Reaching People with Disabilities through Healthy Communities

To address health disparities experienced by people with disabilities, the CDC’s Disability and Health Branch and the National Association of Chronic Disease Directors (NACDD)External developed a collaborative project to promote disability inclusion strategies to make healthier choices the easier choices for all people where they may live, learn, work, and play. The Reaching People with Disabilities through Healthy Communities Project bridges state disability and health efforts and community engagement by addressing physical inactivity, poor nutrition and tobacco use and exposure through multi-sectoral community coalitions and infusing state-level disability expertise and resources to help accelerate local improvements.  CDC and NACDD partnered with the National Center on Health, Physical Activity, and Disability (NCHPAD)External to provide access to and technical assistance for tools that could be used at the local level to identify and address health disparities and inequities faced by people with disabilities.

Please see the list of success stories below to learn more about the work being done in each community.

Inclusive Physical Activity in Carroll County, Iowa

Inclusive Physical Activity in Carroll County, Iowa

Total Population: 20,204 1

Population of People with Disabilities: 2,246 1

Individuals with disabilities, including those with intellectual and developmental disabilities, tend to be less active and are at higher risk for long-standing diseases such as diabetes, heart disease and cancer than individuals without disabilities. They often lack access to routine physical activity for reasons such as cost, not being aware of the activities, fear that they will not be able to keep up with others, and lack of enough accessible services and trained staff to work effectively with them.

In an effort to increase physical activity among individuals with intellectual and developmental disabilities, Homecare Options, Inc. – a Carroll County, Iowa agency that provides independent living services to people with disabilities in day and residential programs – collaborated with the National Association of Chronic Disease Directors (NACDD)’s Reaching People with Disabilities through Healthy Communities project. Together they established a new policy, setting a goal of a minimum of 30 minutes of daily physical activity for the participants in their day programs and for people living in their residential setting. Through an agreement with Platinum Fitness, a local gym, and Train to Inspire, a local nonprofit, 19 people with disabilities served by Homecare Options, Inc. now participate in no-cost personal training sessions and fitness classes.

Inclusive Climbing Wall in Sioux City, Iowa

An Inclusive Climbing Wall in Sioux City, Iowa

Population: 81,783 1

Population of People with Disabilities: 10,701 1

The Americans with Disabilities Act (ADA)External prohibits bias against people with disabilities and requires that public accommodations, such as restaurants, movie theaters, schools, day care facilities, recreation facilities, and doctors’ offices, are accessible. Yet facilities that meet the legal requirements for being accessible may fall short of being inclusive, if their design cannot accommodate the full participation of people with disabilities.

The Long Line Family Recreation Center in Sioux City, Iowa, is an example of a facility that was changed to be inclusive. The recreation center met ADA accessibility standards for the building and grounds, however, the climbing wall was not designed for use by people with mobility disabilities. The Reaching People with Disabilities through Healthy Communities project team worked with the City of Sioux City and the Miracle League of Sioux City—a local nonprofit that provides recreational opportunities for children and adults with disabilities—to propose ideas and find the best approaches for improving the climbing wall. People with disabilities, family members, and other agencies came together to carry out the plan and created changes to the wall to make it useable by people with disabilities. The change has helped make the recreation center more inclusive of the 10,000 community members with disabilities.

Park Project for People of all Abilities in Butte-Silver Bow County, Montana

Park Project for People of all Abilities in Butte-Silver Bow County, Montana

Population: 33,133 1

Population of People with Disabilities: 5,908 1

According to the 2017 Butte-Silver Bow Community Health Needs Assessment,External one quarter of adults in Butte-Silver Bow County are limited in some way in some activities due to a physical, mental or emotional problem. In addition, one in five adults in the County believe that their overall health is only “fair” or “poor,” which is worse than the rest of Montana.

A group of local public health and disability advocates collaborated with the National Association of Chronic Disease Directors (NACDD)’s Reaching People with Disabilities through Healthy Communities project, to develop a Community Action Plan through evaluating the community and identifying factors that could potentially contribute to improving the residents’ health. The results of the evaluation called attention to the lack of inclusive physical activity and healthy eating options in Butte.

Butte residents recently supported an effort to construct a new outdoor pool, and given the lack of inclusive physical activity options, the pool’s design committee decided it was important to add features to make the pool facilities more inclusive of people with disabilities. A representative from NACDDD’s Reaching People with Disabilities through Healthy Communities project team joined the pool’s design committee to provide input on inclusive design for the new facility and suggestions on integrating healthy eating options at the pool.   As a result of the collaboration and guidance of the project team, the new pool will include a sloped entry to the pool, two wheelchair-accessible pool lifts, accessible family changing rooms, as well as other inclusive features. The park where the new pool complex is located will also feature a playground with equipment inclusive of children and adults of all abilities.

Inclusive Healthy Design Workshop and Training in Greater Helena Area, Montana

Inclusive Healthy Design Workshop and Training in Greater Helena Area, Montana

Population: 56,990 1

Population of People with Disabilities: 7,737 1

About 1 in 7 of the residents of Lewis and Clark County, Montana –Helena area – are people with disabilities, and compared to adults without disabilities, they are twice as likely to report not having physical activity in the past month.

The Healthy Communities CoalitionExternal – a local collaborative that seeks to improve access to opportunities for physical activity and healthy nutrition in the Greater Helena area – wants to make sure that everybody, regardless of income, ability or age, can use the newly created Active Living Wayfinding SystemExternal.  As a result of the collaboration between the NACDD’s Reaching People with Disabilities through Healthy Communities project team and the Coalition, this system that links healthy destinations such as parks, urban trails and on-street routes now includes standardized sign design styles that are easy to see and find, accessible formats and supporting materials that encourage residents and visitors of all abilities in the region to live healthy and active lifestyles.

The Coalition also seeks to build capacity to incorporate inclusion in future policies and infrastructure designs, for example, they lead Inclusive Walk Audits where people in the community have the opportunity to walk through the community and identify areas that can be improved. The Coalition worked with Community Coaches from the NACDD’s Reaching People with Disabilities through Healthy Communities project to design and conduct an Inclusive Healthy Community Design Workshop and an Inclusive Walk Audit Facilitator Team Training. Over forty Healthy Communities Coalition members and guests from across state agencies and Montana communities participated in the workshop. Because of this effort, each interdisciplinary facilitator team, who conduct inclusive walk audits throughout the community, now includes one or more individuals with disabilities along with other design experts to consult on public health, planning and engineering efforts across the state. Several communities in the state have conducted inclusive walk audits since the training, including one for new business and professionals in Helena.

Accessible Streets in Cattaraugus County, New York

Accessible Streets in City of Olean, NY

Population: 77,748 1

Population of People with Disabilities: 11,716 1

In Cattaraugus County, New York, three in ten residents live with a disability, and the county has worked diligently to make environmental changes that would include people of all abilities. The city of Olean previously underwent a street redesign that was compliant with the Americans with Disabilities Act (ADA)External and approved by the Department of Transportation, yet residents who experienced mobility, hearing, or vision limitations still had trouble crossing the street safely.

Community Coaches from NACDD’s Reaching People with Disabilities through Healthy Communities project recruited and trained residents with mobility, hearing, and vision impairments to meet with Directions in Independent Living (DIL), a disability advocacy organization, and discuss the new street design. DIL staff facilitated a meeting with the City of Olean’s mayor, city council members, and residents from the city’s disability community to share accessibility and inclusion concerns with city stakeholders. As a result of this consultation, the city purchased and installed new signs designed for people with mobility, hearing, and vision impairments, creating safe and accessible crosswalks in four locations. All Olean residents benefit from these systems changes.

Making the Monday Mile inclusive for all in City of Syracuse, New York

Making the Monday Mile inclusive for all in Syracuse, NY

Population: 141,645 1

Population of People with Disabilities: 22,817 1

Approximately one in five adults in New York State has a disability, and compared to adults without disabilities, they are less likely to get leisure-time physical activity.

Two nonprofit organizations based in Syracuse, NY – ARISEExternal, a Center for Independent Living, and HealtheConnectionsExternal, a group that supports better population health in Central New York – partnered with NACDD’s Reaching People with Disabilities through Healthy Communities project to collaborate on several projects to create inclusive health opportunities.

One project was done in collaboration with the Lerner Center for Public Health Promotion at Syracuse University, which has a Monday Mile programExternal with 25 designated one mile walking routes. Each mile route is marked with maps, directional arrows and distance markers to encourage residents to be physically active. Although the Lerner Center previously worked with the Fitness Inclusion NetworkExternal to address designing inclusive walking routes, no formal policy or established process existed to ensure that new Monday Mile routes would be inclusive of people with all abilities. As a direct result of the NACDD’s Reaching People with Disabilities through Healthy Communities project, the Lerner Center adopted a new Inclusivity Policy to incorporate the principles of inclusion in the design of new Monday Mile routes. They created a checklist of considerations and a feasibility assessment to help designers implement the policy.

Project partners are already using the Inclusivity Policy with local stakeholders to designate a new Monday Mile route in a low-income Syracuse neighborhood that lacks safe, accessible walking paths. Partners are developing Monday Miles routes in parks and public places in Central New York counties where an estimated 95,000 to 115,000 people with disabilities could benefit. The Inclusivity Policy is now an integral part of the Monday Mile toolkit Cdc-pdf[9.26 MB, 71 pages]External, a planning resource used by local communities to plan accessible walking routes.

New Adapted Bikes Bring Inclusive Physical Activity to Adams County, Ohio

New adapted bikes bring inclusive physical activity to Adams County, OH

Total Population: 27,848 1

School-age Children Population: 5,533 2

School-age Children with Disabilities: 807 2

About one in six school-aged children in Adams County has a disability, and until recently, it was difficult for these students to participate in physical activity. However, Community Coaches for NACDD’s Reaching People with Disabilities through Healthy Communities project met with superintendents and directors of special education from two school districts and things began to change. Community Coaches, who are leading experts in healthy communities and disabilities and health, provided education to these officials about the importance of inclusive physical activity and various uses for adapted bicycles by students, teachers, and schools.

Due to the success of the project efforts, both school districts now have formally adopted a new physical activity inclusion policy stating that children with disabilities should have the same opportunity to participate in physical education classes and activities as children without disabilities. Also, as result of project team’s recommendations, all seven schools in Adams County are now equipped with adapted bicycles that students with disabilities can enjoy.

Children with disabilities are more likely to be obese than children without disabilities. Overweight and obesity can have serious health consequences for all people. Programs like the one in Ohio provide opportunities for children with disabilities to stay physically active and improve their health and well-being.

Better Nutrition and Physical Activity Opportunities for People with Disabilities in Marion County, Ohio

Better nutrition and physical activity opportunities for people with disabilities in Marion County, OH

Population: 59,587 1

Population of People with Disabilities: 11,891 1

In Marion County, Ohio, three in four adults and about five in six children report eating fewer than the recommended five servings of fruits and vegetables daily. The 2015 Marion County Health Assessment Cdc-pdf[5.33 MB, 141 pages]External showed that about one in five people were living in poverty, and one in six low-income families lived more than a mile from a grocery store. In addition, about one-third of people in the county had a disability, a population group that, compared to people without disabilities, had higher rates of obesity and long-standing diseases, such as diabetes and heart disease.

Marion Public Health participated in NACDD’s Reaching People with Disabilities through Healthy Communities project by working with partners to launch a mobile food pantry. The partners used community data and the USDA Food Access Research MapExternal to establish distribution locations that would reach underserved and vulnerable populations. They also worked to make the pantry physically accessible to people with disabilities.

Marion County’s mobile food pantry helps to increase reliable access to healthy food and ensure that people with disabilities are part of a community-wide solution. Currently, the mobile food pantry in Marion County serves more than 100 families, including 25 individuals with disabilities.

Building an Accessible Downtown in Benton County, Oregon

Building an accessible downtown in the city of Corvallis, OR

Population: 87,187 1

Population of People with Disabilities: 9,217 1

It is vital to the health and well-being of people with disabilities that they have full, equitable access to all places in their communities. However, in the City of Corvallis, in Benton County, many people with disabilities were not able to access farmers markets, restaurants, theaters, fitness centers, the waterfront, and many other downtown locations where people socialize and shop.

Community Coaches for NACDD’s Reaching People with Disabilities through Healthy Communities project facilitated meetings between the Benton County Health Department (BCHD), Corvallis Public Works, civil engineering graduate students from Oregon State University, and community members to develop a draft concept plan for a re-designed downtown. The final draft presented to the Corvallis City Council, Council advisory boards, community members, and city staff proposed several ideas for increasing access to downtown for people with disabilities, including more accessible parking spots, re-designed crosswalks, curb cuts, and sidewalks, which would create a new streetscape that increases safety and promotes walking, rolling and biking for everyone.

BCHD presentations on the draft concept plan reached many community members and prompted a front-page articleExternal in the local newspaper. This publicity resulted in community discussions on the implementation of the ideas outlined in the plan. Corvallis Public Works is now working closely with the Downtown Corvallis, Downtown Parking, and Bike and Pedestrian Advisory Boards to finalize recommendations to present to the Corvallis City Council for approval. When finished, this project will support inclusion by providing access to resources and facilities that promote better health and wellbeing for all residents with disabilities in the county.

First Mobility-charging Device at Umatilla County, Oregon

Mobility device-charging stations in Umatilla County, OR

Population: 72,041 1

Population of People with Disabilities: 10,791 1

Approximately one in seven community members in Pendleton, Oregon, are living with a disability and many of them rely on power wheelchairs and other mobility devices to get around and actively participate in their communities.  However, all these devices run out of power after a certain period of time and when the battery dies, users can get stuck.

Community Coach Darrin Umbarger, participant in NACDD’s Reaching People with Disabilities through Healthy Communities project and a power wheelchair user himself, found the perfect solution; he developed the mobility device-charging station.  This unit, which can easily be mounted anywhere there is an electrical outlet, can assist power wheelchair users who need to chargei batteries while in the community. Mr. Umbarger and other community coaches collaborated with the Pendleton Parks and Recreation Department to install the power charging stations and accompanying signage in locations around the community.

Ten mobility device-charging stations have been installed in various community settings so far, including a recent installation at the Oregon Statehouse, serving as the first power charging station at a state capitol location in the country. Now, Mr. Umbarger and other power wheelchair users have an added sense of security, safety, and belonging to the community, where access to healthy living venues like community parks and places of interest are improved.


  1. United States Census Bureau / American FactFinder. “S1810: Disability Characteristics.” 2012-2016 American Community Survey. U.S. Census Bureau’s American Community Survey Office, 2016. Web. 2 February 2018
  2.  Ohio Department of Education