A Long Overdue Designation

“Society is built by determination, not designation.” -  Abhijit Naskar

Kids playing in the street, Brooklyn, 1950

By Rick Rader, MD Helen Journal Editor-in-Chief

Growing up in Brooklyn, I had two sets of friends. One group had guys my age. We loved playing cops and robbers and took turns choosing who we’d be. The other guys were a few years older and more sophisticated.

They liked to play Knights of the Round Table, which was cool since we made swords from old hockey sticks and used garbage can covers for shields. The two teams were knights versus invaders. But instead of us choosing our teams, the two leaders designated which side would  face down death and dragons. 

Being designated was far more impressive, prestigious and grown up than deciding and announcing who you wanted to be. I was typically designated as an invader and got slain quickly, giving me enough time to get home in time for dinner.

But designation isn’t just child’s play. The concept plays a prominent part in nearly every part of society, from leisure, to religion, and health care.

We have social class designations that assign individuals to groups based on income, education, occupation, race, age, pedigree, and geography. We know that these designations impact quality-of-life issues.

In Major League Baseball,  designated hitters bat in place of another position player–most commonly the pitcher–but they don’t play a position in the field. 

The New Testament refers to The Divine Designations of the Church, which is the biblical way of referring to the church as Christ’s body, kingdom, or assembly.

We have designated non-smoking areas to protect the public from the ills of tobacco smoke. We have designated parking for drivers with disabilities, and designated seating for VIPS at special events. 

Partygoers are reminded to have a designated driver who abstains from drinking to insure a safe return of the revelers.

Feuding countries have designated demilitarized zones where both countries have agreed to honor the neutrality of the connecting passageway. Likewise, the Federal Government designates Foreign Terrorist Organizations under the Immigration and Nationality Act.

When I first moved to Chattanooga, I was invited for drinks at the home of a couple that lived on Missionary Ridge, the site of significant Civil War battles. I couldn’t help but notice the battle-scared cannon in their front yard. When I asked it, they told me that it wasn’t theirs. The United States Parks Department had designated it a national monument, which meant they couldn’t move it, paint it or disturb it.

Thus, the power of designation.

Photo Credit: Rick Guidotti for Positive Exposure.

Our society, human services, and our healthcare model have long designated and placed people into boxes, places, wards, programs, and groups. We’ve designated them as idiots, morons, imbeciles, feeble minded, menaces, burdens, errors, and mistakes. And we employed these designations to devalue, mistreat, neglect, and harm them. Thus, the power of being designated.

So what’s behind this musing on designation? Well, it comes as a result of the news released on September 26, that the National Institute of Health designates people with disabilities as a population with health disparities. 

So what’s behind this musing on designation? Well, it comes as a result of the news released on September 26, that the National Institute of Health designates people with disabilities as a population with health disparities. 

This long fought for and long overdue designation has been one of the pillars of the American Academy of Developmental Medicine and Dentistry.  The need, wisdom and argument for this designation has been one of the AADMD’s earliest advocacy efforts. The announcement comes from the National Institute on Minority Health and Health Disparities (NIMHD) and opens the door for an abundance of research projects and funding that had previously been denied to this patient population.

This has been on the AADMD’s things-to-do-today list for over 20 years. Elsewhere in HELEN we chronicle the struggle, the challenges, the trench warfare and the people and strategies that were instrumental in this steppingstone announced by the NIH.

What’s interesting about this designation is the realization that people with disabilities have always been a medically disparate group. That harsh reality didn’t require the NIH declaring that.  The official designation does not automatically change the attitudes, commitment and outreach from the health care professionals. It is a start–a start that began over 20 years ago.

And while this announcement deserves to be celebrated, it simply signifies what anthropologist Margaret Mead has always reminded us.  “Never doubt that a small group of thoughtful committed individuals can change the world. In fact, it’s the only thing that ever has.”