Creating inclusive communities

Presentation for Rights & Inclusion Australia & ANUHD Accessible and Affordable Housing ForumSydney, 19 November, 2015

Emily Steelhttp://www.mdpi.com/1660-4601/12/9/11146

Living independently and being included in the community (Article 19, UN CRPD)

Australia’s National Disability Strategy (2010-2020)

1. Inclusive and accessible communities

2. Rights protection, justice and legislation

3. Economic security

4. Personal and community support

5. Learning and skills

6. Health and wellbeing

Communities directly impact on health

“…continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all

the functions of life and in developing to their maximum potential” (WHO, 1998)

People participate in healthy activities when they live in communities that afford them access to cultural, economic, and social

participation.

Threats to the health of communities

Disablement occurs in the space between individuals’ capabilities, the tasks they aspire to, and the environments in which they exist.

• Imbalance: a lack of balance among work, rest, self-care and play.• Deprivation: results from preventing people participating.• Alienation: a sense of estrangement and lack of satisfaction with

one’s life activities.

National Disability Strategy 2010-2020 Evidence Base www.dss.gov.au/sites/default/files/documents/05_2012/nds_evidence_base_nov11.pdf

Reciprocity of participation and health

Level of participation is linked with stress levels, physiological changes and other indicators of physical and mental health.

E.g. The temporary closure of a day centre for elderly people led to increased plasma prolactin and cortisol (hormones that indicate psychological stress).

Participation is a good predictor of quality of life among people with disability.

Law, Steinwender & Leclair, L. (1998)

What is the relationship between community environments and inclusion?

Inclusion is more about interdependence than independence.

Is there a shared (societal) responsibility for the structural restrictions on one’s health that cannot be addressed by individual

agency alone?

https://www.youtube.com/watch?v=R_AEQbxoez8&feature=youtu.be

ICFHealth condition,

disease or disorder

Body functions and structures Activities Participation

Environmentalfactors Personal factors

Functioning and disability

Contextual factors

helps us to think about and describe people’s health and

wellbeing

Findings from the Equipping Inclusion studies

Based on a survey of 100 Victorian adults living with disability

– Supports include assistive technology devices, home modifications, personal support and community environs

– People make trade-offs and ration their participation

– Accessible and inclusive home and community environments are essential for mobility, a necessary capacity for participation.

…. bumpy and steep crossovers are extremely difficult to navigate… my head moves too much for my chin to remain on the chin control…nearly

impossible to get to the park….

…when a shop is only partly accessible and the specials are in an area where there is no

accessibility…

Environmental factors influencing inclusion

Physical

Attitudinal

Socio-economic

Institutional

Virtual

“It only has one small step”“There is just a step into the shower”

“Parking is close by”

“No amount of smiling at a staircase will turn it into a ramp.”

Stella Young, 2014

Collective action to promote inclusion

• Participatory planning, implementation, and evaluation (health enhancing)

• Attempt to modify the sociocultural, political, economic and environmental context to achieve health and wellbeing.

• Focused on population rather than the individual

Desired outcomes: Prevention of problems Increased engagement and participation enhanced well-being Justice for individuals and for the collective

References and resources

• Aids and Equipment Action Alliance: Making Participation and Inclusion a Reality. www.aeaa.org.au

• Disability Inclusive Research Collaboration. Disability Inclusive Research Principles. http://www.cds.med.usyd.edu.au/disability-inclusive-research-principles

• Law, M. Steinwender, S. & Leclair, L. (1998). Occupation, health and well-being, Canadian Journal of Occupational Therapy, 65, 81-91.

• Layton, N.; Wilson, E.; Colgan, S.; Moodie, M.; Carter, R. (2010) The Equipping Inclusion Studies: Assistive Technology Use and Outcomes in Victoria; Deakin University: Melbourne.

• Layton, N (2014). Assistive Technology Solutions as Mediators of Equal Outcomes for People Living with Disability; Deakin University: Melbourne.

References and resources (cont’d)

• Layton, N., & Steel, E. (2015). “An Environment Built to Include Rather than Exclude Me”: Creating Inclusive Environments for Human Well-Being. International Journal of Environmental Research and Public Health, 12(9), 11146-11162

• United Nations. (2006). Convention on the Rights of People with Disabilities and Optional Protocol. Geneva.

• World Health Organisation, & World Bank. (2011). The World Report on Disability. In T. Kahane & B. Ross-Larsson (Eds.). Geneva.

• WHO (1998). Terminology for the European Conference on Health, Society and Alcohol. Copenhagen.

• WHO (2001). International Classification of Functioning, Disability and Health. Geneva.