Jennifer Rowland, Ph.D.

Secondary condition development and severity can be linked to the availability of health-promoting resources such as physical activity programs and nutritious foods. People with disabilities often face numerous barriers to participating in the physical and nutritional activities they need to maintain health and wellness. These include inaccessible exercise facilities and equipment, lack of professional knowledge in understanding the person's disability, inappropriate professional behavior, lack of transportation to get to an exercise facility, and failure on the part of workers to understand the needs of persons with disabilities. The Healthy People 2010 chapter, Disability and Secondary Conditions, suggests that the significantly lower rate of participation among people with disabilities may be related to environmental barriers, including architectural barriers, organizational policies and practices, discrimination, and social attitudes, and recommends that public health agencies begin to evaluate which environmental factors enhance or impede participation.

When examining ways of preventing or reducing the likelihood of developing secondary conditions (i.e., deconditioning, obesity), it is important to consider the type of environment you are surrounding yourself with and how you can minimize these potential health risks. One of the projects we are working on at the University of Illinois at Chicago is entitled, "Building Health Empowerment Zones for Persons with Disabilities." Within this project we are examining how the built environment can influence health for people with mobility disabilities - specifically, whether accessibility to health-related services such as fitness centers and healthy food sections of grocery stores can affect an individual's report of health, including secondary conditions. While the general population obtains most of their physical activity in outdoor settings such as neighborhood streets, shopping malls, parks, and walking/jogging paths, access to walking for people with mobility disabilities who have difficulty walking or cannot walk is often limited by these inaccessible environments. Some streets do not have curb cuts; sidewalks are damaged, creating a higher risk of falling; walkways or walking paths are too narrow for a wheelchair user and partner to walk side-by-side; many communities do not have sidewalks; or the terrain has too steep a grade or slope. Other problems with outdoor environments include unsafe neighborhoods; poor weather making sidewalks slippery or impassable; not having enough benches along a trail for people who need frequent rest periods; poorly designated signage; no accessible bathrooms along a trail or path; and no accessible parking spaces in close proximity to a trail.

Building your own "Health Empowerment Zone" starts with finding out what types of accessible resources are available in your community.

• Locate accessible fitness facilities and programs in your area using NCPAD's searchable programs database at http://www.ncpad.org/directories/15/Programs
• Become more knowledgeable about the types of foods you need to consume to achieve your goals or manage your specific disability or health condition by browsing the nutrition section of NCPAD's website at http://www.ncpad.org/content/12/Health~Promotion~Nutrition.
• Use other NCHPAD Products and Resources listed in this month's Information Specialist's Desk http://www.ncpad.org/newsletter/717/3600/August~2007 to help locate and create accessible physical activity environments in your community.

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I encourage you to write to me with suggestions for future column topics or to comment on the information provided in this column. You can reach me by e-mail at jenrow@uic.edu.