When I first decided to create a menu for those who were low vision or blind, I never could have imagined how many things I would learn on this journey. Color contrast, glossy chalkboards, and how to 3-D print are just a few things I can name. However, the menu project became bigger than itself. I decided to take it further, and analyze exactly why many crucial accessibility components are missing, especially in small towns like Mountain Lakes.
Rural Infrastructure
Taking a look into infrastructure gives a clearer picture of the rural accessibility landscape. Although the scope of the paper was not written in the context of the United States, Dassah finds that “persons using wheelchairs in rural South Africa had to navigate mud and gravel,” and these conditions only worsened with flooding and rain. Dassah found similar results in Thailand as well (Dassah). These findings, while international, can still be applied to the United States. Certain underdeveloped areas in the U.S. use gravel roads, and more run-down commercial centers also pose a challenge to wheelchair users. Confirming this, Ackerman notes that “communities in rural Kendall and McHenry counties have less than 25% of roads with any type of sidewalk coverage” compared to bigger urban cities in Chicago with upwards of 59% sidewalk coverage (Ackerman). This mirrors conditions in South Africa and Thailand. Moreover, the U.S. Department of Transportation has stated that “40% of roads in rural areas are inadequate for travel while nearly 50% of bridges over 20 feet long are currently considered ‘structurally deficient,’” furthering the claim that Dassah made (Ackerman). Both national and international rural areas all, unfortunately, rely on unsafe roads and infrastructure for travel. All these challenges are only exacerbated when storms pass through, causing erosion and mud. Wheelchair users, in turn, have a much more difficult experience when navigating small towns.
A fundamental component to PWDs is the healthcare infrastructure. While there are many concerns with the cost, an often overlooked component is the physical aspect of the clinic itself. Iezzoni discovered that many clinics do not even have ramps at the entrance of the building, making it difficult for wheelchair access. More than that, when conducting medical interviews, it was found that the waiting rooms were often not soundproof, limiting patient confidentiality. When patients actually entered the examination room, the measurement tools were difficult to move and, thus, doctors often had to forgo routine measurements and asked patients to self-measure (Iezzoni). Despite the source being slightly dated (2006), the claims made still largely hold true. Dassah confirms this. They found that many corridors were narrow, preventing wheelchair mobility, and that even bathrooms were hard to reach. Additionally, Dassah furthered the finding about adjustable-height examination tables. There were many reports filed regarding complaints about the tables (Dassah). The physical components of living are typically the most important. Without proper access and care taken to ensure conditions are inclusive, the results can be devastating for those who can not access autonomy as easily.
Concluding Thoughts
So what can be done? It all starts with awareness. That awareness can feed into autonomy and independence for those who lack it. It can also show the value that every human has. When I worked with Maddy, because the little tasks were difficult for her, I never even knew she was a musician until a few weeks into the process. When redesigning infrastructure, I hope we can all realize that while certain tasks may seem simple for us, it can seem like an insurmountable challenge for others. However, through careful reconsideration of policies, even ones that save only a few seconds of time, we can work to create a more accessible community for everyone.
Works Cited
Ackerman, Sidney; Aghevli, Ariana; Aguilar, Jenna; et al., “Accessibility Challenges Encountered by People with Disabilities and Older Residents of Rural Areas” (2025). Undergraduate Coursework. Paper 7. Purdue University.
Dassah, Ebenezer, et al. “Factors Affecting Access to Primary Health Care Services for Persons with Disabilities in Rural Areas: A ‘best-fit’ Framework Synthesis.” Global Health Research and Policy, vol. 3, no. 1, Dec. 2018, https://doi.org/10.1186/s41256-018-0091-x.
Iezzoni, Lisa I., et al. “Rural Residents with Disabilities Confront Substantial Barriers to Obtaining Primary Care.” Health Services Research, vol. 41, no. 4p1, 31 Mar. 2006, pp. 1258-75, https://doi.org/10.1111/j.1475-6773.2006.00534.x.
0
0
