Disability discrimination is not natural and we can have a world without it. That’s the conclusion of a fascinating new book, A Very Capitalist Condition—a history and politics of disability, by Roddy Slorach.

The book uses evidence spanning centuries from across the globe to look at how people with impairments are treated has changed over time.

It assesses political movements that have fought for disabled people’s rights and looks at controversial issues such as assisted dying.

Crucially it shows how disability and attitudes towards it are linked to material factors—and explains why disability discrimination arose with capitalism.

Disability and impairment are often seen as the same thing. But the “social model of disability” shows how societies disable people who have impairments by refusing to properly meet their needs.

Roddy points out that governments with no interest in improving disabled people’s lives have tried to co-opt it. However, it remains a powerful “political tool” because it points towards changing society.

Roddy argues that “disability” emerged out of “class society in general and capitalist society in particular”.

And “an increasing body of research strongly suggests” that discrimination against disabled people “did not exist” before class society.

Remains of the earliest humans indicate that people with serious diseases survived into adulthood with care from others.

The remains of a female Homo ergaster—the first human-like species—found in Kenya were dated to around 1.5 million years ago. They suggested the female had hypervitaminosis A, an extremely debilitating disease.

Roddy wrote, “Living as she did in the African savannah, she must have been fed by others who also protected her from carnivores.”

Archaeology researchers Spikins, Rutherford and Needham found, “The remains of many Neanderthal individuals also show evidence for long term care.”

Roddy explains that in the earliest human societies, made up of around 30 to 40 people who lived off the land, “all group members had a role”. “People with impairments were not marginalised or excluded,” he adds.

Some argue that the roots of disabled people’s oppression lie in Ancient Greece and Rome. Impairment in these societies was common—one study found that ten percent of all Ancient Greek skeletons had at least one bone fracture.

Epileptic

But there was “no concept of disability”. Julius Caesar, an epileptic, became the Roman dictator. Claudius later became a Roman emperor despite severe physical impairments.

And Ancient Greek culture “provides scattered accounts of people with different impairments involved in a wide range of economic activities, with no indication that this was seen as unusual”.

Neither is there any evidence of “any specific, systematic discrimination” towards disabled people in feudal societies. Under feudalism “the rural production process and the extended nature of the family” enabled many people with impairments to work.

Roddy writes, “The origins of disability as a form of discrimination lie in the social and economic changes of the late feudal period.”

Economic crisis in the 14th century signalled the beginning of a massive transformation. The growth of capitalism brought the Industrial Revolution.

Roddy says this “crystallised the rise of an entirely new type of labour, which led to the rise of disability as a specific form of oppression”.

It became harder for people with impairments to play an economic role in the new factories. They came to be seen more as a burden.

Capitalism “leads to the exclusion of impaired people from work” because capitalists see them as “potentially ‘wasted’ investment”.

The book also stresses the importance of alienation. Marx wrote that alienation results from workers’ lack of control over production. They become alienated from their own human nature and from each other.

This is a “key factor” giving rise to mental distress. It follows that “the prospect of and the struggle for social change can also put an end to a lot of that distress”.

Roddy quotes Philippe Pinel, a clinician during the French Revolution. He wrote in 1790, “‘I feel better since the revolution’ has been said by many people.”

During the First World War news of revolution swept Germany. Author Ben Shephard described how “many neurotic patients suddenly shed their symptoms and became revolutionary leaders”.

The book stresses the huge impact of social problems on health and warns that the drugs industry “medicalises problems that are social”.

The British Psychological Society (BPS) noted that one review found up to three quarters of psychiatric inpatients had suffered childhood abuse.

The book points out that “common causes of mental distress include unemployment, domestic violence, housing problems, homelessness and discrimination”. Poor people are more likely to suffer health problems than the rich.

As the BPS put it, “The most effective way to reduce rates of ‘psychosis’ might be to reduce inequality in society.”

The “huge increases” in mental health drug sales bear little relation to their success. But they follow a long history of attempts to “control” people deemed sick.

The book details how disabled people have been given brutal treatments, shut away in institutions or sterilised.

Treatments

From the 19th century the ideas of the new capitalist class—such as a reverence for science—were used to justify such treatments. Ideas about genetics and intelligence targeted people with impairments as inferior.

Sometimes panics about “madness” overlapped with fear of the working class—eugenics supporters were characterised by a “deep fear of the lower classes”.

Changes in society repeatedly shifted attitudes. For instance, disabled people dismissed as unfit for work were quickly called up to help the war effort in 1914.

The injuries and “shell shock” suffered by many who fought in the First World War undermined the idea that such problems only affected a tiny, alien minority.

But disabled veterans found themselves in a contradictory position. They were “lionised as heroes to glorify war, yet hidden away as a reminder of its reality”.

Disabled people’s oppression has sparked numerous political movements. Roddy details their achievements and describes the debates that took place over how to organise.

Some activists argued that “able-bodied society” is the problem and that disabled people have separate interests.

Some deaf people say they are not disabled but have a separate culture as an oppressed linguistic minority.

Roddy argues that such separatism “expresses the approach of a new layer of middle class deaf professionals who have rejected wider social change in favour of a deaf ‘lifestyle’”.

Instead he argues for unity. Roddy says there’s been a revival in disability activism in Britain but its forces remain “tiny”. Disabled people can’t stop attacks “without being part of a more powerful force”.

Disabled people face many contradictions. Many activists rightly campaign for independent living and more choice and control in their lives.

Yet politicians use similar rhetoric to justify cuts and privatisation.

Some people don’t want their disabled child to be segregated in a specialist school. But often their child will have no support in a mainstream school.

Huge debates have raged over whether to support assisted suicide. Roddy says that few people “would not support an individual’s right to an assisted suicide”.

But he also condemns a system that “undermines” people’s will to live. Two people with the same impairment can live massively different lives. As the book points out, “Personal choice is not equally available across society.”

The book develops a Marxist understanding of disability—not for the sake of abstract argument but to help people fighting back.

Roddy told Socialist Worker, “This book is an attempt to break out of the ghetto that disability has existed in for decades. I think of this as the last civil rights issue.

“The message of the book is that disability is not about someone else. And disabled people have a lot of disadvantages when it comes to fighting back for themselves.

“We need to break down divisions between disabled people and others.”