As of November 1, 2017 in Russian Federation There are 12.12 million disabled people, including 643.1 thousand disabled children.
Federal Register of Disabled Persons
On January 1, 2017, the federal state information system – the federal register of disabled people – was put into operation.
In the register, each disabled person has access to a “personal account”, which reflects information about all cash payments and other measures social support disabled person, about the progress of the implementation of his individual rehabilitation or habilitation program.
Through the “personal account” you can receive government services in electronic form, leave feedback on their quality and, if necessary, file a complaint.
The register makes it possible to eliminate multiple appeals of disabled people to various authorities, improve the quality of state and municipal services provided to disabled people, more fully inform disabled people about their rights and opportunities, and also ensures the creation of a database that takes into account the needs of disabled people, their demographic composition and socio-economic status.
The data obtained is used to develop state policy regarding people with disabilities and develop strategic planning documents both at the federal level and at the level of constituent entities of the Federation and municipalities.
State program of the Russian Federation " Accessible environment»
Within the framework of the State Program “Accessible Environment” for 2011-2020, with state support and the active participation of public organizations of people with disabilities, adaptation of the objects most in demand by disabled people and people with limited mobility in priority areas of life is provided - healthcare, social protection, sports and physical education, information and communication , culture, transport infrastructure, education.
The measures taken to create accessibility conditions allow for an integrated approach.
During the implementation of the state program, methods and approaches were developed to identify and eliminate barriers that hinder people with disabilities in various life situations, as well as mechanisms for involving people with disabilities not only at the stage of implementing activities, but also to take active participation at the stage of developing activities.
Thus, in the field of transport and transport infrastructure, it is planned to achieve an indicator of ground transport equipped for disabled people of 11.1% by the end of 2017. At the beginning of the implementation of the state program, it was 8.3%.
In the field of information and communications, an event is being implemented to subtitling television channels. This work is financed by the state program, and by the end of 2017, the number of produced and broadcast subtitles for subtitling television programs of all-Russian mandatory public channels will be 15,000 hours (at the beginning of the implementation of the State program there were only 3,000 hours).
In the healthcare sector, by the end of 2017, the share priority objects accessible for disabled people and others low mobility groups of the population will be 50.9%, in the field of culture - 41.4%, in the field of sports - 54.4%.
In the field of education, 21.5% of schools are adapted, while at the beginning of the implementation of the state program there were just over 2% of such schools.
On January 1, 2016, the implementation of a new subprogram of the state program began, which is aimed at improving comprehensive rehabilitation and habilitation of disabled people and children with disabilities. It is planned that the result will be the creation of a modern system of comprehensive rehabilitation.
The relevance of the implementation of this subprogram lies in the fact that now there are no uniform methodological and regulatory documents on the organization of the rehabilitation process for disabled people, there are no uniform methods for assessing the effectiveness of the rehabilitation measures carried out.
In this regard, at the first stage, during 2016, the development of such documents was carried out, and in 2017-2018 a pilot project is being carried out to create a system of comprehensive rehabilitation of people with disabilities and disabled children. Since the beginning of 2017, the pilot project has been implemented in the Sverdlovsk region and Perm region. The federal budget allocates about 300 million rubles annually for the implementation of the pilot project. The results of the pilot project will form the basis of a bill that will allow organizing an effective rehabilitation process outside the scope of the state program.
By decision of Russian President Vladimir Putin, the State Program “Accessible Environment” should be extended until 2025. This will allow us to further consolidate the efforts of the federal center and regions on the issue of integration of people with disabilities into society.
When developing the state program “Accessible Environment” until 2025, it is proposed to highlight three main areas:
- increasing the level of accessibility of the most significant facilities and services for people with disabilities, including creating conditions for visiting such facilities;
- formation of a modern system of comprehensive rehabilitation of disabled people, including the development of technologies for accompanying disabled people in various life situations, as well as the development of " early help» disabled children;
- modernization of the state system medical and social examination.
Bill on assisted employment of disabled people
On November 21, 2017, the State Duma of Russia approved in the third reading a draft federal law amending the Law of the Russian Federation “On Employment in the Russian Federation.”
The bill is aimed at bringing the current employment law in accordance with the provisions of the UN Convention on the Rights of Persons with Disabilities, which was ratified by Russia in 2012.
Its development is associated with the insufficient efficiency of employment of disabled people of working age. The share of working disabled people of working age in our country is about 31.8% (about 1.1 million people) of the total number of disabled people of working age (about 3.7 million people). Of these, only 25% work stably, in European countries this figure reaches 40%.
Employment service agencies work with people with disabilities without taking into account the fact that they have significant disabilities.
The draft federal law defines the mechanism of interaction between medical and social examination institutions and employment service bodies when assisting in the employment of a disabled person.
Institutions of medical and social expertise in extracts from individual programs rehabilitation of disabled people referred to the employment service, since June 2017, indicate information about the consent of the disabled person to the proactive approach of employment service specialists to him directly.
It is planned to assign the following functions to the employment service bodies:
- conducting an initial consultation with a disabled person;
- analysis of the vacancy database;
- organizing interaction between a disabled person and an employer;
- providing advisory and methodological assistance to the employer;
- determining the need for support when promoting employment of a disabled person.
Accompaniment in promoting the employment of disabled people means the provision of individual assistance to those disabled people who, due to limited health capabilities, experience difficulties and cannot independently find a job or return to the labor process.
Improving medical and social expertise
In May 2017, a road map for improving the medical and social examination system was approved. It sets out key areas of action for the period until 2020.
The first direction involves improving the scientific, methodological and legal support for medical and social examination. Separate classifications and criteria for determining disability for children have been developed and tested; New criteria are being developed to determine the degree of loss of professional ability as a result of industrial accidents.
The second direction is to increase the accessibility and quality of medical and social examination services. It includes measures to train specialists from ITU institutions, equip ITU institutions with special diagnostic equipment, form public councils under the main ITU Bureau, conducting an independent assessment of the quality of the conditions for providing services via ITU.
Law on monitoring the accessibility of the environment for people with disabilities
On January 1, 2018, a law will come into force granting authorities the right to control the accessibility of the environment for people with disabilities.
In accordance with the law, authorized federal and regional bodies executive power Separate functions will be assigned to monitor the provision of accessibility conditions.
The adoption of the law regulates the issue of the powers of the bodies that should exercise state control and supervision over the implementation mandatory conditions availability. This makes it possible to solve problems related to the accessibility of the environment within the framework of pre-trial procedures, including the use of administrative liability mechanisms.
According to the law, control functions are assigned to:
- The Government of the Russian Federation - to the authorities exercising federal control and supervision;
- regional governments - to the authorities implementing regional control and supervision.
In particular, at the federal level:
- on Rostransnadzor - functions of control and supervision over ensuring the accessibility of transportation (including facilities and Vehicle) by air, rail, inland waterway, road transport;
- for Roskomnadzor - monitoring the availability of facilities and services in the field of communications and information;
- for Roszdravnadzor – control of provision special needs disabled people on quality and safety medical activities and in the field of drug supply;
- at Rostrud - monitoring the availability of facilities and services in the field of labor and social protection.
At the regional level, bodies are similarly defined that exercise control over the availability of services and facilities in those areas where it is generally already established by law.
Providing disabled people with technical means of rehabilitation
In 2017, to provide for disabled people technical means rehabilitation (RTR) allocated 32.84 billion rubles, which is 3.54 billion rubles more than in 2016 (29.3 billion rubles). This measure makes it possible to provide the necessary TSR to about 1.6 million people.
In 2018, 30.5 billion rubles are provided.
Considering that the provision of TSR and services is carried out on an application basis and requires the mandatory presence of appropriate recommendations in individual rehabilitation or habilitation programs, the issue of allocating additional funding will be resolved in 2018 as funds are disbursed, taking into account incoming applications.
Annual monetary compensation to disabled persons for the costs of maintenance and veterinary care of guide dogs
In 2017, the annual amount monetary compensation for disabled people, expenses for the maintenance and veterinary care of guide dogs increased by 5.39% compared to 2016 and amounted to 22,959.7 rubles.
In 2018, the amount of annual monetary compensation for disabled people for the costs of maintaining and veterinary care of guide dogs is subject to indexation from February 1 based on the consumer price growth index for the previous year.
The beginning of 2019 was marked by the fact that some federal laws, and in some cases their subsections, as well as acts or technical regulations relating to Russian disabled people. Government structures constantly strive to improve living conditions for this category of citizens. How many disabled people are there in Russia and what is their ratio to the total population, we will consider in this article.
Data for Russia
In the Russian Federation, over the years, the total number of disabled people (maybe insignificantly if we consider annual time periods) is constantly decreasing. So, starting from 2011, it decreased by one million people. Currently, the number of men with a group exceeds 5 million, and women – 6.9, there are 636 thousand children with any physical disabilities.
The majority of Russian disabled people have the second group. As of 2019, there were 4.394 million people with the third disability group. It should be noted that their number (in contrast to disabled people of the second and first groups) Lately increases. Over the previous five years they increased by 7.3%. The number of disabled people of group 1 today is 1.309 million people. However, this number is gradually decreasing every year. Over the past five years, their number has decreased by 2%.
The second group is the largest in numerical terms. It is 5.92 million people. At the same time, the number of disabled people per 1000 people taken from the entire population is constantly decreasing. If in 2011 their number was 92.5, then six years later (in 2017) it already became 83.5.
From total number children with disabilities in school age 176 thousand were registered. Moreover, in the 2017–2019 academic year, about seven thousand applicants with physical disabilities were enrolled in institutes and universities.
Many of them have been disabled since childhood. Learn the basics vocational education During the same period, more than eight thousand such boys and girls aged about 15 years old were admitted. Previously, these figures were significantly lower.
Ten years ago to the highest educational establishments a thousand fewer people arrived, and the number that was sought to be received at that academic year special education, was three thousand lower.
In 2019, the number of working disabled people was more than 1.1 million people
This represents about 32% of the total number of people who have a group and are of working age. The rest either cannot find a job because of their illness, or do not even look for it because they do not believe in the possibility of getting a certain job. However, in 2017, many regions began implementing programs to support young people with disabilities in employment. The results of these innovations will be visible in a few years.
The number of wheelchair users who live in the Russian Federation exceeds 320 thousand. Most of them belong to the first group. Some of them often walk with the help of crutches or a cane. They use strollers only when traveling long distances or when they come to ITU in them.
Disabled children
In recent years, more and more people with disabilities have early age found on the streets. This is due to the fact that previously in Russia most parents sent their children to boarding schools. Nowadays, mothers and fathers are increasingly taking care of their children themselves.
Children are increasingly living and being raised in a full-fledged family
Childhood disability is growing at a fairly rapid rate. At the beginning of 2017, the number of such disabled people in Russia was about 625 thousand, and already in 2019 this figure increased by 26 thousand people.
Just nine years ago their number was 495 thousand. Most often found at this age.
This includes children with disabilities mental development(autists, schizophrenics, epileptics and others).
According to the Minister of Labor and Social Protection Maxim Topilin, the number of disabled children is increasing due to a higher birth rate compared to previous years.
That is, disability does not increase, but remains at the same level, the percentage of babies born with any disabilities does not increase. It should also be taken into account that modern medicine is now able to save very premature newborns.
There is no common base for registering children with cerebral palsy in the country. Therefore, it is quite difficult to estimate their number. However, there is some data from 2010 on Moscow, according to which their number is about four and a half thousand children (data for the city only).
In recent years, many schools in Russia have been adapted for the needs of people with disabilities. However, not all parents agree with their studies healthy child in the same class or even in the entire institution with a disabled person. A survey was conducted in 2015. According to its results, about 17 percent of parents do not agree with their child’s education together with a disabled child. Approximately one tenth of adults could not answer this question definitively.
Pensioners – war veterans and disabled people
Over the entire period of the Great Patriotic War, over 2.576 million disabled people were demobilized from the front. Their number is constantly decreasing. According to the latest data for 2019, more than 16 thousand such citizens live in Russia. There are also about 80 thousand WWII participants and people who worked in air defense at that time. As of 2017, the amount of total material support for war participants with disabilities, together with pensions, additional and monthly payments, amounted to more than 40 thousand rubles.
War veterans who have become disabled have the right to receive two pensions - insurance (for age) and state (due to disability). Widows of soldiers killed in the war and citizens who received the “Resident of Siege Leningrad” award also have such rights.
As of 2017, there were more than two million two hundred thousand disabled people retirement age. Their number before 2015 was significantly less. The number of disabled pensioners has increased, including in connection with the annexation of Crimea to the Russian Federation.
Data by region
Statistics on the growth and decline in the number of people with limited mobility by region are summarized in a table.
| Year | Number of disabled people in various districts of the Russian Federation | |||
| Central. | Far Eastern. | Northwestern. | Southern. | |
| 1998 | 3 041 000 | 266 000 | 1 156 000 | 1 002 000 |
| 2003 | 3 405 000 | 366 000 | 1 350 000 | 1 026 000 |
| 2007 | 4 011 000 | 429 000 | 1 555 000 | 1 127 000 |
| 2012 | 3 927 000 | 439 000 | 1 566 000 | 1 132 000 |
| 2017 | 3 531 000 | 390 000 | 1 369 000 | 1 273 000 |
In the North Caucasus Federal District in 1998, the number of disabled people was less than 400 people, but in 2017 their number increased to one million.
Many experts believe that the decrease in the number of disabled people was simply the result of the introduction of updated criteria for recognizing a sick person as disabled. There are allegations that this was aimed at saving costs in social sphere. However, these experts are unable to deny many of the state’s actions that help rehabilitate this group in public life. The total number of disabled people is decreasing even after the adoption of new criteria.
Disabled people are a population group that includes people with disabilities life activity due to health conditions. Today there are quite a lot of such people. Previously, disability statistics Did not have of great importance. Now it is being carried out very carefully. Statistics allow not only to count the number of people with disabilities, but also provide information about their lives, difficulties, and needs.
These data are important for national policy. They allow us to assess how high-quality and effective programs for people with disabilities are implemented in the country.
World situation
The statistics of people with disabilities in the world is 23% of the total population of the planet. This is approximately more than 1 billion. According to WHO, the number of disabled people increases every year. Reasons for the increase in the number of people with disabilities:
- increase in the population of the planet;
- significant progress in medicine;
- increase in people.
In countries where people live 70 years or more, many people become incapacitated in old age. Among children and middle-aged people, 80% of disabled people live in developing countries ah, where the population has a low level of and. The picture shows the percentage of disabled people out of the total number of inhabitants in European countries.
Disability among children is a huge problem. Not only medical and social, but also economic. There are more and more people with disabilities in the world. This is a worrying trend. According to scientists, the numbers will continue to rise.
Employment of people with disabilities
The International Labor Organization reports that among the working-age population, almost 400 million are disabled. Many of them don't work anywhere. Most employers consider them incompetent. According to statistics, only 20% of the total number of working people are disabled. The remaining 80% are .
For example, in India, there are 70 million people with disabilities and only 0.1 million of them managed to get a job. In the United States, only 35% of employed citizens are in this category.
Many people with disabilities claim that they would like to work and receive a decent salary for it, but they are hardly accepted anywhere.
How is it going in Russia?
The statistics of disabled people in Russia in 2015 numbered more than 12 million people. Almost half of them are men and women of working age. That is, for every 10 thousand people there are approximately 59 citizens of the incapacitated category. Among them, the majority belong to the third group. There are fewer representatives of the first group.
An analysis of the statistics of disabled people across the country shows that we have much fewer of them than in European countries. Domestic indicators are among the lowest in the world. But this is not a reason to be proud. The reason lies not in the fact that our fellow citizens have excellent health. In Russia, in order to receive and then annually confirm their disability, people with disabilities often have to fight an imperfect system. Many patients are simply denied incapacity. Doctors often demand for disability registration.
The diagram shows the statistics of disabled people in the Russian Federation. It shows how the number of people with disabilities living in Russia changed from 1995 to 2005.
So, statistics on the number of disabled people in Russia and the world indicate that the number of disabled inhabitants of the planet is steadily increasing. This global problem of all humanity. Government officials should think about improving the situation.
More than one billion people (15% of the population) suffer from various forms disability. According to a WHO study, 785 million people aged 15 years and older live with a disability, of which 110 million suffer from severe forms of the disorder. Among children aged 0 to 14 years, these figures are 95 million and 13 million, respectively.
According to the World Health Organization (WHO), this figure is increasing due to the aging of the population and the increasing number of people suffering from chronic diseases directly related to disability: diabetes, cardiovascular diseases, mental disorders, etc.
In countries where life expectancy exceeds 70 years, disability years account for an average of about 8 years, representing 11.5% of the total. total duration human life.
The years associated with disability account for an average of about 8 years, which is 11.5% of a person's total life expectancy
According to the Organization for Economic Co-operation and Development (OECD), among population groups with more low level education, the disability rate is higher. The average for OECD countries is 19%, compared with 11% among people with more than high level education. According to the United Nations Development Program (UNDP), 80% of people with disabilities live in developing countries.
1. International documents on the status and rights of persons with disabilities
Comparative studies of disability laws indicate that only 45 countries have anti-discrimination and other disability laws. At the same time, there are a number of international provisions and standards that are of an informational or advisory nature.
2. International classification
International Classification of Functioning, Disability and Health (ICF) - developed by WHO and adopted by the World Health Assembly on May 22, 2001. The document describes the concept of “disability” in relation to physical health(the state of the body), the individual and society as a whole. The structure of the ICF is based on an assessment of the functions and condition of the human body, the level of social activity and participation in public life.
Features of the ICF approach to the concepts of “health” and “disability” are a shift in focus from the cause of the disease and its consequences to the assessment of all components of health, including social aspects disability and “contextual” factors ( environment And personal characteristics). The main idea set out in the document is that every person can experience deterioration in health, and the limitations in opportunities that arise in connection with this are not a characteristic phenomenon only for a certain social group.
Every person can experience deterioration in health, and the resulting limitations in opportunities are not a characteristic phenomenon only for a certain social group.
According to the ICF, a violation is a loss or deviation from the norm of a certain physiological function or body parts. The term "disability" is used to refer to individual characteristics functioning associated with physiological, sensory, mental, and perceptual impairments, as well as various types chronic diseases. Disability is considered in relation to three main aspects: organs and related functions and dysfunctions: paralysis, blindness, etc.; activity and activity limitations: inability to stand or sit, etc.; social activity and its limitations: discrimination in hiring, difficulties when moving around the city, etc.
Types (categories) of disability include various physiological and mental impairment, which make it difficult or impossible for a person to carry out everyday activities, and also complicate communication with others.
Mobility and physiological disorders
- disorders of the structure of the upper limbs;
- structural disturbances lower limbs;
- violations fine motor skills hands;
- coordination problems various organs bodies.
Mobility impairments can be congenital or acquired with age. They can also be the consequences of illness or injury. For example, people who have suffered a broken limb also fall into this category.
Disorders of the spinal cord structures
Injuries spinal cord often lead to lifelong health problems. As a rule, damage occurs as a result of serious accidents. Damage may be complete or incomplete. In case of incomplete damage, the conductive capacity of the nerve fibers of the spinal cord is partially preserved. In some cases, the damage may be the result of a birth injury.
Head injuries are disorders of the brain. Damage to the brain leads to disruptions in its functioning. The two main types of injuries are acquired and traumatic, and the degree of injury varies from mild to severe. The first type of damage is not congenital, but occurs after birth. The second type of damage is mainly due to the influence external influences: road traffic and domestic accidents, sports injuries, criminal incidents, recreational injuries, etc. Traumatic injuries can lead to emotional dysfunction and behavioral disorders.
Visual impairment
Hundreds of thousands of people suffer from vision problems ranging from minor to severe. Some disorders can lead to blindness over time. Most often, visual impairment is caused by damage to the cornea of the eye, damage to the white membrane of the eye, diseases caused by diabetes, dry eyes, and corneal transplants.
Hearing impairment
Hearing loss can be partial or complete. Deafness can be congenital or develop with age due to illness. For example, meningitis can cause damage to the auditory nerve or cochlea.
Perceptual impairments and learning disabilities
Perceptual disorders include dyslexia, various difficulties in acquiring knowledge, and speech disorders.
Mental disorders
Affective disorders- short-term or long-term mood or well-being disorders.
Mental disorders is a term used to describe the condition of people suffering from psychological problems or diseases, such as: personality disorders - inadequate patterns of behavior, in such severe forms that they do not allow a person to lead everyday life, socialize and, in general, maintain a normal lifestyle.
Schizophrenia- a mental disorder associated with the breakdown of thinking processes and emotional reactions.
Invisible violations differ in that they cannot be instantly recognized by others. As a rule, they have a neurological etiology. For example, not all people with visual impairments wear glasses, some experience chronic back pain when sitting or constant fatigue, suffer from sleep disorders, depression or agoraphobia, etc. According to statistics, 10% of US residents suffer from this type of impairment.
3. Accounting for disability
Geographically
Global Burden of Disease (GBD) is a group of indicators characterizing mortality and disability from major diseases, injuries and their risk factors. These indicators were identified as a result of comprehensive regional and/or global health statistical research World Health Organization.
WHO measures the global burden of disease (GBD) in years of life lost due to disability (DALYs). This time measure combines years of life lost due to premature mortality and years of life lost due to health conditions that do not meet criteria for full health. DALYs were developed during the original 1990 GBD study to provide a consistent estimate of the burden of disease by disease, risk factor and region.
Table 1. Global population with moderate and severe disabilities by region, gender and age. Data from the Global Burden of Disease Study, 2004 estimates
High income countries- these are countries whose Gross National Income (GNI) in 2004 was $10,066 or more (according to World Bank estimates).
Low income countries- these are countries whose Gross National Income (GNI) in 2004 was less than $10,066 (according to World Bank estimates).
The classification of diseases by form is given in Table 2. We propose hereinafter to consider severe form disability - an analogue of disability group I according to the classification adopted in the Russian Federation, average - disability group II.
The severity coefficient is calculated for both sexes and all age categories for the entire world population. In some cases, pathologies may occur in one person different degrees heaviness; in this case, he is assigned up to seven classes of disability. Severe disability corresponds to classes VI and VII, moderate - from III and above.
Table 2. Classification of disability groups in the Global Burden of Disease Study, showing chronic diseases and complications for each class
Due to disability
The most common causes of disability worldwide are adult-onset hearing loss and refractive hearing loss. Mental disorders such as depression, alcohol use disorders, mental disorders(For example, bipolar disorder and schizophrenia) are also among the 20 leading causes of disability. The picture between high- and low-income countries differs. In low-income countries, much more people have disabilities due to preventable causes, such as unintentional injuries and infertility resulting from unsafe abortions and maternal sepsis. Also, in low-income countries, disability due to unintentional injuries among young people and cataracts among older people are much more common.
Table 3. Prevalence of moderate and severe disability (millions) for key disabling diseases by age for high-, middle-, and low-income countries, Global Burden of Disease, 2004 estimates.
According to the age
Global aging has a significant impact on the development of disability. Higher levels of disability among older people reflect the fulfillment of accumulated health risks through injuries and chronic diseases.
Table 4. Age prevalence of disability by level of gross national product
Table 5. Age prevalence of disability by gender
The prevalence of disability is higher among people 45 years of age and older in low-income countries than in high-income countries, and higher among women than among men.
Table 7. Distribution of the number of people with disabilities by age using the example of Australia, Canada, Germany, Ireland, New Zealand, South Africa, Sri Lanka, USA (%)
4. Financial situation and payment structure
In Europe, social spending aimed at helping older people is designed to mitigate the risks that arise with old age - lower income levels, insufficient income, loss of independence in carrying out daily activities, decreased participation in social life, etc. At the same time, expenses for medical care the elderly should be assigned to another expense item - in connection with illness and the need for treatment. However, it is not always easy to strictly distinguish between them. In most EU countries, social spending in three areas - old age, death of a family member and disability - is highly interdependent. In order to ensure better comparability, the costs of assistance in connection with old age and in the event of the death of a family member are often combined, considering them together.
In 2007, social payments and benefits amounted to 25.2% of GDP in the EU-27
In 2007, social payments and benefits (excluding administrative costs and other expenses) amounted to 25.2% of GDP in the EU-27. The largest number of payments and benefits were allocated to assistance in connection with old age and the death of a family member - 46.2% of all social benefits and payments, or 11.7% of GDP, as well as in case of illness and the need for treatment - 29.1 % of total social payments and benefits in the EU-27, or 7.4% of GDP. For all payments in other areas social protection 6.1% of GDP was spent.
Picture 1. Social benefits and payments provided to the EU-27 in 2007, by purpose,%
Table 6. Amount and terms of disability payments per person per month,,
Disability - urgent problem, directly affecting the social and economic potential of any state. According to WHO, 15% of the world's population has some form of disability, with the majority of these people living in countries with relatively low incomes. Developing countries account for 4/5 of all disabled people in the world.
In 2006, Russia signed the UN Convention on the Rights of Persons with Disabilities, and six years later, ratified it, agreeing with the basic principles of policy regarding this group of citizens adopted in international community(note that only 45 countries in the world have laws regarding people with disabilities).
An obligatory component of work in this area is the accumulation of disability statistics, which is carried out in our country by Rosstat, Pension Fund Russia, the Ministry of Labor, etc. The information they provide is not always identical, since the methods used differ and the databases overlap. Nevertheless, it is obvious that the total number of disabled people has grown exponentially since the beginning of liberal reforms in Russia, and this growth does not stop (Fig. 1). Given the unfavorable demographic situation in the country, the share of disabled people in the total population is increasing even faster.
Rice. 1. Total number of disabled people in the Russian Federation, thousand people.
If you look at the dynamics of the number of people recognized as disabled for the first time, you will find a noticeable peak in 2005, notorious for the Government’s Monetization of Benefits, when medicines and Spa treatment were replaced cash payment. As a result, beneficiaries in need of expensive medications were left without them. The result is clearly visible on the graph (Fig. 2).
Rice. 2. Number of persons recognized as disabled for the first time (constructed according to Rosstat data)
According to unofficial estimates, the real number of disabled people in Russia exceeds that announced by state statistics services by approximately two to three times. An innovation will be the creation of a Federal Register of Disabled Persons, which will contain information about the assigned group, the degree of disability, social protection measures, etc. The register should start operating in January 2017, and the Pension Fund of Russia has been appointed its “curator”. The point is that the bases of individual departments, such as the Ministry of Defense, the Ministry of Health, plus regional bases of disabled beneficiaries will be combined into one.
The idea is good, but one of the key questions is whether officials will be able to ensure the confidentiality of information about Russian citizens. The very word “confidentiality” in our country is greatly discredited and the faith of our compatriots in the ability of the state to ensure the safety of personal information is low. People with disabilities are one of the most vulnerable categories who need to ensure their own safety, including information security.
In addition, when creating a single information system it is necessary to take into account the fact that a significant part of disabled people are physically unable to use " personal accounts"or simply does not have access to the Internet, and, therefore, receiving all the necessary services and access to social programs should be possible without the obligatory direct use of the electronic resource.
Officials are already warning that as a result of the creation of a unified register, the number of disabled people in the Russian Federation may change greatly, since today the existing databases overlap and duplicate each other. In addition, it has recently become fashionable in the government environment to explain the increase in the number of disabled people by the massive nature of unfounded decisions on granting disability.
Apparently as a result of this, in 2016 the procedure for determining disability, both for adults and for children, changed. The ideas about who is considered disabled and what assessment criteria to apply for this have been revised, while the functions of experts are performed by medical and social examination specialists (MSE), their commission should include only one doctor, for whose specialty there are no special requirements. That is, it is assumed that a person with a medical education can be fully competent in all possible nosological forms.
This is how he characterizes current system ITU Head of the Interregional Center for Independent Medical and Social Expertise Doctor of Medical Sciences Danilova S.G.: “The level is really low. There are few professionals: the leaders are weak, sometimes it is embarrassing to listen to them - they do not know regulatory documents, are poorly versed in the legislation, and experts in the regions lack the knowledge and competencies to understand and implement the orders of the Ministry of Labor of the Russian Federation. This is sad because the ITU system is an absolute monopoly. Her decisions cannot be challenged.".
As a result of the introduction of new criteria, disability statistics will, of course, improve, significant budget funds previously allocated to support disabled people will be saved, but social discontent will increase, since in an already difficult economic and political situation, the least protected part of society may lose state benefits and subsidies.
Following changes in the health assessment system and the procedure for assigning disability, there has already been a flurry of complaints from disabled people who have lost this status this year. The changes naturally affected not only adult citizens, but also children. For them, disability is an opportunity to receive free treatment in specialized clinics, receive medications, benefits, set the required school schedule, and purchase special equipment. It is also scary that parents, who have made incredible efforts to improve the health of their children, are, as a result of the reform, denied recognition of their children as disabled. Consequently, they are deprived of what is necessary to maintain and consolidate success. state aid, which threatens their children with new relapses.
The number of disabled children receiving social pensions in our country remains consistently high. Moreover, a sharp escalation of childhood disability occurred at the end of the twentieth century - if in the RSFSR in the 1990s, 155 thousand disabled children were registered with social protection authorities, then just ten years later the figure increased 4.4 times, reaching a value of 675 thousand. (Fig. 3).
Rice. 3. Number of disabled children under 18 years of age receiving social pensions (based on Rosstat data)
The dynamics of childhood disability are affected not only by purely medical factors, but also, for example, by military conflicts (according to the UN, for every child killed during hostilities, three remain disabled), dietary patterns, and the level of toxic addictions of parents (60–80%). In many cases, children's disability is caused by perinatal pathology and is associated with parental deviations).
The greatest growth over the past eight years has been achieved by following reasons disability: illness endocrine system, eating and metabolic disorders, mental and behavioral disorders, diseases nervous system and neoplasms. In the etiology of almost all listed diseases important role allocated to psycho-emotional trauma and stress. During the post-Soviet period, rates of primary childhood and adolescent morbidity increased by more than one and a half times (Fig. 4). Of course, not all diseases lead to disability, but general trend These data illustrate the deteriorating health status of the Russian population.
Rice. 4. Primary morbidity in children aged 0 to 14 years, calculated per 100 thousand children (based on Rosstat data)
The country's disability continues to increase, the healthcare system and medical and social examination are being reformed, and the criteria for assessing health status are changing. One thing is certain. The situation of disabled people is one of the most accurate criteria for the degree of civilization of a state and the level of moral state of society. At this stage of Russia’s development, the efforts undertaken are practically not bringing positive results, and behind every figure that appears or disappears in statistical reports are the physical and psychological torment of a particular person.
NOTES
World Health Organization and World Bank. World report on disability.
