Definitions of disability, impairment, and rehabilitation in the health sciences, social sciences, law, and economics: a meta-study review

Introduction The definitions we use to structure our research matter. In the context of rehabilitation research, the meaning, interpretation, and use of disability, impairment, and rehabilitation definitions have far reaching effects for clinical practice, policy development, and the advancement of rehabilitation science. Recognizing that definitions of disability, impairment, and rehabilitation vary widely, we sought to understand how these terms are defined and used in the health sciences, social sciences and the humanities, law, and economics. With this multidisciplinary perspective, we also sought to understand whether such definitions are grounded in or responsive to the experiences of people with disabilities, and if not, what effects this has for people with disabilities, and for those in need of rehabilitation. Methods Meta-study review methodology was used. A total of 269 items of multidisciplinary scholarship and case law were identified using systematic database searching, purposive sampling, and hand searching of Web of Science and Journal Citation Reports. Included materials were narratively synthesized. Results A wide range of definitions were identified; however, definitions of disability, impairment, and rehabilitation are predominantly shaped by conceptual models of disability such as the moral, religious, charity, (bio)medical, social, human-rights, ICF or biopsychosocial, crip, Mad, and Freak models. Scholarship critical of these models and related definitions highlight relevant scholarly issues pertaining to universalizing discourses, unquestioned Eurowestern ideologies about normativity, individualism, and race, and the exclusion of Indigenous and other non-Eurowestern knowledges, worldviews, and experiences embedded in the histories and use of these models and definitions. Discussion We found that available models and definitions of disability, impairment, and rehabilitation are not inclusive of the wide range of embodiments, sociocultural meanings, and historical conditions shaping experiences of and relationships with disability, impairment, and rehabilitation. We suggest that the definitions used in rehabilitation science need to be revisited and repaired to ensure that both rehabilitation research, and its application to clinical practice, policy and advocacy work is inclusive, equitable, and appropriate.