Equality of Opportunity: The Making of the Americans with Disabilities Act

Contours of Disability in America

Disability has a history. In colonial America, persons with disabilities were often viewed as part of the “deserving poor.” They were consequently accepted by local communities, where they contributed however possible and shared in the community’s offerings. But with the nineteenth-century industrial and market revolutions and the growth of a liberal individualistic culture, the cohesion of physical and geographic communities began to break down.¹ One consequence was that persons with disabilities, increasingly deemed unable to compete in America’s industrial economy, were spurned by society. Growing side-by-side with social structures catering to individual achievement were custodial institutions for those who did not “fit” with the American creed: persons with sensory impairments, reduced cognitive capacities, physical impairments, mental illnesses, or other conditions. Institutions supposedly “protected” these persons from public harm.² Institutions also allegedly protected society from those who were feared by many as dangerous and a threat to the gene pool. Some persons with physical disabilities were displayed as “freaks” of nature, to be marveled at like exotic animals.³ Such literary works as Herman Melville’s Moby Dick reinforced stereotypes of persons with disabilities as sinister, or even crazy, through such characters as the peg-legged Captain Ahab.⁴

Racism, ethnic imperialism, and xenophobia plagued early twentieth-century America. Darwin’s theories about the origin of species gave rise to universal theories about natural selection within humankind and the evolution of society.⁵ Many believed it was in the best interest of humanity to eliminate or at least curtail populations considered inferior, as witnessed in the treatment of African Americans and Jews. These ideas also adversely affected persons with disabilities, displayed most starkly in the 1927 Supreme Court case Buck v. Bell. 

Carrie Buck argued before the Court that state-imposed sterilization, based on disability, was unconstitutional. The Court disagreed. Instead, the Court sided with “experts” who alleged that persons with disabilities, namely those collectively classified as “the feeble-minded,” were “a menace” to society, threatened society’s “best citizens,” and tended to “sap the strength of the state.” Justice Oliver Wendell Holmes thought it best for society to seek to avoid “being swamped with incompetence.” He thus ruled that it was “better for all the world, if, instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind."⁶ Although sterilization and segregation practices targeted those classified as “feeble-minded” persons—or people with mental retardation, mental illness, and epilepsy—it reflected a general intolerance for those who allegedly did not fit the model for the rugged, individualistic, capitalistic American.

Significant developments over the course of the twentieth century, however, transformed the nature of disability in American life. These included demographic changes among persons and parents of persons with disabilities, the creation of disability organizations, and the growth of rehabilitation as a profession. In the early twentieth century, the demographics of disability changed as thousands of Americans acquired disabilities through industrial, work-place injuries. Moreover, World War I introduced thousands of veterans with disabilities, as did World War II, the Korean War, and the Vietnam War. In addition to the increased numbers of disabilities caused by injuries, Americans also began to live longer. Whereas in 1900 the average life span was 47 years, by 1980 life expectancy had increased to the age of 74. Since disability tends to increase with age, an older population meant an America with greater prevalence of disability.⁷ By 1980 at least thirty million Americans experienced disability first-hand. As all Americans, these persons wanted the best life possible and worked to get it. Increasing numbers of persons with disabilities made disability a societal challenge rather than a scattered, personal predicament.

As demographics changed, persons with disabilities began forming organizations to act as advocates for their interests. Early examples include the Disabled Veterans of America (DVA) and the National Mental Health Association (NMHA), both founded in 1920, and the National Federation of the Blind (NFB), founded in 1940. After World War II, this growth accelerated. The Paralyzed Veterans of America (PVA) opened its doors in 1946, the United Cerebral Palsy Associations (UCPA) began in 1949, the National Association for Retarded Citizens (ARC) was founded in 1950, the first Home Office of the National Association of the Deaf (NAD, originally founded in 1880) opened in 1953, and the American Council of the Blind (ACB) started its operations in 1961. These organizations dedicated their existence to improving the lives of their constituencies and gave persons with disabilities a stronger voice. They raised money, identified areas of need, and lobbied to pass legislation that would help solve problems. They looked for ways to achieve employment and to gain better education. By working with Congress and the judiciary to achieve their goals, they also gained valuable legal experience. As a result of these activities, they further imprinted disability on the American landscape.

Throughout the twentieth century a variety of professions developed to attend to the challenges posed by disability. By giving increased attention to persons with disabilities, physicians, researchers, nurses, physical and occupational therapists, and vocational rehabilitation counselors, and other professionals enabled many persons with disabilities to live healthier lives. New technologies, drugs, and devices enabled persons to live longer with lower incidence of secondary disabilities, and with greater control over their daily activities. It also helped transform disability rehabilitation into a full-fledged industry, which had the concomitant affect of making rehabilitation a commodity to be bought and sold in the marketplace.⁸ Moreover, professionals tended to focus their attention on specific disabilities, fostering the compartmentalization and fragmentation of people with disabilities.

As the numbers of persons with disabilities grew, and as they, their parents, organizations, and professionals worked to improve their lives, the attitudes manifest in Buck v. Bell came under attack: persons with disabilities, too, deserved to be part of society. National policy developments assisted in this transition. Over the course of the twentieth century, the scope and power of the Federal Government expanded to meet the growing demands of an industrializing nation. New legislative endeavors accordingly addressed disability issues. Reforms directed at corporate America provided benefits to persons injured on the job. By 1941, forty-five states ensured compensation for work-place injuries. The United States Public Health Service (USPHS), established in 1902, gave new attention to the importance of health care for society. The Veterans’ Rehabilitation Act of 1918 established a program for training veterans with disabilities. In 1920, the combined problems posed by industrial impairments and war veterans led to the Smith-Fess Act, which established the vocational rehabilitation program. By 1935, every state had a vocational program in operation, providing vocational training, job placement assistance, and counseling to those with physical disabilities. During World War II, Congress expanded the vocational rehabilitation program to offer “medical, surgical, and other physical restorative services” and to include services for the mentally ill and mentally retarded.⁹ Legislatures passed other laws directed toward greater access for persons with disabilities: for example, laws permitting the public use of guide dogs and white canes for blind persons.

The Social Security system also had a profound effect on persons with disabilities. In the 1950s, Congress amended the Social Security Act to provide income benefits to working-age people with disabilities who could not engage in any “substantial gainful activity.” In 1965, Congress established the Medicare and Medicaid programs that provided health care coverage to select groups of people with disabilities, as well as to elderly and lower income persons. Persons with disabilities could also be eligible for food stamps, school lunches, and housing subsidies if they met income tests. Although these programs demonstrated a recognition of disability as a matter of national concern, they would later prove to be a mixed blessing. While they provided much-needed income security, they could make paid employment less appealing.

Despite many improvements, problems for persons with disabilities were widespread: unemployment, lack of education, low income, and isolation. Moreover, most Americans still understood disability primarily as a problem that resided in the individual. They viewed disability as a “medical” problem that required medical supervision. People were to be “rehabilitated” to become “normal.” The public policy approach to disability, however, would be revolutionized in the wake of the 1960s.

1. Robert H. Wiebe, The Search for Order, 1877–1920 (New York: Hill and Wang, 1967).

2. David J. Rothman, Discovery of the Asylum: Social Order and Disorder in the New Republic (Boston: Little, Brown, 1971).

3. Rosemarie Garland Thomson, ed., Freakery: Cultural Spectacles of the Extraordinary Body (New York: New York University Press, 1996.)

4. Joseph Shapiro, No Pity: People with Disabilities Forging a New Civil Rights Movement (New York: Times Books, 1993), pp. 30–31

5. Carl N. Degler, In Search of Human Nature: The Decline and Revival of Darwinism in American Social Thought (New York: Oxford University Press, 1991).

6. Quoted in Timothy M. Cook, “The Americans with Disabilities Act: The Move to Integration,” Temple Law Review 64:2 (Summer 1991), p. 399.

7. Gerben DeJong and Raymond Lifchez, “Physical Disability and Public Policy,” Scientific American 248:6 (June 1983), p. 43.

8. Gary L. Albrecht, The Disability Business: Rehabilitation in America (Newbury Park, California: Sage Publications, Inc., 1992).

9. Senate Committee on Labor and Public Welfare, Rehabilitation Act of 1973: Report, 93rd Cong., 1st sess., July 16, 1973, Report No. 93-391, reprinted in 1973 USCCAN, pp. 2082–83.