Health conditions that need to be considered for universal design
Our bodies are incredibly complex. Sometimes things quit working and our bodies don’t function at 100%. Sometimes it’s not possible to fully correct problems. Life often goes on. Design can and should support variations of human ability as best as possible.
Universal design is, by definition, “design that’s usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.” It’s typically thought of as a softer, more positive way of designing stuff for people with disabilities. I don’t know how long it’ll take people to see the flaw in that (forever?), but that’s where we are today.
Most people associate universal design with physical accommodation, which makes sense because the physical world is the most tangible and the most visible. But what often goes overlooked is design that’s accommodating to a vast range of sensory, cognitive, and social variations of human ability.
I sat down with Sarah and two occupational therapy students to brainstorm some different health conditions that need to be considered for successful universal design efforts.
Health Conditions
The following is by no means an exhaustive list of health conditions, but it should help you see that universal design, if it truly is “usable by all people,” should consider the needs of far more people than just those who use wheelchairs or those who are on the older end of the lifespan.
Physiological & Systems Functions
Conditions like cancer, osteoporosis, arthritis, fibromyalgia, or diabetes can chronically decrease our occupational performance (i.e., how well we do the things we do). Parts of our bodies (heart, lungs, skin, bones, etc.) and their associated systems (cardiovascular, respiratory, integumentary, skeletal, etc.) are susceptible to problems that can decrease function, or cause fatigue and pain. The tricky part is that many effects of conditions related to physiological and systems functions are often not visible to the untrained eye.
Sensory
When our senses are compromised, the ways we interact with environments and other people can also be compromised. Our senses include vision (sight), audition (hearing), gustation (taste), olfaction (smell), tactition (touch), thermoception (heat, cold), nociception (pain), equilibrioception (balance, gravity), and proprioception (body awareness). As you might imagine, a myriad of conditions can affect our senses, such as retinitis pigmentosa, tinnitus, multiple sclerosis, cerebrovascular accident (stroke), tetraplegia/paraplegia (spinal cord injury), vertigo, sensory processing disorder, and more.
Neurological (Cognitive & Physical)
Examples of neurocognitive and neurophysical conditions include amyotrophic lateral sclerosis, craniocerebral trauma (brain injury), epilepsy, Parkinson’s, Alzheimer’s, Guillain-Barré syndrome, cerebral palsy, muscular dystrophy, spinal cord injury, and more. The neurological system carries messages to and from the brain and spinal cord to various parts of the body. If this system is compromised, often someone’s functional ability is compromised as well, which can result in the daily need for mobility equipment or the potential need for assistance from caregivers.
Intellectual & Developmental
Many individuals with intellectual disabilities and/or developmental delay (ID/DD) live independently, but many require support for success. These supports may be environmental (e.g., the design of the home or infrastructure of the community), or interpersonal. Examples of ID/DD conditions include autism, Down Syndrome, attention-deficit/hyperactivity disorder (ADHD), Asperger’s, fetal alcohol syndrome, and more.
Mental Health
Conditions such as Post-Traumatic Stress Disorder (PTSD, or Post-Traumatic Stress), Seasonal Affective Disorder, Reactive Attachment Disorder, anxiety, depression, Bi-Polar and many other examples, can significantly impact everyday life. It’s less obvious how design can support individuals with mental health conditions, but optimizing safety (and the perception thereof) and minimizing stimuli can make a big difference here.
Orthopedic
The obvious examples of orthopedic impairments are fractures (broken bones) and amputations, both of which can greatly impact how people perform activities of daily living (ADLs) at home and participate in their communities. Conditions like arthritis, osteoporosis, hip dysplasia, spondylolisthesis, carpal tunnel syndrome, herniated disks, and more will often have long-term effects on someone’s functional capacity, even after corrective surgeries and treatments.
Universal design vs. specialized design
It’s important to recognize that universal design isn’t a one-size-fits-all approach to design. Rather, it’s about designing things that are usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.
Many of the aforementioned health conditions will require the use of adaptation or specialized design. This is perfectly acceptable, but is beyond the scope of universal design. The challenge is to know where to draw the line between design that’s usable by all people and design that’s tailored to certain individuals.
The solution
In order to understand where that line is, and thus do universal design successfully, it’s imperative to involve people who understand the functional issues related to health conditions like the ones mentioned above. This is why we’re convinced that collaboration between design professionals, health professionals, and people who have life experience with disability is the best way to approach universal design work.
And no, it’s not easy, nor inexpensive, but it’s worth it if we want to make sure everyone is included.
