Definitions and determinants of handicap in people with disabilities.

Researchers have made a distinction between disability and its social and psychological consequences, now known as handicap, both conceptually and in terms of intervention. More work is needed in standardizing and refining the assessment of handicap and in highlighting risk factors for its development. Epidemiology has major contributions to make in understanding handicap in both aging and young populations. Data on the prevalence and incidence of handicap are scarce and difficult to obtain. Efforts are needed in the following areas: 1) contributing to the methodology of handicap assessment through the provision of valid and reliable scales; 2) defining and identifying risk factors for handicap formation, which underscores the need for analytic studies in this regard; 3) understanding the dynamics of these factors in the production of disadvantage, which calls for more qualitative and in-depth interviews with persons with handicaps; and 4) formulating critical points of intervention at the personal and community levels for handicap prevention. Such efforts will assist policy-makers in formulating appropriate and acceptable policies for safeguarding the opportunities of people with disabilities, ensuring their optimal participation in society, and enabling them to lead independent and self-sufficient lives. Efforts to evaluate the effect of legislation, both existing and recent, on handicap development are also called for. These efforts may help to reduce the gap between disabled and nondisabled people and improve the quality of life for people with disabilities and their families.