Beyond burden: reframing disability in health and policy discourse

The word “burden” is embedded in health and policy discourse, from “disease burden” to portrayals of disability schemes as fiscal burdens. This commentary argues burden is not a neutral descriptor but a term that does political and conceptual work, aligning economic rationality with normative assumptions about which bodies are desirable and which lives are costly. Drawing on social, relational and rights-based models of disability, lived experience of short stature, and the resistance of disabled scholars and activists, we show how burden language locates disadvantage within individual bodies rather than in inaccessible environments, inadequate welfare and underfunded services that produce it. We extend this critique to artificial intelligence, where deficit-based definitions of disability risk being encoded into algorithmic eligibility and healthcare prioritisation. We propose reframing research questions toward the conditions shaping disabled people’s health and highlight responsibilities for health economists and policymakers, centring disabled people as recognised collaborators and leaders.