance to people with disabilities are of significant importance.

The lag in income levels from the rising cost of living, the decline in consumption standards, and the protein and vitamin deficiency experienced by certain segments of the population directly affect both the health of adults and especially the health of children, making it difficult to correct the development of those who need enhanced care and additional assistance for their medical, psychological, pedagogical and social rehabilitation. Lack of healthy lifestyle skills, unsatisfactory nutritional standards, and consumption of substitute alcoholic beverages also adversely affect health. There is a direct and significant correlation between socio-economic difficulties and the increase in disability.

As a result of transport injuries, an unprecedented number of residents are dying, while the number of people losing their health is many times higher. Military conflicts also result in mass disability of both direct participants in hostilities and the civilian population.

Thus, for our country, the problem of providing assistance to persons with disabilities is one of the most important and pressing, since the increase in the number of disabled people acts as a stable trend in our social development, and there is no data yet indicating a stabilization of the situation or a change in this trend.

Provisions on the protection of the rights of persons with disabilities are also contained in many international documents. The most integrative of them, covering all aspects of the life of people with disabilities, are the Standard Rules for the Equalization of Opportunities for Persons with Disabilities, approved by the UN in 1994.

The ideology of these rules is based on the principle of equal opportunity, which assumes that persons with disabilities are members of society and have the right to remain in their communities. They should receive the support they need through the regular health, education, employment and social services systems. There are 20 such rules in total.

Rule 1 - Understanding of Issues - provides States with an obligation to develop and promote programs aimed at increasing people with disabilities' understanding of their rights and opportunities. Increasing self-reliance and empowerment will enable people with disabilities to take advantage of the opportunities available to them. Deepening understanding of the problems should become an important part of educational programs for disabled children and rehabilitation programs. Persons with disabilities could help develop understanding of the issue through the activities of their own organizations.

Rule 2 - health care - requires measures to be taken to develop programs for the early detection, assessment and treatment of defects. Disciplinary groups of specialists are involved in the implementation of these programs, which will prevent and reduce the scale of disability or eliminate its consequences; ensure full participation in such programs of persons with disabilities and members of their families on an individual basis, as well as organizations of persons with disabilities in the planning and evaluation process.

Rule 3 - rehabilitation - involves the provision of rehabilitation services to people with disabilities in order to enable them to achieve and maintain an optimal level of independence and functioning. States are required to develop national rehabilitation programs for all groups of persons with disabilities. Such programs should be based on the actual needs of persons with disabilities and the principles of their full participation in society and equality. Such programs should include, but are not limited to, basic training to restore or compensate for lost function, counseling for persons with disabilities and their families, development of self-reliance, and provision of services such as assessment and guidance as needed. Persons with disabilities and their families must have the opportunity to participate in the development of programs aimed at changing their situation.

States should recognize that all persons with disabilities who require assistive devices must have the ability, including the financial means, to use them. This may mean that assistive devices should be provided free of charge or at a cost that is affordable to people with disabilities and their families.

Subsequent rules establish standards regarding the removal of barriers between a disabled person and society, providing persons with disabilities with additional services that would allow them and their families to realize their rights.

Thus, in the field of education, states have recognized the principle of equal opportunities in primary, secondary and higher education for children, youth and adults with disabilities in integrated structures. Education for people with disabilities is an integral part of the general education system. Parent groups and organizations of people with disabilities should be involved in the education process at all levels.

A special rule is dedicated employment - States have recognized the principle that persons with disabilities should be given the opportunity to exercise their rights, especially in the area of ​​employment. States must actively support the inclusion of persons with disabilities in the free labor market. Such active support can be provided through a variety of activities, including vocational training, incentive quotas, reserved or targeted employment, loans or subsidies to small businesses, special contracts and preferential production rights, tax incentives, contract guarantees, or other types of support. technical or financial assistance to businesses that employ disabled workers. States should encourage employers to make reasonable accommodations for persons with disabilities and take measures to include persons with disabilities in the development of training programs and employment programs in the private and informal sectors.

Under the income maintenance and social security rule, states are responsible for providing social security to persons with disabilities and maintaining their income. States must take into account the costs that people with disabilities and their families often suffer as a result of their disability when providing assistance, and provide financial support and social protection to those who have taken care of the person with a disability. Social security programs should also encourage people with disabilities themselves to find work that generates income or restores their income.

The Standard Rules on Family Life and Personal Freedom provide for persons with disabilities to be able to live with their families. States should ensure that family counseling services include appropriate services related to disability and its impact on family life. Families with disabled people should have the opportunity to use foster care services, as well as have additional opportunities to care for disabled people. States must remove all undue barriers to individuals seeking to either adopt a child with a disability or provide care for an adult with a disability.

The rules provide for the development of standards to ensure the inclusion of people with disabilities in cultural life and participation in it on an equal basis. The standards provide for the adoption of measures to ensure equal opportunities for recreation and sports for people with disabilities. In particular, states must take measures to ensure access for persons with disabilities to recreational and sports facilities, hotels, beaches, sports arenas, halls, etc. Such measures include providing support to personnel involved in the organization of recreation and sports activities, as well as projects involving the development of methods for access and participation in these activities for people with disabilities, the provision of information and the development of training programs, and the encouragement of sports organizations that expand opportunities for the inclusion of people with disabilities in participation in sports activities . In some cases, such participation requires simply ensuring that people with disabilities have access to these events. In other cases it is necessary to take special measures or organize special games. States should support the participation of persons with disabilities in national and international competitions.

In the field of religion, the standard rules include the promotion of measures aimed at ensuring the equal participation of persons with disabilities in the religious life of their community.

In the area of ​​information and research, States are required to regularly collect statistical data on the living conditions of persons with disabilities. The collection of such data could be carried out in parallel with national population censuses and household surveys and, in particular, carried out in close cooperation with universities, research institutes and organizations of disabled people. This data should include questions about programs, services and their use.

When considering the creation of data banks on persons with disabilities, which would contain statistics on available services and programs, as well as on different groups of persons with disabilities, the need to protect individual privacy and freedom must be taken into account. Programs should be developed and supported to study the social and economic issues affecting the lives of persons with disabilities and their families. Such research should include an analysis of the causes, types and extent of disability, the availability and effectiveness of existing programs and the need for the development and evaluation of services and interventions. Survey technology and criteria need to be developed and improved, while measures are taken to facilitate the participation of persons with disabilities themselves in data collection and study. Information and knowledge on issues relating to persons with disabilities should be disseminated among all political and administrative bodies at the national, regional and local levels. The Standard Rules define the requirements for policy development and planning for persons with disabilities at the national, regional and local levels. At all stages of decision-making, organizations of persons with disabilities should be involved in the development of plans and programs concerning persons with disabilities or affecting their economic and social situation; Where possible, the needs and interests of persons with disabilities should be included in overall development plans rather than considered separately.

The Standard Rules stipulate that States are responsible for establishing and strengthening national coordinating committees or similar bodies to serve as national focal points on issues affecting persons with disabilities.

The standard rules recommend economically and in other ways to encourage and support the creation and strengthening of organizations of persons with disabilities, members of their families and (or) persons defending their interests, as well as to ensure an advisory role for organizations of persons with disabilities in decision-making on issues affecting persons with disabilities.

States are responsible for ensuring adequate training at all levels of personnel involved in the development and implementation of programs and services related to persons with disabilities.

Special aspects of the standard rules are devoted to responsibility for the ongoing monitoring and evaluation of the implementation of national programs and for the provision of services aimed at ensuring equal opportunities for persons with disabilities, as well as other provisions.

The years that have passed since the adoption of the standard rules, the analysis of the experience of their application, and the achievements of democratic and humanistic development have made it possible to raise international legislation on the rights of persons with disabilities to a new level.

Based on these documents, the Council of Europe adopted an Action Plan to promote the rights and full participation of people with disabilities in society: improving the quality of life of people with disabilities in Europe, 2006-2015. It reaffirms the universal, indivisible and interrelated nature of all human rights and fundamental freedoms and emphasizes the need for people with disabilities to be able to enjoy them without discrimination. The proportion of people with disabilities in the European population is estimated at 10-15%, and it is noted that the main causes of disability are diseases, accidents and the disabling living conditions of older people. It is predicted that the number of people with disabilities will constantly increase, also due to an increase in average life expectancy.

The main areas of activity are: participation of people with disabilities in political and public life, in cultural life; information and communications; education; employment, career guidance and training; architectural environment; transport; living in the local community; health protection; rehabilitation; social protection; legal protection; protection from violence and abuse; research and development, raising awareness.

The main purpose of the Disability Action Plan is to serve as a practical tool for developing and implementing effective strategies to ensure the full participation of people with disabilities in society.

Analyzing the content of modern documents regulating the obligations and technologies of states to implement equal rights and opportunities for people with disabilities (persons with limited health capabilities), we can conclude that the result of the major political, economic, social and technological changes in recent years is a radical transformation of public consciousness and at the same time - a global change in the paradigm of social policy regarding people with disabilities: a transition from the concept of “patient” to the concept of “citizen”.

The development of information and communication technologies, changes in demography and social relations, the legislative framework and the mentality of the population lead to the fact that the processes of social exclusion that affected people with disabilities (as well as representatives of national minorities, migrants, the poor, etc.) ), are considered reversible. The integration of disabled people is now interpreted not as the inclusion of some separate part into a single whole, but as the integration of disabled people and society. The understanding of activities to provide social support measures to disabled people as unidirectional public charity, albeit comprehensively regulated by law, is gradually being overcome, and the task of the state is now considered to be the creation of conditions so that all categories of people, with all special needs, can freely and equally exercise their universal rights .

Attitudes towards people with disabilities are changing: they are no longer seen as patients in need of care who do not contribute to society, but as people who need barriers to their rightful place in society to be removed. These obstacles are not only of a social and legal nature, but also the rudiments of the attitude that still exists in the public consciousness towards people with disabilities only as victims of biological and social impairment. It is characteristic that European parliamentarians, despite the developed ideas and effective technologies of comprehensive social rehabilitation, which have proven their effectiveness throughout the second half of the 20th century, still consider it urgent to stimulate the transition from the outdated medical model of disability to a model related to the implementation of a complex of social human rights . It can be briefly formulated that the strategy of isolation and segregation is replaced by a strategy of social inclusion - this implies not only inclusive learning, but generally inclusive social functioning.

The transformation of the patient paradigm into the citizen paradigm assumes that the basis for providing all necessary types of support is not a diagnosis, not a list of existing disorders and methods of their medical correction, but a whole person, whose rights and dignity are not subject to derogation. As a result, since the last years of the 20th century. Until now, in many European countries there has been such a transformation of social policy towards people with disabilities, which allows a person with disabilities to control his own life and act as the main expert in assessing measures of social support and social services organized by state and local governments.

The Action Plan identifies groups of people with disabilities who are particularly in need of equal opportunity services: women (and girls) with disabilities; people with complex and complex disabilities who require a high level of support; elderly people with disabilities.

The basic principles that should guide all decision-making bodies and program developers for the social inclusion of people with disabilities are:

• prohibition of discrimination;
• equality of opportunity, full participation of all people with disabilities in the life of society;
• respect for differences and viewing disability as part of humanity's inherent diversity;
• the dignity and personal autonomy of persons with disabilities, including freedom to make their own decisions;
• equality between men and women;
• participation of people with disabilities in all decisions that affect their lives, both at the individual level and at the level of the entire society, through organizations representing them.

Of great importance for the implementation of the rights of persons with disabilities is the Convention on the Rights of Persons with Disabilities, adopted by the General Assembly of the PLO on December 6, 2006, as well as the European Social Charter, revised on May 3, 1996, to which Russia has also joined.

Both of these international instruments emphasize the importance of disability issues as an integral part of their respective sustainable development strategies.

For our country, the problem of providing assistance to persons with disabilities is one of the most important and pressing, since the increase in the number of disabled people acts as a stable trend in social development, and there is no data yet indicating a stabilization of the situation or a change in this trend.

In addition, the general negative characteristics of population reproduction processes, depopulation processes, and a decrease in the birth rate place high demands on the social and labor resources of the future. Disabled people are not only persons in need of special social assistance, but also a possible significant reserve for the development of society. It is believed that in the first half of the 21st century. they will constitute at least 10% of the total workforce in industrialized countries Comprehensive rehabilitation of children with disabilities due to diseases of the nervous system. Methodological recommendations. - M.; St. Petersburg, 1998. - T. 2. - P. 10.

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2 General information 1. A disabled person is defined as a person who has a health impairment with a persistent disorder of body functions, caused by diseases, consequences of injuries or defects, leading to limitation of life activity and necessitating his social protection. 2. Depending on the degree of dysfunction of the body’s functions and limitation of life activity, persons recognized as disabled are assigned a disability group, and persons under the age of 18 are assigned the category “disabled child.” 3. The basis for establishing the first group of disability is such a violation of body functions in which the disabled person cannot care for himself and needs constant help, care or supervision. 4. The basis for determining the second group of disability are significantly pronounced functional impairments that lead to complete or long-term disability, or to a state where certain types of work can only be accessed in specially created conditions. 5. The basis for determining the third group of disability is a significant decrease in disability due to impaired body functions caused by chronic diseases or anatomical defects. 6. Recognition of a person as disabled is carried out by the federal institution of medical and social examination. 7. Re-examination of disabled people of group I is carried out once every 2 years, disabled people of groups II and III once a year. 8. Without specifying a period for re-examination, disability is established for men over 60 years of age and women over 55 years of age, disabled people with irreversible anatomical defects, and other disabled people in accordance with the criteria approved by the executive body authorized by the Government of the Russian Federation. 9. After recognizing a person as disabled by the specialists of the institution who conducted the medical and social examination, an individual rehabilitation program is developed within a month, approved by the head of the institution. 10. A person recognized as disabled is issued a certificate confirming the fact of disability, as well as an individual rehabilitation program.

3 Rehabilitation of disabled people 1. Rehabilitation of disabled people is defined as a system and process of full or partial restoration of the abilities of disabled people to everyday, social and professional activities. 2. The main directions of rehabilitation of disabled people include: restorative medical measures, reconstructive surgery, prosthetics, orthotics, sanatorium treatment; vocational guidance, training and education, assistance in employment, industrial adaptation; social-environmental, socio-pedagogical, socio-psychological and sociocultural rehabilitation, social and everyday adaptation; physical education and health activities, sports. 3. The implementation of the main directions of rehabilitation of disabled people includes: the use of technical means of rehabilitation by disabled people; creating the necessary conditions for unhindered access of people with disabilities to engineering, transport, social infrastructure facilities and the use of means of transport, communications and information; providing disabled people and their family members with information on rehabilitation of disabled people. 4. The state guarantees disabled people the implementation of rehabilitation measures, the receipt of technical means and services provided for in the federal list at the expense of the federal budget.

4 Technical means of rehabilitation of disabled people 1. Technical means of rehabilitation of disabled people include devices containing technical solutions, including special ones, used to compensate for or eliminate persistent limitations in the life of a disabled person. 2. Technical means of rehabilitation of disabled people are: special means for self-service; special care products; special means for orientation (including guide dogs with equipment), communication and information exchange; special means for training, education (including literature for the blind) and employment; prosthetic products (including prosthetic and orthopedic products, orthopedic shoes and special clothing, eye prostheses and hearing aids); special training and sports equipment, sports equipment; special means of transportation (wheelchairs). 3. The technical means of rehabilitation provided for by individual rehabilitation programs for disabled people, provided to them at the expense of the federal budget and the social insurance fund of the Russian Federation, are transferred to disabled people for free use

5 Social protection of disabled people 1. Social protection of disabled people is defined as a system of state-guaranteed economic, social and legal measures that provide disabled people with conditions for overcoming, replacing (compensating) disabilities and aimed at creating equal opportunities for them to participate in society with other citizens. 2. Economic measures to ensure the life of disabled people include: pension provision for disabled people; monthly cash payments (MCB), the size of which depends on the disability group. Part of the EDV amount can be used (at the request of the disabled person) to finance a set of social services (social package); additional monthly financial support for disabled people (DEMO) whose disability is caused by military trauma; provision of a set of social services (NSS) (social package), including: - provision of medicines; - spa treatment; - free travel on suburban railway transport. The provision of NSO is subject to the preservation of the right to receive it. social services for people with disabilities by institutions of the state social service system (including home-based services), including the provision of services: - social, social, medical, socio-psychological, social-legal, social-rehabilitation, socio-economic, social-consultative, social-pedagogical .

6 3. Measures of social support for people with disabilities include: providing housing for people with disabilities and families with disabled children in need of improved housing conditions at the expense of the federal budget. Provided that a disabled person suffers from severe forms of chronic diseases provided for in the list established by the executive body authorized by the Government of the Russian Federation, he may be provided with residential premises under a social tenancy agreement with a total area exceeding the provision norm for one person (but not more than twice ); priority acquisition of land plots for individual housing construction, farming and gardening; ensuring that people with disabilities receive publicly accessible and free primary general, basic general, secondary general and secondary vocational education, as well as free higher education. ensuring the employment of disabled people by establishing quotas in organizations for hiring disabled people and creating working conditions for them in accordance with individual rehabilitation programs for disabled people; creating conditions for entrepreneurial activity; organizing training for disabled people in new professions. 4. In order to protect the rights and legitimate interests of people with disabilities, providing them with equal opportunities with other citizens, people with disabilities have the right to create their own public associations.

7 The state provides assistance and assistance to public associations of disabled people, including material, technical and financial. Authorized representatives of public associations of disabled people are involved in preparing and making decisions affecting the interests of disabled people. Decisions made in violation of this rule may be declared invalid in court. State authorities and local governments can provide support to public associations of people with disabilities and organizations created by all-Russian public associations of people with disabilities by providing free use of property (including buildings, non-residential premises) used by them legally for at least five years. The state guarantees free legal assistance to people with disabilities.

8 PUBLIC SERVICES PROVIDING SOCIAL SUPPORT FOR DISABLED PEOPLE GU TO “Department of Social Protection of the Population of the Aleksinsky District” Aleksin, st. Lenina, 10 tel. 8 (48753) Monday-Thursday Friday Reception of citizens in a “one-stop shop” mode: - monthly cash payments and subsidies for housing and communal services - consultations on legal issues in the social sphere of the State Technical Institution “Center for Social Services for the Population of the Aleksinsky District”, Aleksin , st. Pionerskaya, 2 tel. 8 (48753) tel. 8 (48753) tel. 8 (48753) Monday-Thursday Friday social and socio-medical services at home - social rehabilitation of people with disabilities, psychological assistance, sociocultural adaptation - rental of technical rehabilitation equipment - consultations on legal issues in the social sphere

9 Bureau 15 - branch of the Federal Institution "Main Bureau of Medical and Social Expertise in the Tula Region" Aleksin, st. Lenina, 18 - passing a medical and social examination - medical examination - establishing a disability group tel. 8 (48753) Monday, Wednesday Tuesday, Thursday Office of the Pension Fund of the Russian Federation in the city of Aleksin and Aleksinsky district Aleksin, st. Oktyabrskaya, 1 tel. 8 (48753) tel. 8 (48753) Monday-Thursday Friday pension provision and social cash payments

10 GU-Tula regional branch of the Social Insurance Fund, Aleksin, st. Geroev-Aleksintsev, 8a - sanatorium-resort treatment - provision of technical means for the rehabilitation of bodies. 8 (48753) Monday-Thursday Friday GU TO “Employment Center of the Aleksinsky District” Aleksin, st. Mira, 10a - employment of disabled people - obtaining a new profession "hotline" - tel. 8 (48753) tel. 8 (48753) Monday-Thursday Friday

11 Department of Education of the Municipal Formation “Aleksinsky District” Aleksin, st. Pionerskaya 8 - implementation of the right to study in educational institutions for persons with disabilities tel. 8 (48753) Administration of the municipal formation “Aleksinsky district” Aleksin, st. Geroev-Aleksintsev, 10 Committee on Property and Land Relations Legal Adviser Office 210 tel. 8(48753) Office 211 tel. 8(48753) Office 117 tel. 8(48753) provision of housing - allocation of land plots - free legal assistance (once a quarter)

13 Legislative framework Federal Law dated 181-FZ (as amended) “On social protection of disabled people in the Russian Federation” Federal Law dated 323-FZ “On the fundamentals of health protection in the Russian Federation” Federal Law dated 178 -FZ “On State Social Assistance” Federal Law No. 122-FZ “On Social Services for Elderly and Disabled Citizens” Federal Law No. 166-FZ “On State Pensions” Federal Law No. 173-FZ “On Labor pensions" Federal Law dated 323-FZ "On free legal assistance in the Russian Federation" Federal Law dated 173-FZ "On labor pensions" Resolution of the Government of the Russian Federation dated 965 "On the procedure for recognizing citizens as disabled" Resolution of the Government of the Russian Federation Federation dated 59 “federal comprehensive program “Social support for people with disabilities” Decree of the Government of the Russian Federation dated “On the federal list of state-guaranteed social services provided to elderly citizens and disabled people by state and municipal social service institutions”

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A disabled person is a person who has a health impairment with a persistent disorder of body functions, caused by diseases, consequences of injuries or defects, leading to limitation of life activity and necessitating his social protection.

Disability is a social insufficiency due to health problems with persistent disorders of body functions, leading to limitation of life activity and the need for social protection.

Social insufficiency is the social consequences of health impairment, leading to disruption of human life and the need for his social protection.

self-care ability;

ability to move independently;

ability to learn;

ability to work;

ability to orient in time and space;

ability to communicate (establishing contacts between people, processing and transmitting information);

¦ ability to control one's behavior.

Recognition of a person as disabled is carried out by the State Service for Medical and Social Expertise. The procedure and conditions for recognizing a person as disabled are established by the Government of the Russian Federation.

Disability is a social phenomenon from which no society is free. As they say, no one is immune from disability. A civilized society must do everything possible to enable people with severe disabilities to participate in economic and social life. This is a question of fundamental human rights, the provision of which is the responsibility of society, the state and legislation. The whole question is whether there are enough available economic resources for this.

To a large extent, the effectiveness of the relevant policy depends on the scale of disability in the country, which is determined by many factors. This is the state of health of the nation, the level of healthcare, socio-economic development, the quality of the ecological environment, historical heritage, participation in wars and armed conflicts, etc. In Russia, all of the above factors have a pronounced negative vector, which predetermines high rates of disability in society. Currently, the number of disabled people is approaching 10 million people. (about 7% of the population) and continues to grow.

The social vulnerability of people with disabilities as a specific group of the population is clearly visible across all social indicators. In comparison with the rest of the population (non-disabled), their income at the age of 20 years and older is 1.7 times lower, employment in working ages is 5.5 times lower, the level of education is significantly lower, the proportion of single people (living separately), widows, and divorcees is higher (divorced) and never married.

The degree of social disadvantage of a disabled person largely depends on age. The general pattern recorded by the latest population census, social inequality between people with disabilities and the rest of the population manifests itself especially clearly at the age of 20-40, then gradually weakens and disappears at older ages, and sometimes even turns into some advantage for people with disabilities.

Disability is one of the mediating mechanisms of social differentiation of mortality. Numerous studies of social inequality in mortality show that the survival rate of socially vulnerable groups of the population is significantly lower, especially in pre-retirement ages. The “protective” function of high educational qualifications and marital status is well known from mortality studies.

In terms of marital status, the differences between people with disabilities and the rest of the population are greatest at young marriageable ages and disappear in old age. No less contrasting are the differences between disabled and non-disabled people by level of education. At the age of 20 to 40 years, the proportion of people without education is more than 200 times higher, and the proportion of people with primary and incomplete secondary education among disabled people is 2 times higher than among non-disabled people; illiterate people, as census materials show, almost entirely consist of disabled people. The tendency towards leveling out differences with age is manifested in education even more clearly than in marital status. The income gap is also greatest at working age (especially at 20-39 years of age), and starting from 65 years of age it decreases.

The gradual weakening of social differentiation of disability with age can be explained by the “selective” effect and changes in population heterogeneity. Early disability can be considered both as a cause and as a sign of social disadvantage. In the specific conditions of Russia in the 1990s. disability in older ages can to some extent be considered an adaptive behavior.

The peculiarity of Russian selectivity is manifested in the accessibility of the status of a disabled person, including awareness of the possibility of obtaining a disability and the benefits associated with it, and the accessibility of medical institutions.