Including people with disabilities in everyday activities involves implementing practices and policies to identify and eliminate barriers. The World Health Organization (WHO) defines barriers as,“Factors in a person’s environment that, through their absence or presence, limit functioning and create disability.” This can include physical, communication, and attitudinal barriers. Including people with disabilities in everyday activities involves implementing practices and policies to identify and eliminate physical, communication, and attitudinal barriers. These efforts ensure that people with disabilities can fully participate in society, just like those without disabilities.

The ADA Standards for Accessible Design and Title II and III regulations outline what is required for a building or facility to be physically accessible to people with disabilities. The ADA Standards for Accessible Design (“ADA Standards”) cover:

• Newly constructed buildings and facilities;
• Alterations such as renovations and other changes that affect usability—made to buildings and facilities;
• Making architectural changes in existing state and local government buildings to provide “program access”;
• It removes architectural barriers that are easily accomplishable with little difficulty or expense in existing buildings of businesses.

One approach to ensuring equitable access and accommodations in public facilities for the disabled population is universal design principles. Universal design is the design of products and environments to be usable by all people, to the greatest extent possible, without adaptation or specialized design. Crossing signals that are audible and visible, curb cuts, ramps, broad sidewalks for wheelchairs and strollers, screen reader usability, and font size are a few examples of universal design. The term “universal design” is often considered a compliance measure for ADA. Universal design goes beyond minimum standards and legislation to ensure that people with disabilities are considered in the designing process of products, services, and physical spaces. Universal design is the design and composition of an environment that all people can access, understand, and use it to the greatest extent possible, regardless of age, size, ability, or disability. Universal design is based on seven principles:

• Equitable Use - The design is useful and marketable to people with diverse abilities.
• Flexibility in Use - The design accommodates individual preferences and abilities.
• Simple and Intuitive Use - The use of the design is easy to understand, regardless of the user’s experience, knowledge, language skills, or current concentration level.
• Perceptible Information - The design communicates necessary information effectively to the user, regardless of ambient conditions or the user’s sensory abilities.
• Tolerance for Error - The design minimizes hazards and the adverse consequences of accidental or unintended actions.
• Low Physical Effort - The design can be used efficiently, comfortably, and with minimal fatigue.
• Size and Space for Approach and Use - Appropriate size and space are provided for approach, reach, manipulation, and use regardless of the user’s body size, posture, or mobility.

The barriers that hinder accessibility for the disabled population extend far beyond the physical environment. In the era of advanced technologies, the implementation of technological products and services fail to include various disabilities in the design process. Some of the prominent disabilities that lack inclusion in the design process include those with blindness or low vision and deafness/hard of hearing. Assistive technology (AT) has immense potential to improve access and social participation for those with disabilities. Examples of universal design that can be implemented by local health departments include using inclusive communication and assistive technology.

Integrating Universal Design principles enables local health departments to create more inclusive, efficient, and user-friendly environments, ultimately leading to better health outcomes for their communities. By ensuring that health services and information are accessible to people of all abilities, departments can promote equitable health care to reach a wider audience. This approach also enhances public health outcomes, reduces long-term costs by minimizing the need for reconstructing building and improves the overall user experience by making services simple, intuitive, and adaptable to diverse needs. Additionally, aligning with regulatory requirements and promoting accessibility initiatives builds community trust and encourages greater participation in health programs, enhancing public health through greater engagement and inclusivity.