Universal Livability: A Dream for Tomorrow, A Plan for Today

California 2005-10 Strategic Plan for Promoting the Health of People with Disabilities

California Department of Health Services Office on Disability and Health and Living Healthy Advisory Committee

Dedication

The Office on Disability and Health (ODH) Team and Living Healthy Advisory Committee wish to dedicate this plan to:

Steven, who lived his life more quickly than some and more slowly than others, and helped us see the human face behind our policy discussions.

Suzanne Fitts Valters, one of the ODH Team's greatest mentors, who lived her life to the fullest, but died from preventable secondary conditions. We will remember Suzanne as a fearless advocate, policy expert, diplomat, and cherished friend.

Preface

Disability can be described as the difficulties people have doing ordinary things because of a mismatch between their capacities and the demands of their environment.1 Following the traditional Medical Model, most policies and programs have focused on people's incapacities or impairments and the related activity limitations. Little attention has been given to changing the second part of the equation, or adopting the Social Model of Disability, which shifts the focus away from "fixing the impaired individual" to creating universally accessible physical and social environments.1

Both the Medical Model and Social Model are part of the public health approach. Public health addresses entire populations, whose health depends both on individual care and physical and social environments. Public health approaches disability by using science to inform policies and practices aimed at promoting the health of people with disabilities.

Many of the triumphs of public health have come from changing the social and physical environment: smoke-free communities, lead and asbestos abatement, buckled up babies and families, and safer cars and highways. Changes like these prevent much morbidity and save countless lives, mostly by creating a safer environment rather than by trying to bend human behavior to adapt to environmental hazards. Likewise, environmental changes are the goal of smart policies for improving the well-being of people with disabilities.

Using a public health approach, the ODH Team and the Living Healthy Advisory Committee, have together created Universal Livability: A Dream for Tomorrow, A Plan for Today. This plan proposes policies and interventions to improve social and physical environments, prevent secondary conditions, and increase participation in health promotion opportunities for Californians with disabilities. Public health defines environment in terms of "units of solution" that can be subject to deliberate change. Communities, hospitals, schools, businesses, and neighborhoods are all examples of these units.2 This plan identifies units of solution for the issue of accessibility, consistent with the Americans with Disabilities Act (ADA), which makes disability access the responsibility of government, including the California Department of Health Services (DHS).

During the development of this document, the Living Healthy Advisory Committee and the ODH Team agreed on the following principles as the foundation for this plan: