WHO statistics on diseases of children with disabilities. World Report on Disability. Central Federal District

Since 1998, there has been a steady downward trend in the number of disabled people in Russia, which is largely due to changes in the legislation on the procedure for recognizing a person as disabled. Since 2010, a negative trend in disability has been observed only in the first two disability groups, while the number of disabled group III and disabled children is increasing.

Figure 1. The total number of disabled people in the Russian Federation as of January 1, 2016, thousand people

Figure 2. The total number of disabled people by disability groups as of January 1, thousand people

Below is the general distribution by sex and age. As of January 1, 2015, 65% of all Russian disabled people registered with the Pension Fund of the Russian Federation belong to the category of citizens older than working age. 30% are people of working age, among which the largest group is citizens aged 31 to 59 for men and 31 to 54 for women.

Figure 3. Distribution of disabled people by sex and age as of January 1, 2015, thousand people

More information on the number of people with disabilities in each age group can be found in the figure below. At the time of writing, the latest statistics for this indicator date back to 2014. The data are given in percentages, the study is based on a sample, the size of which is not specified. The largest proportion of disabled people (one third of all those surveyed) represent the older age group - 60-72 years. It also recorded the largest percentage of economically inactive disabled people. Among economically active citizens with disabilities, the peak of disability occurs at 50-54 years.

Figure 4. The structure of persons with disabilities by age groups in 2014 (according to the sample survey of the population on employment issues), %

1. Data on persons recognized as disabled for the first time

According to the Ministry of Labor of the Russian Federation, as of 2015, 695,000 people were recognized as disabled for the first time, of which 125,000 are group I, 262,000 are group II, and 308,000 are group III.

325 thousand citizens recognized as disabled for the first time are of working age (up to 60 years for men, up to 55 years for women), which is 47% of the total number of persons who first examined disability in 2015.

Figure 5. Number of people recognized as disabled for the first time in 2015, people

Among the most common causes of disability, according to data for 2015, are diseases of the circulatory system (221 thousand people) and diseases accompanied by malignant neoplasms (213 thousand people)

Visual disability was recorded in 22 thousand people who received the status of a disabled person in 2015. Since 2008, the proportion of people with diseases of the organs of vision has changed quite slightly, therefore, it can be assumed that in Russia at the moment there are approximately 400 thousand people who have received the status of a disabled person for this reason. However, a caveat is necessary: ​​the calculation does not take into account other cases of illness or injury, accompanied by partial or complete loss of vision. Consequently, the real number of visually impaired is much higher. This conclusion also applies to other priority categories for us: disabled people with impaired hearing, hearing and vision, mental functions, musculoskeletal system, etc.

According to the results of the Russian census of the deaf-blind, conducted with the support of the So-edinenie Foundation, for every 7,500 people with visual impairments, there is one deaf-blind.

Direct impairment of the functioning of the hearing organs was recorded in 12 thousand disabled people registered in 2015, which is approximately 2% of the total number of disabled people. However, according to the All-Russian Society of the Deaf (VOG), approximately eight to nine million people throughout Russia have various hearing impairments. Among them are approximately 1.5 million people with severe hearing impairment and 250-300 thousand totally deaf. According to our calculations, there are about 255,000 people who have received disability status for ear and mastoid diseases.

According to the World Health Organization (WHO), by 2020 the number of people suffering from hearing loss will increase by 30%.

According to the World Health Organization (WHO), by 2020 the number of people suffering from hearing loss will increase by 30%. According to selective statistics and WHO data, there are currently about a million children and adolescents with hearing impairment in Russia. In recent years, there has been an increase in the number of children suffering from various forms of hearing impairment in our country.

In addition, about a million Russian disabled people have a certified disability due to diseases of the nervous system and disorders of the psyche and behavior.

Figure 6. Distribution of the number of people recognized as disabled for the first time, by reason of disability (data from the Russian Ministry of Labor, Rosstat calculation)

2. Financial situation, structure of cash payments

For the disabled, monthly cash payments (UDV) are provided. For different categories of citizens, the size of the UDV is different.

Also, a disabled person is entitled to social payments, part of which is carried out by the Pension Fund of Russia, and the other part - by the executive authorities of the constituent entities of the Russian Federation. Information on regional payments can be obtained from the authorized executive body of the subject of the Russian Federation at the place of residence.

Citizens who are recognized as disabled in accordance with the established procedure are entitled to one of the types of disability pension:

• disability pension;
• disability state pension;
• social disability pension.

If an unemployed able-bodied citizen takes care of a disabled person, then he has the right to apply for a monthly or compensation payment. The type and amount of the payment depends on the category of the disabled person being cared for, as well as on the status of the caring citizen.

The total number of disabled people registered in the system of the Pension Fund of the Russian Federation in 2016 is 12.4 million people.

The statistics also include persons registered and receiving a disability pension in the system of the Pension Fund of the Russian Federation, the Ministry of Defense of Russia, the Ministry of Internal Affairs of Russia and the Federal Security Service of Russia. Since January 1, 2008, the statistics include persons registered and receiving a pension in the Federal Penitentiary Service of the Ministry of Justice of Russia. The data provided by the Federal Statistical Service on the average size of assigned disability pensions indicate the figure of 11,972.9 rubles.

The average size of assigned disability pensions is 11,972.9 rubles.

This indicator is an average and includes various types of pensions, the amounts of which vary considerably: for example, the state disability pension in some cases can range from 14,900 to 24,800 rubles, while the amount of a social pension ranges from 4,215 to 9,919 rubles, depending on from the disability group.

The amount of UDV (monthly cash payments) remains fixed and does not depend on the district coefficient established by the Government of the Russian Federation depending on the area (locality) of residence. However, certain categories of disabled people (for example, war invalids or disabled people who depend on two or more people) can receive an increased monthly cash payment due to increased pensions and benefits.

Figure 8. Average amount of monthly cash payments per person from the federal budget of the Russian Federation, as of January 1, 2016, rub.

The total number of people with disabilities who receive the UDV is 12,163,029 people, which is approximately 97% of the number of all people with disabilities registered in the PF system of the Russian Federation.

Figure 9. Number of people with disabilities by disability groups receiving monthly cash payments (CDI) and amounts of payments

Survey data on the subjective assessment of their financial situation by households with disabled people indicates that about half of them experience difficulties: 44% - when buying clothes and paying utility bills, and another 43% cannot afford the purchase of durable goods .

The figure below shows the general indicators for assessing the financial situation for the population as a whole. Households with disabled people in their composition noticeably more often indicated difficulties with buying clothes and paying utility bills. With regard to the purchase of durable goods, the shares of responses for the population and among persons with disabilities are similar.

From the above data, it follows that families with disabled children in general assess their financial situation better than households consisting of disabled people of older age groups (over 18 years old).

Figure 10. Assessment of their financial situation by households with disabled people (according to the Comprehensive Observation of the Living Conditions of the Population in 2014), %

Figure 11 shows the income structure of households with persons with disabilities. The largest share of household income is assigned to social payments (88%), of which 66% are pensions and 22% are allowances and compensations of various kinds.

Figure 11. The structure of monetary income of households consisting of persons with disabilities (according to sample observation of household income and participation in social programs for 2014), %

3. Public life, Internet

According to a survey of citizens with an established disability group and / or receiving a disability pension, in 87% of cases, respondents subjectively assessed their own inability to lead an “active lifestyle on an equal basis with everyone else” (the wording is not specified). Probably, this situation is explained by the fact that, as we have seen, more than eight million Russian disabled people are elderly people; on the other hand, the social environment and the lack of necessary infrastructure can serve as an obstacle.

Figure 12. Availability of the ability to lead an active lifestyle by people with disabilities aged 15 years and over in 2014 (according to the Comprehensive Monitoring of Living Conditions of the Population), %

According to the Comprehensive Monitoring of Living Conditions of the Population, only about 3% of all registered disabled people are active members of voluntary non-profit organizations.

Figure 13. Number of people with disabilities aged 15 and over who are members of voluntary non-profit organizations in 2014 (according to the Comprehensive Monitoring of Living Conditions of the Population), %

15% of respondents said that they could access the Internet, but in the overwhelming majority of cases, the respondents do not have access to the Internet. Of course, respondents aged 15 to 29 stand out against this background - 54% have the opportunity to use the Internet. However, these statistics do not allow us to speak with confidence about the prevalence of the practice of using the Internet among people with disabilities.

Figure 14. Availability of access to the Internet among disabled people aged 15 years and over in 2011 (according to the Comprehensive Monitoring of Living Conditions of the Population), %

4. State registration of disabled people

Information on state statistics on disability issues, including a complete list of citizens with certified disabilities, is maintained by the Pension Fund of the Russian Federation, the Ministry of Health of the Russian Federation, and the Ministry of Labor and Social Protection of the Russian Federation (some information on disability may also be contained in the documents of law enforcement agencies in the event that when it comes to injuries received as a result of military operations and the performance of official duties).

The vast majority of citizens recognized as disabled are registered with the Pension Fund of the Russian Federation, which determines the procedure for social payments for disability. The payment of pensions and other social benefits is possible only if the person is examined and the status of disability is recognized.

Examination of disability is carried out by decision of the Bureau of Medical and Social Expertise (BMSE): as of 2015, 1728 branches were registered in the territory of the Russian Federation. Reception and examination (including re-examination) of citizens is carried out in the district offices of the BMSE.

All subsequent documentation is administered by the Federal Bureau of Medical and Social Expertise. An exhaustive list of the results of examinations may be contained in the automated database of the scientific and methodological center of the Federal Bureau of Medical and Social Expertise.

The allocation of the relevant segment from the total mass of bank customers can be carried out, among other things, by calculating and fixing the average amount of cash payments for disability. For example, the size of the social disability pension is established by the state and is subject to changes only on the basis of relevant acts or indexation (recall that in 2016 for group III - 4215.90 rubles, for group II - 4959.85 rubles, for group I - 9919.73 ruble, for disabled children - 11,903.51 rubles).

When calculating, it is necessary to take into account the fact that the same person can receive more than one type of social benefits, as well as the fact that the amounts of other pensions are not fixed and are calculated individually.

When calculating, it is necessary to take into account the fact that the same person can receive more than one type of social benefits, as well as the fact that the amounts of other pensions are not fixed and are calculated individually. For example, an insurance (labor) pension is calculated by summing up the base amount (depending on the degree of incapacity for work) with the amount of personal accumulated pension funds divided by the duration of probable survival (the norms are 228 months). The calculation is influenced by district coefficients, the presence of dependents (for child care), living in the Far North and experience (20 years of experience give the right to receive a pension at a higher rate). The state pension is calculated from the amount of the social pension (that is, ultimately also fixed), multiplied by a value from 100% to 300%, but the circle of its recipients is noticeably narrower. The coefficient is affected by the group of disability and the basis for receiving a state pension.

Segmentation by enrollment of UDV is possible, but taking into account the category of disability, the fact of having a social package and other circumstances (for example, for a disabled person of group I, the amount of payment from February 1, 2016 is 3357 rubles 23 kopecks (with a social package).

In our country, a classification has been adopted that includes three groups of disability.

Group I is assigned to persons with complete permanent or long-term disability who need constant outside care, supervision or assistance.

Group II disability is established for those who have significant functional impairments and almost complete disability, but who do not need outside care and assistance, that is, who are able to serve themselves independently.

The establishment of the third group of disability provides for the possibility of extending employment.

The total number of disabled persons includes persons registered and receiving a pension in the system of the Pension Fund of the Russian Federation, the Ministry of Defense of the Russian Federation, the Ministry of Internal Affairs of the Russian Federation and the Federal Security Service of the Russian Federation and the Federal Penitentiary Service of the Ministry of Justice of Russia. Rosstat calculation.

According to the Pension Fund of the Russian Federation, from the Federal Register of Persons Eligible for State Social Assistance.

In the world, more than one billion people (15% of the population) suffer from various forms of disability. According to a WHO study, 785 million people aged 15 years and older live with a disability, of which 110 million suffer from severe forms of disability. Among children aged 0 to 14, these figures are 95 million and 13 million, respectively.

According to the World Health Organization (WHO), this figure is increasing due to the aging of the population and an increase in the number of people suffering from chronic diseases directly related to disability: diabetes, cardiovascular diseases, mental disorders, etc.

In countries where life expectancy exceeds 70 years, disability-related years account for an average of about 8 years, representing 11.5% of a person's total life expectancy.

Years associated with disability account for an average of about 8 years, which is 11.5% of the total life expectancy of a person

According to the Organization for Economic Co-operation and Development (OECD), population groups with lower levels of education have higher rates of disability. On average for OECD countries, it is 19%, compared with 11% among the population with a higher level of education. According to the United Nations Development Program (UNDP), 80% of people with disabilities are in developing countries.

1. International instruments on the status and rights of persons with disabilities

Comparative studies of disability legislation show that only 45 countries have laws against discrimination and other laws relating to persons with disabilities. At the same time, there are a number of international regulations and standards that are informational or recommendatory in nature.

2. International classification

International Classification of Functioning, Disability and Health - ICF (International Classification of Functioning, Disability and Health, ICF) - developed by WHO and adopted by the World Health Assembly on May 22, 2001. The document describes the concept of "disability" in relation to physical health (body condition), the individual and society as a whole. The structure of the ICF is based on an assessment of the functions and condition of the human body, the level of social activity and participation in public life.

Features of the ICF approach to the concepts of "health" and "disability" - a shift in focus from the cause of the disease and its consequences to the assessment of all components of health, including the social aspects of disability and "contextual" factors (environment and personality traits). The main idea set out in the document is that every person can experience a deterioration in health, and the resulting disability is not a characteristic phenomenon only for a certain social group.

Everyone can experience deterioration in health, and the resulting disability is not a characteristic phenomenon only for a certain social group.

According to the ICF, a disorder is the loss or deviation from the norm of a certain physiological function or part of the body. The term "disability" is used to refer to individual functioning characteristics associated with physiological, sensory and mental impairments, perceptual disorders, as well as various types of chronic diseases. Disability is considered in relation to three main aspects: organs and related functions and dysfunctions: paralysis, blindness, etc.; activity and activity limitations: inability to stand or sit, etc.; social activity and its limitations: discrimination in employment, difficulties in moving around the city, etc.

Types (categories) of disability include various physiological and mental disorders that make it difficult or impossible for a person to perform daily activities, as well as complicate communication with others.

Mobility and physiological disorders

• violations of the structure of the upper limbs;
• violations of the structure of the lower extremities;
• violations of fine motor skills of the hands;
• incoordination of various organs of the body.

Mobility disorders can be congenital or acquired with age. They can also be the result of illness or injury. For example, people who have a fractured limb also fall into this category.

Violations of the structures of the spinal cord

Spinal cord injuries often lead to lifelong health problems. As a rule, damage occurs as a result of serious accidents. Damage can be complete or incomplete. In the case of incomplete damage, the conductive capacity of the nerve fibers of the spinal cord is partially preserved. In some cases, damage may be the consequences of birth trauma.

Head trauma is a disorder of the brain. Brain damage leads to disruption in its work. There are two main types of injuries - acquired and traumatic, the degree of damage varies from mild to severe. The first type of damage is not congenital, but occurs after birth. The second type of injuries is mainly due to the influence of external influences: traffic and domestic accidents, sports injuries, criminal incidents, recreational injuries, etc. Traumatic injuries can lead to emotional dysfunction and behavioral disorders.

visual impairment

Hundreds of thousands of people suffer from various visual impairments - from minor to serious. Some disorders can lead to blindness over time. Most often, visual impairments are caused by damage to the cornea of ​​the eye, damage to the white of the eye, diseases provoked by diabetes, dry eyes, corneal transplants.

Hearing disorders

Hearing loss can be partial or complete. Deafness can be congenital or develop with age due to diseases. For example, meningitis can cause damage to the auditory nerve or cochlea.

Perceptual disturbances and learning disabilities

Perceptual disorders include dyslexia, various difficulties in acquiring knowledge, and speech disorders.

Mental disorders

affective disorders- short-term or long-term mood or well-being disorders.

Mental disorders- a term that is used to describe the condition of people suffering from psychological problems or diseases, such as: personality disorders - inadequate behavior patterns, in such severe forms that they do not allow a person to lead a life, socialize and, in general, maintain a normal lifestyle.

Schizophrenia- mental disorder associated with the disintegration of thought processes and emotional reactions.

Invisible Violations differ in that they cannot be instantly recognized by others. As a rule, they have a neurological etiology. For example, not all people with visual impairments wear glasses, someone experiences chronic back pain when sitting or constant fatigue, suffers from sleep disorders, depression or agoraphobia, etc. According to statistics, 10% of US residents suffer from this type of impairment.

3. Accounting for disability

Geographically

Global Burden of Disease (GBD) is a group of indicators that characterize mortality and disability from major diseases, injuries and their risk factors. These indicators have been identified as a result of comprehensive regional and / or global medical statistical studies of the World Health Organization.

WHO measures the global burden of disease (GBD) in terms of years of life lost due to disability (DALYs). This temporal measure combines the years of life lost due to premature death and the years of life lost due to health conditions that do not meet criteria for full health. The DALY indicator was developed during the original 1990 GBD study to provide a consistent estimate of disease burden by disease, risk factor and region.

Table 1. World population with moderate and severe disabilities by region, sex and age. Data from the Global Burden of Disease study, 2004 estimate

High income countries- These are countries whose Gross National Income (GNI) in 2004 was $10,066 or more (according to World Bank estimates).

Low income countries- These are countries whose Gross National Income (GNI) in 2004 was less than $10,066 (according to World Bank estimates).

The classification of diseases according to forms is given in Table 2. Here and below, we propose to consider a severe form of disability as an analogue of disability group I according to the classification adopted in the Russian Federation, and an average form - II disability group.

The severity coefficient is calculated for both sexes and all age categories for the entire world population. In some cases, one person may have pathologies of different degrees of severity; in this case, he is assigned up to seven classes of disability. The severe form of disability corresponds to classes VI and VII, the average form - from III and above.

Table 2 Classification of disability groups in the Global Burden of Disease study, with indication of chronic diseases and complications for each class

Due to disability

The most common causes of disability worldwide are adult hearing loss and refractive hearing loss. Psychiatric disorders such as depression, alcohol use disorders, psychiatric disorders (such as bipolar disorder and schizophrenia) are also among the top 20 causes of disability. The picture is different between high- and low-income countries. In low-income countries, many more people are disabled due to preventable causes such as unintentional injury and infertility resulting from unsafe abortions and maternal sepsis. Also, in low-income countries, disability due to unintentional injuries among young people and cataracts among the elderly are much more common.

Table 3. Prevalence of moderate and severe disability (millions) for key disabling diseases by age for high-, middle- and low-income countries, Global Burden of Disease, 2004 estimate.

By age

Global aging has a significant impact on the development of disability. The higher rate of disability among older people reflects the fulfillment of accumulated health risks through injury and chronic disease.

Table 4. Age prevalence of disability by gross national product

Table 5. Age prevalence of disability by sex

The prevalence of disability among people aged 45 and over in low-income countries is higher than in high-income countries and is higher among women than among men.

Table 7. Distribution of the number of people with disabilities by age on the example of Australia, Canada, Germany, Ireland, New Zealand, South Africa, Sri Lanka, USA (%)

4. Financial situation and structure of payments

In Europe, social spending directed towards helping older people is designed to mitigate the risks that arise with the achievement of old age - lower income levels, lack of income, loss of independence in daily activities, reduced participation in social life, etc. At the same time, spending for medical care for the elderly should be attributed to another item of expenditure - in connection with illness and the need for treatment. However, it is not always easy to strictly distinguish between them. In most EU countries, social spending in three areas - in connection with old age, the death of a family member and disability - are highly interdependent. In order to ensure better comparability, the cost of assistance for old age and for the death of a family member is often combined, considering them together.

In 2007, social payments and benefits in the EU-27 amounted to 25.2% of GDP

In 2007, social payments and benefits (excluding administrative costs and other costs) in the EU-27 amounted to 25.2% of GDP. Most payments and benefits were directed to help in connection with old age and on the occasion of the death of a family member - 46.2% of all social benefits and payments, or 11.7% of GDP, as well as on the occasion of illness and the need for treatment - 29.1 % of total social transfers and benefits in the EU-27, or 7.4% of GDP. 6.1% of GDP was spent on all payments in other areas of social protection.

Figure 1. Social benefits and payments provided in the EU-27 in 2007, by purpose, %

Table 6. Amount and conditions of disability payments per person per month,,

The disability of society is the scourge of our time!

As of 01.01.2018 the number of disabled people in Russia is - 11,750,000.0 for a population of 146,800,000.0 people. Just think about these figures, this is about 8% of the population.

1,083,000.0 are citizens who have received their disability since childhood, their number is 9.21% of the total number of people with disabilities in Russia. For children, the statistics are also sad, as of 01/01/2018. disabled children under 18 years old in the Russian Federation - 655,000.0 is 5.6% of the total number of disabled people.

If you look at the statistics, the percentage of children with disabilities is growing, despite the demographic decline. The population is practically unchanged, only due to migration growth. The natural increase has been in huge minus since 1992.

The number of disabled children registered in the pension fund system of the Russian Federation

The results of primary examinations of children under the age of 18 and recognized as disabled in the category "disabled child"

The results of re-examination of disabled children under the age of 18 and were repeatedly recognized as disabled in the category "disabled child"

If we take into account children who were first recognized as disabled due to diseases of the nervous system, as well as children with mental and behavioral disorders, then the picture does not look rosy at all.

Also pay attention to the statistics by region. There are regions where there are many times more children with disabilities than the average throughout Russia.

All data was obtained from the official website of the Federal State Statistics Service. And taking into account the fact that in Russia there has been no natural increase in the population since 1993, the statistics are not entirely accurate, because. in the population, migration growth is taken into account, which is very high - 250/300 thousand annually. According to statistics, an average of 700 thousand people since 1992. declined every year.

From 2007 to 2017, state support programs managed to reduce the population decline to 118 thousand on average per year. But here, too, there are kinks. Since Russia began to fight against infant mortality and nurse non-viable children born at short terms, the number of disabled children has increased. Almost every premature baby is at risk for cerebral palsy.

Let's hope that our State keeps abreast, and will continue to take steps aimed at the health of the nation, to increase natural growth. And it would be great to give the parents of sick children the opportunity to go to work and benefit the State, give birth to healthy children. By creating kindergartens with medical services for children with disabilities, where they accept not only walking children, but also those who do not serve themselves. Thus, it would be possible to save many families from disintegration, to give the mothers of such children the opportunity to realize themselves in the professional sphere, to give birth to a healthy child in the future, thanks to State support measures.

As of November 1, 2017, there are 12.12 million disabled people in the Russian Federation, including 643.1 thousand children with disabilities.

Federal Register of Disabled Persons

On January 1, 2017, the federal state information system - the federal register of disabled people - was put into operation.

In the register, each disabled person has access to a “personal account”, which reflects information on all cash payments and other measures of social support for a disabled person, on the progress of his individual rehabilitation or habilitation program.

Through the "personal account" you can receive public services in electronic form, leave feedback on their quality and, if necessary, file a complaint.

The register makes it possible to exclude multiple appeals of persons with disabilities to various authorities, improve the quality of state and municipal services provided to persons with disabilities, more fully inform persons with disabilities about their rights and opportunities, and also ensures the creation of a database that takes into account the needs of persons with disabilities, their demographic composition and socio-economic situation.

The data obtained are used to develop a state policy regarding the disabled and to develop strategic planning documents both at the federal level and at the level of subjects of the Federation and municipalities.

State Program of the Russian Federation "Accessible Environment"

Within the framework of the State Program "Accessible Environment" for 2011-2020, with state support with the active participation of public organizations of people with disabilities, the facilities most in demand by people with disabilities and people with limited mobility are adapted in priority areas of life - health care, social protection, sports and physical culture, information and communication , culture, transport infrastructure, education.

The ongoing measures to create accessibility conditions make it possible to provide an integrated approach.

During the implementation of the state program, methods and approaches were developed to identify and eliminate barriers that hinder people with disabilities in various life situations, as well as mechanisms to involve people with disabilities not only at the stage of implementing events, but also to take an active part in the stage of developing events.

Thus, in the field of transport and transport infrastructure, it is planned to reach the indicator of 11.1% of land transport equipped for the disabled by the end of 2017. At the beginning of the implementation of the state program, it was 8.3%.

In the field of information and communications, an event is being implemented to subtitle television channels. This work is funded by the state program, and by the end of 2017, the number of produced and broadcast subtitles for subtitling television programs of all-Russian mandatory public channels will be 15,000 hours (at the beginning of the implementation of the State program there were only 3,000 hours).

In the health sector, by the end of 2017, the share of priority facilities available to the disabled and other people with limited mobility will be 50.9%, in the field of culture - 41.4%, in the field of sports - 54.4%.

In the field of education, 21.5% of schools are adapted, while at the beginning of the implementation of the state program, there were a little more than 2% of such schools.

On January 1, 2016, the implementation of a new subprogram of the state program was launched, which is aimed at improving the comprehensive rehabilitation and habilitation of the disabled and children with disabilities. It is planned that the result will be the creation of a modern system of complex rehabilitation.

The relevance of the implementation of this subprogram lies in the fact that now in the country there are no unified methodological and regulatory documents for organizing the rehabilitation process for people with disabilities, there are no unified methods for assessing the effectiveness of the rehabilitation measures taken.

In this regard, at the first stage, during 2016, such documents were developed, and in 2017-2018 a pilot project is being carried out to form a system for the comprehensive rehabilitation of disabled people and children with disabilities. Since the beginning of 2017, a pilot project has been implemented in the Sverdlovsk Region and the Perm Territory. About 300 million rubles annually are allocated in the federal budget for the implementation of the pilot project. The results of the implementation of the pilot project will form the basis of the draft law, which will allow organizing an effective rehabilitation process outside the scope of the state program.

By decision of the President of Russia Vladimir Putin, the State Program "Accessible Environment" should be extended until 2025. This will allow us to further consolidate the efforts of the federal center and the regions in the issue of integrating disabled people into society.

When developing the state program "Accessible Environment" until 2025, it is proposed to single out three main areas:

• increasing the level of accessibility of the most significant facilities and services for persons with disabilities, including the creation of conditions for visiting such facilities;
• formation of a modern system of comprehensive rehabilitation of disabled people, including the development of technologies for accompanying disabled people in various life situations, as well as the development of "early help" for disabled children;
• modernization of the state system of medical and social expertise.

Assisted Employment Bill for the Disabled

On November 21, 2017, the State Duma of Russia approved in the third reading the draft federal law on amendments to the Law of the Russian Federation "On Employment in the Russian Federation".

The bill aims to bring the current employment law in line with the provisions of the UN Convention on the Rights of Persons with Disabilities, which was ratified by Russia in 2012.

Its development is associated with the lack of efficiency in the employment of people with disabilities of working age. The share of working people with disabilities of working age in our country is about 31.8% (about 1.1 million people) of the total number of people with disabilities of working age (about 3.7 million people). Of these, only 25% are stable workers, in European countries this figure reaches 40%.

Employment service bodies work with people with disabilities, not taking into account the fact that they have significant disabilities.

The draft federal law defines a mechanism for the interaction of institutions of medical and social expertise and employment service bodies with assistance in finding a disabled person for employment.

Since June 2017, the institutions of medical and social expertise in extracts from individual rehabilitation programs for people with disabilities sent to the employment service have indicated information about the consent of the disabled person to the initiative of the employment service specialists to contact him directly.

And the following functions are planned to be assigned to the employment service bodies:

• conducting an initial consultation with a disabled person;
• analysis of the database of vacancies;
• organization of interaction between a disabled person and an employer;
• providing advisory and methodological assistance to the employer;
• determination of the need for escort with the assistance of the employment of a disabled person.

Accompanying with the assistance of the employment of persons with disabilities is understood as the provision of individual assistance to those persons with disabilities who, due to limited health opportunities, experience difficulties and cannot independently find a job or return to the labor process.

Improvement of medical and social expertise

In May 2017, a road map was approved to improve the system of medical and social expertise. It sets out key areas of action for the period up to 2020.

The first direction involves the improvement of scientific, methodological and legal support for medical and social expertise. Separate classifications and criteria for establishing disability for children have been developed and tested; new criteria are being developed to determine the degree of loss of professional ability to work as a result of accidents at work.

The second direction is to increase the availability and quality of the provision of medical and social expertise services. It includes activities to train specialists of ITU institutions, equip ITU institutions with special diagnostic equipment, form public councils at the main ITU bureaus, and conduct an independent assessment of the quality of the conditions for providing ITU services.

Law on the implementation of control over the accessibility of the environment for persons with disabilities

From January 1, 2018, a law will come into force on granting authorities the right to exercise control over the accessibility of the environment for people with disabilities.

In accordance with the law, the authorized federal and regional executive authorities will be entrusted with separate functions to monitor the provision of accessibility conditions.

The adoption of the law regulates the issue of the powers of the bodies that should exercise state control and supervision over the observance of the mandatory conditions of accessibility. This allows solving problems related to the accessibility of the environment within the framework of pre-trial procedures, including using the mechanisms of administrative responsibility.

According to the law, control functions are assigned to:

• the Government of the Russian Federation - to the authorities exercising federal control and supervision;
• regional governments - to the authorities exercising regional control and supervision.

In particular, at the federal level:

• on Rostransnadzor - the functions of control and supervision over ensuring the availability of transportation (including facilities and vehicles) in air, rail, inland waterway, and road transport;
• Roskomnadzor - control of the availability of facilities and services in the field of communications and information;
• on Roszdravnadzor - control of ensuring the special needs of people with disabilities in terms of the quality and safety of medical activities and in the field of drug provision;
• on Rostrud - control of the availability of facilities and services in the field of labor and social protection.

At the regional level, the bodies exercising control over the availability of services and facilities in those areas where it is generally already established by law are defined in a similar way.

Providing disabled people with technical means of rehabilitation

In 2017, 32.84 billion rubles were allocated to provide disabled people with technical means of rehabilitation (RTR), which is 3.54 billion rubles more than in 2016 (29.3 billion rubles). This measure makes it possible to provide the necessary TSW to about 1.6 million people.

In 2018, 30.5 billion rubles are provided.

Given that the provision of TSW and services is carried out on a declarative basis and requires the mandatory availability of appropriate recommendations in individual rehabilitation or habilitation programs, the issue of additional funding will be resolved in 2018 as funds are disbursed, taking into account incoming applications.

Annual monetary compensation to disabled people for the costs of maintenance and veterinary care of guide dogs

In 2017, the amount of annual monetary compensation to disabled people for the maintenance and veterinary care of guide dogs increased by 5.39% compared to 2016 and amounted to 22,959.7 rubles.

In 2018, the amount of annual monetary compensation to disabled people for the maintenance and veterinary care of guide dogs is subject to indexation from February 1, based on the consumer price growth index for the previous year.

Disabled people - a group of the population, which includes persons with disabilities due to their health characteristics. There are quite a lot of such people today. Formerly disability statistics didn't matter much. Now it is being done very carefully. Statistics allows not only to count the number of people with disabilities, but also provides information about their lives, difficulties, needs.

These data are important for national policy. They allow assessing how high-quality and effective programs for people with disabilities are being implemented in the country.

The situation in the world

The statistics of disabled people in the world is 23% of the total population of the planet. That's over 1 billion. According to WHO, the number of people with disabilities is increasing every year. Reasons for the increase in the number of people with disabilities:

• increase in the number of the planet;
• significant progress in medicine;
• increase in people.

In countries where people live for 70 years or more, many people become incapacitated in old age. Among children and middle-aged people, 80% of disabled people live in developing countries, where the population has a low level of and. The picture shows how many percent of disabled people out of the total number of inhabitants in European countries.

Disability among children is a huge problem. Not only medical and social, but also economic. There are more and more people with disabilities in the world. This is a worrying trend. According to scientists, the numbers will continue to grow.

Employment of people with disabilities

The International Labor Organization reports that nearly 400 million of the working-age population are disabled. Many of them do not work anywhere. Most employers consider them incompetent. According to the statistics of working disabled people, only 20% of their total number. The remaining 80% are .

For example, in India, 70 million disabled people and only 0.1 million of them managed to get a job. In the United States, only 35% of employed citizens of this category are employed.

Many people with disabilities claim that they would like to work and get a decent salary for it, but they are hardly accepted anywhere.

How is it in Russia

The statistics of disabled people in Russia in 2015 totaled more than 12 million people. Almost half of them are men and women of working age. That is, for every 10 thousand people there are approximately 59 citizens of the incapacitated category. Most of them belong to the third group. Least of all representatives of the first group.

An analysis of the statistics of disabled people across the country shows that we have much fewer of them than in European countries. Domestic rates are among the lowest in the world. But this is not a reason to be proud. The reason lies not in the fact that our fellow citizens are in perfect health. In Russia, in order to receive and then annually confirm their disability, people with disabilities often have to fight against an imperfect system. Many patients are simply denied the award of incapacity. Doctors often demand for disability registration.

The diagram shows the statistics of disabled people in the Russian Federation. It shows how the number of people with disabilities living in Russia changed from 1995 to 2005.

So, the statistics of the number of disabled people in Russia and the world suggests that the number of disabled people on the planet is steadily increasing. This is a global problem for all mankind. Representatives of the authorities should think about improving the situation.