Rethinking Health: Disability, Difference, and Relational Approaches

Healthy Difference

But physical and mental variations are a natural part of the human condition, and these variations do not necessarily translate to poor health (although they may result in certain disadvantages and vulnerabilities in some settings) (Berthelot-Raffard, 2022). Indigenous knowledge frameworks have long understood variation and difference as common aspects of being that inform the interdependence of all things (Norris, 2014; Schelbert, 2003). Indigenous models of kinship offer understandings of health that are not based on statistical normalcy, binaries or individualism. Instead they conceive of a “‘spider web’ of relations” (Little Bear, 2000) in which all are equal, and all contribute to the continual give-and-take of all life (Schelbert, 2003). In Anishinaabe culture, for instance, people are recognized for the unique gifts they bring to the community, rather than focusing on what they lack or cannot do (Ineese-Nash, 2020). Leo Schelbert (2003) offers a description of how all life’s entities are valued with equal personhood and as sacred forces in the health of the collective:

The disability rights community have long echoed these relational understandings of health and well-being in their problematizations of the prevailing discourses on health and disability (Berthelot-Raffard, 2022; Sherwin, 1998). These relational frameworks conceive health as rooted in the interconnections between people and the supports they need to be well (e.g., people, resources, technologies). Through this framework, disability is understood as a social construct that arises from the relationship between people and the social environment which creates barriers that exclude and limit them from full participation in society (Schwartz et al., 2023; Oliver, 1996; Goodley et al., 2019). Oftentimes, these barriers create obstacles to accessing the social resources needed to be well, resulting in harms such as food insecurity (Berthelot-Raffard, 2022; Schwartz et al., 2023).

However, there is nothing inherently unhealthy or pathological about being disabled or having an impairment. Berthelot-Raffard (2022) gives the example that someone who is deaf or blind may need additional supports to access information provided in a society that assumes a capacity to see or hear, but they do not necessarily require any treatment. Someone who is on the autism spectrum may be diagnosed as such because they are not easily understood by the biomedical field of rationality, but they can still be regarded as healthy.