4.4 Define how environment can impact health outcomes for people with disabilities.

There is a direct relationship between how the environment where people live, work and recreate in affects their physical and mental health outcomes. Environment is a social and physical determinant of health.7 Poor health outcomes can be made worse because of the interaction between people with disabilities with their social and physical environments.7

Physical determinates of health related to environments include built environments like transportation and buildings, worksites, recreational settings, housing and neighborhoods, as well as physical barriers.  Social determinates of health related to environments include availability of resources, employment, and healthy foods, exposure to crime and violence, social supports, transportation options, and socioeconomic conditions. Knowledge of the relationship between environment and health outcomes is essential to decreasing health disparities among this population. To put this in context, a “visitable” home is one which has at least one zero-step entrance, a bathroom on the main floor, and hallways and doorways wide enough to accommodate a wheelchair.

Example: Concrete Change is an international coalition organization formed in Atlanta that advocates for structural and legislative shifts that promote basic home access.  Concrete Change provides information and resources on making all homes accessible to everyone such as information for builders, contractors, realtors, architects and others. Their website includes information about visitability, a movement to change home construction practices so that virtually all new homes offer a few specific features to make them easier for people with disabilities to live in or visit. Concrete Change worked with the City of Atlanta to pass the nation’s first visitability law, which required that all public housing be accessible.  Atlanta now has more than 500 single family homes with visitability features.