According to Ms. Amy Rauworth and Ms. Allison Hoit Tubbs, from the National Center on Health, Physical Activity and Disability (NCHPAD), disability is projected to increase as aging population increases. Although the prevalence of disability in the U.S. indicates that 57 million Americans have some type of disability, this has been an underserved population and often ignored by the general health community having the highest rate of health disparities out of any subgroup in this country.
Accessibility and inclusion of people with disability in existing and future public health promotion programs geared toward improving their PA, nutrition and healthy weight management are imperative. As approximately one in five Americans has a disability of some sort, I wonder if as practitioners, can we develop skills to identify, include, and collaborate with a diverse range of individuals to increase community health inclusion? Are we aware of the principles of inclusive organizations, policies, and programs? And what actions can be taken to create inclusive programs and organizations in public health?
In the webinar, the presenters detailed how inclusion means to transform communities based on social justice principles in which all community members, for example, are presumed competent and experience reciprocal social relationships. They emphasized the need to go beyond the traditional medical approach, which is not always easy, to achieve inclusion. They also recommended what is commonly known as Universal Design, meaning the design of projects and environments to be usable by all people, to the greatest extent as possible, without the need for specialized design.
Creating inclusive communities, we can provide equal access to and opportunities for healthy living by implementing environmental designs that increase access to PA and healthy food. It has been also demonstrated that persons with disabilities are best served by public health when they are included in mainstream public health activities and programs. Having this in mind, some efforts for reaching individuals with disabilities through healthy communities could include the availability of trails designed for those individuals who have low vision, curb cuts and wide sidewalks that are easy to navigate, accessible entries, wheelchair accessible spaces in public places for recreation, audible traffic signals and elevators, lower sinks, toilets and dryers, wheelchair charging stations, parking that is safe, among others. A small change can make a big difference for somebody to live as independently as possible, the key is prioritizing accessibility, setting expectations, engaging the community –and its diversity- we wish to serve, and commit to inclusion.
IMC,
While it is not shocking, I still hate to read that disability is currently projected to increase as aging population increases. The huge number of Americans (57 million) with some type of disability is reason enough why we should stop underserving this population and still expect numbers to decrease. Equal access is not something that should need fighting for today.
With the Americans with Disability Act (ADA) passing in 1990, communities have been more inclusive and people with disabilities have better access to buildings, transportation, and employment. Accessibility and inclusion are two of the driving forces behind ADA, but this act does not touch on inclusion featuring physical activity or community health. Wide sidewalks, audible traffic signals, lower public appliances (sinks, toilets, water fountains), and sufficient parking spaces are all things that can be expected from ADA. Communities can take the next steps to help fill the gap and be more inclusive by incorporating easy to navigate curb cuts, designing friendly trails, and public recreation places that are accessible and inviting to those with and without a disability.
Filling the gap will take community officials openly engaging the community and commit to inclusion and equal accessibility for everyone. Just like all community-based campaigns, easy and equal access for the population, and utilizing low cost/low resource projects increases the chance of success. The community must buy-in and that is why local officials must be as inclusive as possible.
How to appropriately include or make accommodations to include people with disabilities in mainstream public health activities and programs?
A list of characteristics or ideas?
One rural/urban community template that can be applied in multiple similar settings?
Although disability impacts all of us, there is a lack of training on how to appropriate include or make accommodations to include this population in existing and future public health activities, programs, and interventions. The National Center on Health, Physical Activity and Disability (NCHPAD), has been working on some interesting and innovative initiatives such as How I Walk: A Campaign to Rebrand Walking, which is a movement aimed to promote walking as an inclusive physical activity by encouraging a transformation in individual and societal attitudes; the Inclusive Fitness Coalition, and public mobility programs focused on, for example, trying to make it easier for people to get around downtowns or places where they can have access to leisure activities and convenient stores. They also provide plenty of examples of community-based successful experiences that can be accessed here https://www.nchpad.org/, or through their channel on youtube (https://www.youtube.com/user/NCPAD). A good step could be including people of disabilities in committees and interdisciplinary teams dedicated to improving public health, and let their voices be heard improving the understanding of why disability is a health disparity and not a health outcome.