Gayle-Geddes, A. (2015). Disability and Inequality: Socioeconomic Imperatives and Public Policy in Jamaica. New York: Palgrave MacMillan. ISBN 978-1-137-44925-2.

Reviewed by Jacqui Getfield
University of Toronto
j [dot] getfield [at] mail [dot] utoronto [dot] ca

Disability and Inequality: Socioeconomic Imperatives and Public Policy in Jamaica is the seminal book that examines disability as a development phenomenon in the Caribbean. Since author Annicia Gayle-Geddes has positioned the content within an international context, this book is of critical importance to international audiences, including policy analysts, policymakers, health care professionals, educators, disability advocates, and disabled persons. Arguably, there has never been a concerted effort to conduct research among the affected population and to analyze the considerable body of empirical data covering education, employment, and other social services for people with disabilities (PWDs) in Jamaica. This book is the first in the Caribbean to analyze both quantitative and qualitative data as it looks at the environmental, physical, and social impacts of a disabling society. It enunciates that in the context of the Caribbean many PWDs cannot access the economic and social life of their communities.

Disability and Inequality provides analysis according to disability type and severity, dissects the social environment occupied by PWDs, and distills the relationship between disability and socioeconomic inequality. In this important text, Gayle-Geddes recommends a set of strategies for future policymaking or, as articulated in the introduction, a

timely, rights-based policy making machinery for Jamaica, the Caribbean and similar southern countries to fulfill the CRPD [Convention on the Rights of Persons with Disabilities] and policy commitments to sustain existing progress through programs and to address structural systemic inequalities that continue to deny PWDs long-term sustainable development (6).

In the Caribbean, where the study of disability remains on the periphery of the development agenda, Gayle-Geddes is a pioneer in the field of disability studies. Her work responds to a field largely focused on children with disabilities and addresses the paucity of research on working age PWDs. Disability and Inequality provides an actionable strategic road map embodied in an evidence-based, theoretically grounded, and implementable public policy, what she calls a “Framework of Key Determinants for the Political and Socioeconomic Inclusion of PWDs across the Caribbean as well as in developing countries with similar characteristics in southern contexts” (6). This book will assist policymakers in the Caribbean and in countries such as Canada, the United States of America, and England, where Caribbean nationals are domiciled in large numbers as immigrants. A careful reading of Disability and Inequality will enable policymakers to establish and prioritize goals that foreground the vulnerabilities of Caribbean peoples. As with all good research, while the content may not be generalizable among all Canadian immigrants, this book can equip policymakers with transferrable knowledge.

In the first chapter, titled “The Globality of Disability, Human Rights and Development,” Gayle-Geddes outlines the theoretical framework used to conceptualize disability as an important public policy issue. She discusses the sociocultural environment and arguments upon which inequality and exclusion of PWDs are built, locally in Jamaica and internationally. Gayle-Geddes leans heavily on the sociopolitical model of disability which considers “the various forms of oppression evident in socioeconomic inequalities, challenges discrimination, and promotes equal rights of DPs [disabled persons]” (12). The first chapter concentrates on definitions of key terms and outlines concepts pertaining to disability, hegemony, and oppression.

Disability and Inequality paints a realistic picture of the challenges and frustrations experienced by PWDs of Jamaica due to attitudinal discrimination. The author explores institutional and environmental discrimination against disability that is fueled and sustained by a hegemonic, normalized construct of disability. Gayle-Geddes explains “the truncated human rights of PWDs and development are inextricably joined” (16). Stigma begets a cycle of denied access and the social and cultural exclusion of disabled persons, little or no development, and therefore persistent and systemic poverty and related dependence. Participation in the labour force is significantly determined by access to educational space. Since post-secondary enrolment is dependent on excellence at primary and secondary levels of education, it is no surprise that PWDs are not represented in any significant numbers. Without a post-secondary education, PWDs are challenged to find employment, which is necessary for economic independence, social engagement, and societal inclusion.

Chapter Two provides the reader with a number of opportunities to hear directly from interviewees including caregivers and PWDs. It is interesting to note that for both groups, disability is mainly defined according to the traditional charity model. Through Disability and Inequality, we learn that disability discourse in Jamaica has not yet transcended themes of limitation and personal impairments that obstruct function. The everyday lives of disabled persons are not yet a consideration of those who aim to better the lives of citizens of Jamaica. In giving us a window into the world of PWDs, Gayle-Geddes deconstructs the value-based sociocultural identity of disability. Awareness is a marker of education and a pre-requisite for meaningful change. Therefore, it is not surprising that Gayle-Geddes suggests that an ongoing reorientation of society would facilitate a shift toward more positive attitudes regarding disability as an identity. To this end, in the conclusion of the second chapter, the author rewards the reader with realistic sustainable recommendations specific to policy responses.

In Chapter Three, statistical data, Chi-Square tests, and regression analysis combine with the voices of PWDs to paint a picture of the challenges that result from inadequate educational opportunities for PWDs. In this chapter, the reader considers limitations in education and training advancements and the main barriers that promote systemic discrimination. Based on empirical data, the chapter concludes that special education is not the most effective and appropriate means of educating and training PWDs.

“Labour Market Inequality” is the title of Chapter Four, which explains the effect of the workplace barriers faced by people with disabilities in Jamaica. The ability to work is a rite of passage that signals the onset of adulthood for people in general, but since many PWDs remain unemployed and are deemed unemployable they are not able to make this transition. Disability and Inequality provides comparative statistical data representing gender and labour force participation in Jamaica, as well as employment and unemployment rates of both disabled and non-disabled persons. Prejudice and discrimination combined with low or non-existent expectations result in the unemployment and underemployment of disabled persons: “the underemployed condition of PWDs for extended periods in Jamaica reflects labour force liminality and inequality” (115).

Since PWDs of Jamaica are often paid low wages, and even below the nationally defined minimum wage, they are caught in a cycle of poverty, powerlessness, and hopelessness for improved conditions. This affects the trajectory for their children. As a result, they simply cannot afford a better future for their families on an island that does not have a welfare safety-net as secure as Canada’s. Gayle-Geddes’s challenge for the Jamaica’s public policy framework to integrate structural and financial commitments from the public, private, and non-governmental sectors is thus critically important. She explains: “piecemeal approaches from the public, private and NGO sectors will not realize the commitment to labour force equality” (118).

The concluding chapter offers a comprehensive account of an integrative framework for creating political and socioeconomic inclusion of PWDs in Jamaica. Described as a people-centred model, her Framework of Key Determinants for the Political and Socio-economic Inclusion of PWDs presents a required foundation of six distinct but interconnected enablers: “human rights, social protection and basic social services; diagnostic assessment, rehabilitation, and health care; communication, adaptive and environmental access; education and training; and employment” (125).

From a feminist perspective, there is much more work to be done regarding the subject of disability and persistent inequality that results from and is sustained by stigmatization, disregard, and continued systemic marginalization. And, when all is said and done, the real effect of public policy must be felt by the people who are most affected. Though comparatively, we are socioeconomically better positioned in Canada, there are many similarities to be drawn with Gayle-Geddes’s analysis of the Jamaican context. For populations of persons with disabilities in both countries, she offers an urgent call for governments, NGOs, and other agencies and corporations to attend to the socioeconomic disabling inequalities that continually and systemically subjugate.