Disabled-by-design: effects of inaccessible urban public spaces on users of mobility assistive devices – a systematic review

Kapsalis, Efthimis; Jäger, Nils; Hale, Jonathan

doi:10.1080/17483107.2022.2111723

Cited by 33 publications

(14 citation statements)

References 99 publications

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“…This oversight may have been due to factors such as focusing on neighborhood-level approaches to decision-making and resource investments or lack of data to guide prioritization. Regardless, inclusive community design, whether for bicycling or other forms of mobility, is rarely prioritized ( 29 ) and deserves more consideration from decision makers and advocates.…”

Section: Discussionmentioning

confidence: 99%

Integrating Equity Into Bicycle Infrastructure, Planning, and Programming: A Mixed Methods Exploration of Implementation Among Participants in the Bicycle Friendly Community Program

Lemon,

Neptune,

Goulding

et al. 2023

Prev. Chronic Dis.

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Introduction Integrating equity considerations into bicycle infrastructure, planning, and programming is essential to increase bicycling and reduce physical inactivity–related health disparities. However, little is known about communities’ experiences with activities that promote equity considerations in bicycle infrastructure, planning, and programming or about barriers and facilitators to such considerations. The objective of this project was to gain in-depth understanding of the experiences, barriers, and facilitators that communities encounter with integrating equity considerations into bicycle infrastructure, planning, and programming. Methods We administered a web-based survey in 2022 to assess communities’ experiences with 31 equity-focused activities in 3 areas: 1) community engagement, education, events, and programming (community engagement); 2) data collection, evaluation, and goal setting (data); and 3) infrastructure, facilities, and physical amenities (infrastructure). Respondents were people who represented communities in the US that participated in the League of American Bicyclists’ Bicycle Friendly Community (BFC) Program. We then conducted 6 focus groups with a subset of survey respondents to explore barriers and facilitators to implementing equity-focused activities. Results Survey respondents (N = 194) had experience with a mean (SD) of 5.9 (5.7) equity-focused activities. Focus group participants (N = 30) identified themes related to community engagement (outreach to and engagement of underrepresented communities, cultural perceptions of bicycling, and funding and support for community rides and programs); data (locally relevant data); and infrastructure (political will, community design, and infrastructure). They described barriers and facilitators for each. Conclusion Communities are challenged with integrating equity into bicycle infrastructure, planning, and programming. Multicomponent strategies with support from entities such as the BFC program will be required to make progress.

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Section: Discussionmentioning

confidence: 99%

Integrating Equity Into Bicycle Infrastructure, Planning, and Programming: A Mixed Methods Exploration of Implementation Among Participants in the Bicycle Friendly Community Program

Lemon,

Neptune,

Goulding

et al. 2023

Prev. Chronic Dis.

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“…This suggests the need for a prevention-centered safety strategy. Incidental and inadvertent usage have been frequently found among people with disabilities when participating in public spaces, where injuries tend to occur in public facilities, and some city parks contain potentially dangerous features as a result of unsafe design conditions, such as restrooms, sidewalks, or different height levels (Kapsalis, Jaeger and Hale 2022). A tradeoff between accessible and safety solutions must not be a consideration for people with disabilities since it can cause severe or long-term harm.…”

Section: A Modified Approach For the Universal Designmentioning

confidence: 99%

Improving Accessibility to Urban Greenspaces for People with Disabilities: A Modified Universal Design Approach

Selanon,

Chuangchai

2023

Journal of Planning Literature

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Despite the integration of universal design, access to urban greenspaces, which provide multiple health benefits, has been restricted among people with disabilities, particularly in developing countries. This article argues that the sole use of the seven principles of universal design is inadequate for urban greenspace planning as it consistently fails to prevent serious injuries, accommodate multiculturalism, and disregard subjective feelings when addressing people with disabilities. Additional approaches, including a safety strategy, diverse cultural behavior acceptability, and emotional design through landscape naturalness, are considered to improve accessibility, thereby reducing urban health inequalities and achieving an inclusive city.

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“…Prior work suggests that adults living in socioeconomically deprived neighborhoods, which have higher rates of crime, 3 less available green space, 4 poorer quality built environments (eg, sidewalks), 5 and higher noise pollution 6 may be more vulnerable to both psychological and cognitive declines. 7 Residents of nursing homes located in these areas are not immune to these neighborhood concerns, which may impact sleep, social functioning, and exposure to green space due to limited opportunities for outings outside the nursing home, and ultimately contribute to mental and physical health stressors 8 that may manifest with behavioral symptoms or agitation.…”

Section: Introductionmentioning

confidence: 99%

Staffing and Antipsychotic Medication Use in Nursing Homes and Neighborhood Deprivation

Travers,

Hade,

Friedman

et al. 2024

JAMA Netw Open

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ImportanceInappropriate use of antipsychotic medications in nursing homes is a growing public health concern. Residents exposed to higher levels of socioeconomic deprivation in the area around a nursing home may be currently exposed, or have a long history of exposure, to more noise pollution, higher crime rates, and have less opportunities to safely go outside the facility, which may contribute to psychological stress and increased risk of receiving antipsychotic medications inappropriately. However, it is unclear whether neighborhood deprivation is associated with use of inappropriate antipsychotic medications and whether this outcome is different by facility staffing levels.ObjectiveTo evaluate whether reported inappropriate antipsychotic medication use differs in severely and less severely deprived neighborhoods, and whether these differences are modified by higher levels of total nurse staffing.Design, Setting, and ParticipantsThis was a cross-sectional analysis of a national sample of nursing homes that linked across 3 national large-scale data sets for the year 2019. Analyses were conducted between April and June 2023.ExposureNeighborhood deprivation status (severe vs less severe) and total staffing hours (registered nurse, licensed practical nurse, certified nursing assistant).Main Outcome and MeasuresThis study estimated the association between neighborhood deprivation and the percentage of long-stay residents who received an antipsychotic medication inappropriately in the nursing home at least once in the past week and how this varied by nursing home staffing through generalized estimating equations. Analyses were conducted on the facility level and adjusted for state fixed effects.ResultsThis study included 10 966 nursing homes (1867 [17.0%] in severely deprived neighborhoods and 9099 [83.0%] in less deprived neighborhoods). Unadjusted inappropriate antipsychotic medication use was greater in nursing homes located in severely deprived neighborhoods (mean [SD], 15.9% [10.7%] of residents) than in those in less deprived neighborhoods (mean [SD], 14.2% [8.8%] of residents). In adjusted models, inappropriate antipsychotic medication use was higher in severely deprived neighborhoods vs less deprived neighborhoods (19.2% vs 17.1%; adjusted mean difference, 2.0 [95% CI, 0.35 to 3.71] percentage points) in nursing homes that fell below critical levels of staffing (less than 3 hours of nurse staffing per resident-day).Conclusions and RelevanceThese findings suggest that levels of staffing modify disparities seen in inappropriate antipsychotic medication use among nursing homes located in severely deprived neighborhoods compared with nursing homes in less deprived neighborhoods. These findings may have important implications for improving staffing in more severely deprived neighborhoods.

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Disabled-by-design: effects of inaccessible urban public spaces on users of mobility assistive devices – a systematic review

Cited by 33 publications

References 99 publications

Integrating Equity Into Bicycle Infrastructure, Planning, and Programming: A Mixed Methods Exploration of Implementation Among Participants in the Bicycle Friendly Community Program

Integrating Equity Into Bicycle Infrastructure, Planning, and Programming: A Mixed Methods Exploration of Implementation Among Participants in the Bicycle Friendly Community Program

Improving Accessibility to Urban Greenspaces for People with Disabilities: A Modified Universal Design Approach

Staffing and Antipsychotic Medication Use in Nursing Homes and Neighborhood Deprivation

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