Disability and Health Journal 5 (2012) 233e240

www.disabilityandhealthjnl.com

Review Article

Im Healthy: Construction of health in disability

Aylin Nazli, Ph.D.
_
Egean University, Department of Sociology, Izmir,
Turkey

Abstract
Background: The bio-mechanical view of medicine being disabled, implies unhealthiness because these states are not included in the
physical and mental medical norms. This study is to show how people with physical disabilities define health and being healthy within
a social framework and to demonstrate the impact of social environments on people with physical disabilities given their application of
the social model and their process of social construction.
Objective: This study is to demonstrate that the meaning of health and the definition of oneself as healthy take place in a socialconstruction process involving an interaction between people and society.
Methods: To attain this goal, a qualitative technique was applied, and qualitative data were obtained. Terms were formed by encoding
the data, and themes were formed using the terms. Analysis and interpretation were made based on 5 themes that emerged from the encoding of the research.
Results: The qualitative data obtained in the research indicate that being healthy is equal to not being ill, that a disability does not imply
unhealthiness for people with disabilities, and that people with physical disabilities interpret their physical adequacy and body images
positively.
Conclusions: The results show that people with physical disabilities socially construct their states of being healthy and their states of
health and interpret themselves as healthy despite the medical models definition of health. The positive impact of this positive social
construction of physical adequacy and body image is evident in their interpretations of themselves as healthy. 2012 Elsevier Inc. All
rights reserved.
Keywords: Health; Disability; Social; Construction

Introduction: Rethinking WHOs health definition

What does being healthy mean? This question was
answered by the World Health Organization (WHO):
Health is a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity.1 According to WHOs definition of health, the social
context of health is indicated with the state of social wellbeing. This term, which is stated in the WHOs definition,
shows the influence of the bio-cultural view that was subsequently developed in medicine.2 Similarly, the WHO definition was clarified during the process, and various norms
were influential in determining the definitions of disability
(ICIDH-1, WHO, 1980; ICIDH-2, WHO, 1999 & ICF,
WHO, 2001 & ICF, 2009).3 The most important aspect of
The author has no financial disclosures to report.
This manuscript, containing original material, has not been previously
published or submitted to any other outlet for publication and has not been
presented at any meeting regarding this research.

Corresponding author. Ege Universitesi,

Edebiyat Fakultesi, Sosyoloji
_
B
ol
um
u, 35100 Bornova/Izmir,
Turkiye. Tel.: 90 232 311 30 54.
E-mail address: aylin.nazli@ege.edu.tr
1936-6574/$ - see front matter 2012 Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.dhjo.2012.06.001

ICF 2009 is that it takes into account the social aspects

of disability and does not see disability only as a medical
and physical dysfunction.
The phrase the state of social well-being highlights
the impact of social factors on the states of health and
unhealthiness of societies and people. Similarly, according
to Hunt & McEwen,4 differences occur in the definitions of
disease and health at both societal and individual levels,
and, now, social-based health indicators have begun to be
considered as influencing factors on the determination of
health. Additionally, in the study by Faull et al,5 emerging
awareness of the impact of factors, such as social relationships, social values, beliefs and self-perceptions on the
perception of health by people with physical disabilities,
supports the social aspects of the above-mentioned health
indicators. Viruell-Fuentes and Schulz posited that social
ties and social support may contribute to better-thanexpected health outcomes and terminology of health among
Mexican immigrants in the United States.6 Mold focused
on the need to develop an alternative terminology of health
and health care for the aged in the United States.7 Robinson
focused on qualifying preschool childrens terminology of

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A. Nazli / Disability and Health Journal 5 (2012) 233e240

8

health and illness. Williamson and Carr examined the

terminology of health as a resource for everyday life and
the implications that such a definition has for publichealth programs and policies.9
This study takes a further step to demonstrate that the
meaning of health and the definition of oneself as healthy
take place in a social-construction process involving an interaction between people and society. Denton and Waters
focused on the stress, depression and tiredness associated
with the social construction of health among women.10
Although health has not traditionally been a male concern,
the past few years have observed the gradual development
of a shared term for mens health within the public domain.
Stibbe analyzed the social construction of health and masculinity in mens health magazines.11 Jarvel and RinneKoistinen stated that the terms of clean and dirty are
socio-cultural constructions in the shanty towns of Nigeria,
Lagos.12 The meaning of health and the definition of being
healthy by people with disabilities are not what might be
generally held by people without disabilities. In the study
by Putnam & Geenen & Powers, participants (with disabilities) primarily defined health and wellness as being able
to function and to do what they want to do.13 According
to Albrecht and Devlieger, disability is a condition that
requires action and interpretation in a social context. The
quality of life of people with disabilities depends upon
finding a balance between the body, mind and spirit and with
their social context and external environment.14
In this context, the purpose of the study is to show how
people with physical disabilities define being healthy, both
in general and in terms of their own health, and to demonstrate the impact of the social-construction process on health.
Disability and the social construction of health
The first studies concerning the requirement of considering
disability within a social view beyond the medical model appeared 25 years ago. Unlike the medical model of disability,
the social view considers disability together with societal
influence and makes the connection between disability and
social, political and environmental factors.15e17 The assumption that people with physical disabilities form their perceptions of physical disability and health in a socio-cultural
atmosphere and through a social-construction process indicates a social-construction model.
The social-constructionist view takes into consideration
the processes of defining and interpreting the components
of the world around us. The definition and interpretation
of every component in this process is an initiative proposed
jointly by those who interact. This reality, is a crucial
term for Berger and Luckman,18 who regard society as
a human product that interprets itself and on which actions
are performed, each of its components being socially constructed in daily life.
One of the most important components of the reality of
daily life is a persons body, which is a proof that a person

is alive here and now. The body, which enables a person to

inhabit daily life, contains a framework of limitations as
much as it contains a framework of opportunities in the
context of its functions. The physical quality of the body
determines the general structure of these opportunities
and limitations. Disability, among other attributes like race
and sex, shows a person the limitations of his/her body. The
body is a carrier for individuality, and, in this sense, the
limits of a person are set by the limits of his/her body.19
Thus, a persons disability brings physical and social limitations to him/her in everyday life.
Within this framework, what will a physical problem
mean for a person who experiences the reality of his/her
daily life and an understanding of his/her health via this
physical problem? This question may be answered using
the persons social construction of the physical problem
and, consequently, the state of being healthy in the reality
of their daily life. This process involves socially interpreting his/her disability and the state of being healthy in the
reality of daily life as well as adapting to routine daily life
based on the theory by Berger and Luckman.
In accommodating to such a situation, a person with
a disability socially constructs the impacts of his/her
disability on his/her life through a process of social interpretation. The person makes practical adjustments to his/
her physical and social environments to overcome physical
limitations and adapts his/her expectations and relationships to reflect the change occurring to his/her body and
to accommodate himself/herself to this change. This same
process occurs when health (or unhealthiness) is constructed on the social plane.20 A person with a physical
disability who is able to successfully fulfill at least most
of the actions and arrangements required for him/her can
qualify himself/herself as healthy, and, if he/she cannot
fulfill those actions, as unhealthy, thus representing a social
construction of being healthy or unhealthy based on his/her
utility in social life.

Methods
According to data from the Turkish Disability Survey of
2002,21 the rate of disability throughout Turkey is 12.29%,
of which 2.58% consists of people with physical disabilities. Also, the survey states that throughout Turkey, there
are an estimated total of 857,630 people with physical
disabilities.
This study was performed in Istanbul, the most densely
populated city in Turkey. To determine the sample of the
population with physical disabilities in Istanbul, the purposive sampling technique generally preferred in qualitative
research and the snowball sampling technique were each
used.22 People with physical disabilities were found from
the member lists formed by Foundation of Physically
Handicaps Association of Persons with Disabilities of
Turkey, Special Education and Disabled Centre of Social

A. Nazli / Disability and Health Journal 5 (2012) 233e240

Assistance Department of Istanbul Uskudar Municipality

and Turkish Foundation for the Handicapped People.
The participants were provided with an explanation of
the fact that the basic aim of this study was to investigate
how they defined their state of being healthy. The interviewees were informed that their names and private information would not be included in the study, that a tape
recorder would be used during the interview, and that all
the information they provided would be included only in
this study. Because an informed consent form containing
these stipulations was prepared and permission was obtained from all interviewees, this research is exempt from
the need for ethical approval.
To obtain the data, a semi-structured interview form was
used. Open-ended interview questions were created under
the categories Meaning of Health, Physical Adequacy in
Daily Activities and Body Image. Under these three categories, five open-ended questions were asked. The openended questions posed were: In your opinion, what does
being healthy mean?, Are you healthy?, Does your
physical disability affect your health state?, Can you
perform your daily activities on your own?, How do
you evaluate your physical appearance?. The data recorded with a recorder during the interviews was transcribed and stored onto a computer soon after the
interview. In the research, the technique of thematic analysis was used. The data were managed, organized and
analyzed using the principles for the analysis of qualitative
research described by Strauss and Corbin.23 In the analysis,
text passages were read and reviewed carefully. While the
text passages were being reviewed, short notes were taken.
The Open Coding technique was used to code the text
passages.23 The researcher identified the key terms according to the meanings indicated by the data. Following this
procedure, a code list of key terms was obtained. Later
on, the data were classified according to this code list of
key terms. To form themes, the key terms were gathered
and their common qualities were determined.23,24 The
themes were formed on the basis of the opinions and terms
that were cited most in the interviews. The themes expressing this common quality were expressed in the form of
a sentence. At the next stage, thematic coding was performed for the whole data set. It was manually performed
and a table was created by giving 1 if a theme was available
and 0 if no theme was available. Analysis and interpretation were made based on 3 categories and 5 themes that resulted from the encoding.

Results
A total of 17 people with physical disabilities were interviewed in this study, which was performed between
February 15 and April 21, 2010. When the responses began
to roughly repeat each other after a point, the number of
people with physical disabilities interviewed was limited

235

to 17. Of the interviewees with physical disabilities, 11

were female and 6 male, whereas 14 were single and 3
married. Of the participants, 2 were in the age group of
18e24 years, 4 in the age group of 25e31 years, 7 in the
age group of 32e38 years, 2 in the age group of 39e45
years and 2 in the age group of 46e52 years. Of the interviewees, 6 had a disability degreea of 40e59%, 5 had
a disability degree of 60e79% and 5 had a disability degree
of 80% and greater. A participant stated that she did not
know her disability degree.
Meaning of health
People with physical disabilities were asked what it
meant to be healthy, whether they considered themselves
healthy and whether their general state of health was
affected by physical disability. Three themes occur in the
responses: first, Being healthy 5 Not being ill; second,
I am healthy; and third, My physical disability sometimes negatively affects my state of health.
Being healthy 5 Not being ill.
K.Y. 21, Female, Single. (She has loss of function and
shortness in one leg. She uses crutches. Her degree of
physical disability is 67%). . In my opinion, being
healthy means, for example, not getting ill or not
going to a doctor and not taking a medicine. It means
the absence of a disease that will require going to
a doctor and being treated.
D.D. 35, Female, Single. (She has loss of function in
one arm and, partially, in one leg. Her degree of physical disability is 50%). .You can wake up without
any pain or twinge. If you are able to say hello to
a new day, this means being healthy. In my opinion,
being healthy is that your arm or leg does not ache,
you do not have any twinge anywhere on your body,
it is very good, your breath is very good, you breathe
and you can feel that newly rising sun in your heart at
that moment.
B.I. 35, Male, Married. (He has loss of function in
one leg. He walks without any crutches and with hand
support. His degree of physical disability is 40%).
.I definitely do not think that a man has a health
problem if he has a disability. When I consider
health, something associated with our internal organs
comes to my mind or I consider whether he has
a disease or not. This man has a problem with his life,
for me, this man is not a healthy man. He has
a

The disability degrees are according to the regulation published on

16/12/2010 on Official Gazette (No: 27787) of Turkey. This is based on
International Classification of Functioning, Disability and Health. The
calculation of the degrees and expression in percentage is also according
to related regulation. Necessary documents can be obtained from the
following link: http://www.saglik.gov.tr/TR/belge/1-11521/ozurlulukolcutu-siniflandirilmasi-ve-ozurlulere-verile-.html.

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A. Nazli / Disability and Health Journal 5 (2012) 233e240

hepatitis. In my opinion, this man is not a healthy

man. When we say a healthy person, in my
opinion, a healthy person might be a person with
a disability. It is not a criterion for health, as far as
I am concerned. If a person has had a check-up and
all his rates turn out to be normal, then I consider this
man healthy.
For the interviewees with physical disabilities, having
a disability is not the same as having any organic disease.
For these individuals, having a disability does not mean
being unhealthy. Not having a disease that causes them to
suffer from aches and pains is the basic criterion for being
healthy as far as they are concerned.
I am healthy
N.A. 33, Female, Single. (She has loss of function and
shortness in one leg. She uses no support. Her degree
of physical disability is 46%). .I actually feel
healthy. That is to say, when I consider it in terms
of my internal organs, everything of mine is indeed
very good. At the present, I am walking and I can
move.
Z.E. 23, Female, Single. (She uses a wheelchair
because she has spinal cord paralysis. Her degree of
physical disability is 76%). .I am healthy. In my
opinion, I do not have any problems. Actually, I do
not consider myself an unhealthy person.
B.I. 35, Male, Married. (He has loss of function in one
leg. He walks without any crutches and with hand
support. His degree of physical disability is 40%).
.I have no health problems.
D.D. 35, Female, Single. (She has loss of function in
one arm and, partially, in one leg. Her degree of physical disability is 50%). .I am healthy. If I wanted to
be born again, I would like to be born in the same
way.
Z.U. 50, Female, Married. (She has loss of function in
her legs due to spinal cord paralysis. She uses a wheelchair. Her degree of physical disability is 80%). .I
am healthy.
N.T. 49, Male, Single. (He has loss of function in one
leg. He uses crutches. His degree of physical
disability is 80%). .I am healthy. I have a disability,
but I am healthy.
It is evident that people with physical disabilities interpret themselves as healthy, similar to their interpretation
of health as socially constructed. They do not equate
disability with unhealthiness in their own social interpretations. For them, a person might have a disability; however,
this does not mean that he/she is unhealthy. In their social
interpretations, disability and unhealthiness overlap only
when disability causes disease. Unless they have a disease
that causes them to suffer from aches and pains, they interpret themselves healthy.

My physical disability sometimes negatively affects my

state of health
B.P. 32, Male, Single. (He has loss of function and
shortness in one leg due to poliomyelitis. He uses
crutches. His degree of physical disability is 60%).
.Actually, there are some negative situations due
to poliomyelitis. There is curvature in my backbone,
which causes pains. Sitting for a very long period
somewhat prevents me. I do not have any other health
problems.
A.E. 28, Male, Married. (He has loss of function in
one leg. He walks with no support. His degree of
physical disability is 40%). .There occur some
health problems owing to immobility. As you also
see, the greatest problem is immobility, the limitation
of our movement.
D.D. 35, Female, Single. (She has loss of function in
one arm and, partially, in one leg. Her degree of physical disability is 50%) .For the last one year after I
had the plate in my arm removed, I have had many
operations. I have had 8 operations in total due to
my disability.When I was 17-18 years old, I was
really highly influenced psychologically.
Z.U. 50, Female, Married. (She has loss of function in
the legs due to spinal cord paralysis. She uses a wheelchair. Her degree of physical disability is 80%).
.Affected. For example, I get tired and when I go
home, I excessively eat.
A.A. 30, Female, Single. (She has loss of function in
her legs. She uses a wheelchair. Her degree of physical disability is 95%) .The intestines of people
with disabilities, who sit like us, do not work much
due to immobility. This is a problem. Apart from
this, the other day, I had my analyses made and I
became very happy that the results showed no
osteolysis.
B.I. 35, Male, Married. (He has loss of function in one
leg. He walks without any crutches and with hand
support. His degree of physical disability is 40%)
.As we have an orthopedic disability, sometimes
we experience orthopedic hip dislocation in our hip
region. However, apart from it, we do not have any
problems at the moment maybe owing to the vigor
brought about by our age.
N.T. 49, Male, Single. (He has loss of function in
one leg. He uses crutches. His degree of physical
disability is 80%). .I just have slight pain only,
which are very normal. They do not hinder my life
as long as I am careful.
E.A. 31, Male, Single. (He uses a wheelchair due to
spinal cord paralysis. His degree of physical disability
is 95%). .Of course.I am affected from time to
time. That is to say, although some things seem to
be a bed of roses, they affect people. .I naturally
ask such questions as Why am I not able to go out

A. Nazli / Disability and Health Journal 5 (2012) 233e240

whenever I want or why am I unemployed?.They

psychologically affect me as long as these questions
remain unanswered.
For people with physical disabilities, unhealthiness is
experienced as the problems their disabilities cause their
bodies and their mental states. People with physical disabilities know that these problems are caused by their disabilities; however, they classify these problems as diseases.
While affected by these diseases, they experience a period
of unhealthiness; however, they assume that they will return
to a healthy state when they recover.
Physical adequacy in everyday activities

only when setting the table but also in doing

everything.
A significant criterion that determines health for people
with physical disabilities is their abilities to carry on with
their daily lives. Most participants feel that health encompasses independence and carrying on with their daily lives.
For some participants, having the capacity to perform
necessary daily activities was an important measure of
health. Carrying on with their daily lives is measured by
the extent to which they can perform their basic daily activities. The more successful their performances of these daily
activities, the healthier and more normal they consider
themselves to be.

People with physical disabilities were asked whether

they were able to perform daily activities in their lives
and to describe how they managed these activities. The
theme that recurred in these responses was I find a way
to do everything.

Body image

I find a way to do everything

This is me

N.T. 49, Male, Single. (He has loss of function in one

leg. He uses crutches. His degree of physical
disability is 80%) .I have difficulty in everything
in my life, but I surely find a way to do them. I try
to find a way to do them as much as I can.
G.B. 32, Female, Single. (She has loss of function in
her legs. She uses a wheelchair. She does not know
her degree of physical disability) .I am 32 years
old and so far, no one has said let me help you wear
your socks to me. Thank God. I wake up in the
morning and prepare the breakfast for brothers wife.
I wash the dishes and go out. Thank God. I do not
have such problems.
N.A. 33, Female, Single. (She has loss of function and
shortness in one leg. She uses no support. Her degree
of physical disability is 46%) .I am able to take
a bath, put on and take off my clothes and do anything
that can be done at home, i.e., cooking, washing the
dishes, washing the clothes and anything. Only the
vacuum cleaner. I can use it as well to sweep the
house, but of course, I may somewhat have difficulty
in doing it.
F.S. 40, Female, Single. (She has loss of function in
her legs. She uses a wheelchair. Her degree of physical disability is 76%) .I can put on my clothes
myself. I comb my hair, do my make-up and wear
my head scarf, but when bath is considered, there is
a small question mark about it.
S.P. 21, Female, Single. (She has loss of function in
her legs. She uses a wheelchair. Her degree of physical disability is 60%) .I do. There is a wagon at
home, like those at hotels. When I have to set the
table, I put everything on it. That is to say, that wagon
acts as my hands and my feet. I use that wagon not

237

People with physical disabilities were asked to explain

how they evaluated their physical appearance. A common
theme emerged from the responses:

K.Y. 35, Female, Single. (She has loss of function and

shortness in one leg. She uses crutches. Her degree of
physical disability is 67%) .I like myself physically. It does not bother me. For instance, when I go
to the seaside, I even think that I am very esthetic.
There is just shortness in my leg. I think I am nice.
M.S. 28, Female, Single. (She has loss of function in
one arm. Her degree of physical disability is 51%).
.From time to time, it bothers me, but mostly I
am pleased. I can console myself just by thinking
so.
B.P. 32, Male, Single. (He has loss of function and
shortness in one leg. He uses crutches. His degree
of physical disability is 60%). .I sometimes
consider it a problem, but previously, I considered it
much more. There were times when I thought why I
was like this. You overcome it in time.
G.A. 36, Female, Single. (She has loss of function and
shortness in one leg. She walks without any crutches
and sometimes with hand support. Her degree of
physical disability is 40%) .I think I will become
very beautiful if I lose a few more weights.
A.E. 28, Male, Married. (He has loss of function in
one leg. He walks with no support. His degree of
physical disability is 40%). .Anyway, it is now part
of our life.
D.D. 35, Female, Single. (She has loss of function in
one arm and in one leg. Her degree of physical
disability is 50%). .Normally, when I have a photograph taken or when I dont move, no one understands
that I have a disability. And now I say let anyone
understand it anyway. I dont care about it at all.
E.O. 40, Male, Single. (He has loss of function in his
legs because of spinal cord paralysis. He uses

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A. Nazli / Disability and Health Journal 5 (2012) 233e240

a wheelchair. His degree of physical disability is

85%). .For the time being, I do not see any problems. I am a person, who is 1.90 m in height and
about 100 to 110 kilos in weight, on a wheelchair.
That is to say, I do not consider myself so much
incomplete in terms of appearance. I just cannot walk.
If I walked, I would be a more different person.
Nevertheless, in terms of my body, I do not have
any appearance that bothers the people in front of
me. Thank God.
Although another condition that determines health is
physical integrity, people with physical disabilities have
adapted to their impaired integrity and comprehend their
disabled bodies using various social interpretations. People
with disabilities dont explain this disability as a defect.
For participants, having a disability does not preclude
health. This social meaning of health and being successful
in their performances of daily activities support the definition of body image. Considering themselves normal
encompasses the definition of body image as well. So, they
construct their body image positively, and thank God.
Through these above-mentioned social interpretations,
they adapt to their disabled bodies and accept them
(Table 1).

Discussion
For people with physical disabilities, their definition of
health differs somewhat from the WHO definition. For
people with disabilities, health does not mean being
disabled; rather, it means not being ill. Thus, unhealthiness
equals illness. Although these people have physical disabilities, they are healthy because they are not ill. Therefore,
people with physical disabilities interpret themselves as
healthy.
Table 1
Summary of comments
Categories/themes
1. Meaning of health
Being healthy 5 Not being ill.
I am healthy

My physical disability sometimes negatively

affects my state of health
2. Physical adequacy in everyday activities
I find a way to do everything

3. Body image
This is me

The periods during which they qualify themselves as

unhealthy or ill occur when various diseases result from
their physical disabilities. These diseases affect their bodies
more negatively than their disabilities do. When they get ill,
their disabilities become of minor importance, and their
unhealthiness or illness resulting from their diseases moves
to the forefront. Recovery from the above-mentioned
diseases is equal to returning to daily life, which indicates
living with physical disabilities but in a healthy state.
For people with physical disabilities, there are two more
significant factors that influence their interpretations of
themselves as healthy: physical adequacy in daily activities
and body image. It is of great importance that they carry on
with their daily lives. However, their states of disability
complicate this. Therefore, their physical adequacy in
completing daily activities is very important for people
with physical disabilities. Due to their physical disabilities,
they carry on with their daily lives through environmental
and social adjustments. Their success with these arrangements, which are based on the interaction between people
and the environment, enables people with physical disabilities to positively interpret their physical adequacy; this
data shows parallelism with the results of Heyvood.25 That
people with physical disabilities positively interpret themselves as adequate/successful in terms of physical adequacy
contributes to their interpretation of themselves as healthy.
Being physically adequate/successful in daily life and ones
perceived health positively mutually support their social
meaning.
Physical disability is a state that often negatively affects
and impairs body image. However, people with physical
disabilities socially interpret their disabled physical appearance, including it in their lives and accepting it, thus reconfiguring their body images. The disabled body then moves
beyond its negative connotation and becomes a quality that
makes the disabled person different. This social meaning of

Comments
*
*
*
*

Having a disability is not the same as having an organic disease.

A person might have a disability; however, this does not mean that he/she is unhealthy.
They are healthy because they are not ill.
Unless they have a disease that causes them to suffer from aches and pains, they interpret
themselves healthy.
* Health problems are caused by the state of disability; however, they classify them as diseases.
* Diseases affect their bodies more negatively than disability.
* When they recover, they assume that they return to their healthy state and are healthy.
* A significant criterion that determines health for people with physical disabilities is their abilities
to carry on with their daily lives.
* The more successful their performances of these daily activities, the healthier and more normal
they consider themselves to be.
* People with physical disabilities socially interpret their disabled physical appearance, including it in
their lives and accepting it, thus reconfiguring their body images.
* They adapt to their disabled bodies and accept them.

A. Nazli / Disability and Health Journal 5 (2012) 233e240

ones body image supports the definition of being healthy

as well. This result is also in agreement with the data of
Ville et al,26 who suggest a connection between the identity
of disability as a social construction and self-representation
and, consequently, suggests that disabled people positively
define themselves. These data also support the results of the
study by Tighe that showed that women with physical
disabilities interpret their state of health through their physical experiences within a social framework.27 Positive interpretation of ones body image also promotes the
interpretation of being healthy in that the person who
makes peace with his/her disability and body image can
easily interpret himself/herself as healthy.
Both the health definitions of people with physical
disabilities and their states of defining themselves as
healthy based on social construction indicate social and
physical qualities that comprise ones state of well-being.
The processes by which people with physical disabilities
interpret themselves as healthy might vary from those of
normal people, a finding that parallels the results of Drum
et al.28
These social interpretations of health and being healthy,
which occur through social construction, indicate that
a wealth of information can be obtained from studies on
disability, as also stressed by Smith and Sparkes.29
Although the data are individualized in this study, they
contain clues about the social area where one lives. Similarly, according to Ravesloot et al,30 four of the factors that
are influential on health-behavior change of people with
physical disabilities are individual-social-based and will
be crucial to the findings of studies on the social construction of health and health-behavior changes in people with
physical disabilities. It is thought that these data will
contribute to the literature on disability and be useful for
researchers who highlight the significance of new paradigms, such as social diversity and social construction,
particularly as they relate to the literature on disability.31
In conclusion, the data in this study demonstrate that
people with physical disabilities adapt their perceptions of
being healthy and health in connection with disabilities
through positive social construction and that they interpret
themselves as healthy. The positive social construction
of physical adequacy and body image help them achieve
this interpretation. That disabled people consider unhealthiness to mean illness and, therefore, interpret themselves as
healthy differs from the medical model. The social
construction of health by people with physical disabilities
indicates the strength of the connection between health
and the social explanation and further indicates that the
social models perspective is also influential in the field
of health. All comments and comparisons performed in this
study are based on data from the 17 interviews. Thus, these
findings are not generalizable to every person with a physical disability. In conclusion, we hope that the data obtained
from this research will serve as a step for other researchers
working on this subject.

239

Acknowledgment
I would like to thank Meyse Yilmaz Budakli, my PhD
student, who assisted me in obtaining the data for this
study.
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