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We explore the effects and interplay of physical and social environments on the inaccessibility of gynecological health care for women with spinal cord injury. We also explore women’s responses to the inaccessibility of this care, in hopes of trying to understand better how women navigate their gynecological health and health care when faced with physical and social environmental constraints.

The data for this phenomenological study were gathered using in-depth, qualitative interviews with 20 women living with spinal cord injuries in or around Detroit, Michigan. Each interviewee was questioned about overall health and physical functioning, accessibility of doctor offices, interactions with health care providers, gynecological health-seeking behaviors, and complementary and alternative medicine use. In this paper we report on data on women’s difficulties in securing gynecological health care experiences and related attitudes and practices.

Findings echo past literature about the inaccessibility of doctor’s offices, including the lack of suitable exam tables and medical equipment. Office staff varied in their willingness to help transfer women from wheelchairs to exam tables as well, often creating what we term an inaccessible social environment. Individual women in our sample found different strategies for navigating the environmental contexts of a doctor’s office and the encounters that they had with providers within medical settings. These strategies had varying impacts on individuals’ abilities to secure gynecological health care.

Our findings point to the possibility of an interplay between and intersection of physical and social environments within medical settings that needs to be explored further and, potentially, the primary importance of the social environment over the physical environment in determining whether an individual’s disability makes health care inaccessible.

The size of the population classified as people with disabilities or older adults is increasing globally. The World Health Organization estimates that the average prevalence of disability is around 18% among adults age 18 and older. People with disabilities and older adults have lower levels of physical activity and experience significant barriers to walking in local neighbourhoods. A new perspective is needed that views disability in the context of the built environment and across the lifespan. The purpose of this chapter is to examine walking as an activity that is inclusive of any age, ability or assistive device used for mobility. Through a literature review, we illustrate the complex relationship that exists between individuals with disabilities/older adults and the built environment. We describe environmental and social factors, which have been found to be associated with walking among people with disabilities and older adults as well as factors perceived to be barriers to walking. Factors cited in the literature include aspects that fall into the environmental domains of the International Classification of Functioning. We conclude by highlighting key factors needed for planning supportive walking environments for people with disabilities and older adults. Recommendations include the use of walking audits to gain information on detailed aspects of the built environment, developing inclusive walking initiatives, including people with disabilities and older adults in the planning process and planning for maintenance.

Since the mid-1990s, the social model of disability has come under scrutiny. Several researchers have examined the role of ontology (philosophical ideas about the nature of what it means to be human) in relation to disability. In this paper, we situate this burgeoning understanding of disability within the set of post-cartesian ontologies, which disrupt the separation of the mind from the body and its attendant dichotomies. Furthermore, we seek to show how such a change can carry through to the research paradigm and therefore affect tangible outcomes of disability research.

A commitment to an embodied ontology requires first and foremost that researchers rethink what is being studied by focusing on the diverse characteristics of being and its actualization within the world. This will involve an emphasis on the lived experience of the body, including issues of affect, identity and movement, as well as broader issues of embodied being.

Using a research program currently underway at the Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) as a detailed example, we draw on the ontological framework to help articulate the way research can be re-organized. We show how projects at different scales can be brought to work together, and highlight how a focus on embodiment issues facilitates such multi-disciplinary, inter-project collaboration. We note that adopting such an ontology-based framework will accomplish three major outcomes: (1) increase the relevance and effectiveness of new projects with regard to the overall vision; (2) enhance cross-project synergies and ensure stronger ties between research and practice; and (3) contribute to shifting the underlying ontology from a more cartesian approach to a post-cartesian embodied perspective.

The new ontologies embrace, integrate and extend the earlier social and biomedical perspectives, and offer a critical perspective on technology. The embodied approach recognizes not only the embodiment of research subjects, but also the embodied experience of the researchers themselves. In addition, the approach leads to a more holistic organization of research within a global, interconnected structure of projects rather than simply a collection of separate projects organized into thematic areas, as was done in previous decades. This reorganization of research enhances the ability to engage academic researchers with practitioners not just in the hospital and clinical settings, but also within the wider community.

In recent years, recognition of environmental influences in public health has expanded to include more components of the environment such as the built environment, attitudes, and public policies. This environmental attention has addressed the need for healthier housing, schools, roads, and work sites, as some examples. Paralleling the development of awareness of the impact of environment on health and health behaviors, the influence of the environment and its contribution to the experience of disability has become more apparent. This national descriptive analysis of environmental barriers contributes to our understanding of the extent of environmental considerations for the entire U.S. adult population, not just older individuals, and will document those problems for those with self-reported functional limitations (i.e., disability).

This analysis uses the 2002 National Health Interview data to examine physical, social, and policy barriers experienced by the U.S. national population of adults age 18 or over. Focusing specifically on those who report a physical, activity, participation, or mental health limitation, the experience of barriers in the home, workplace, school, and the community is examined using descriptive analyses.

Results indicate that approximately 11% of the population with disabilities and 2% of the nondisabled adult population experience barriers in their daily lives. Severity of limitations and poor health status among those with disabilities increase the experience of barriers. The only sociodemographic factor related to reporting barriers was income. Depending on the kind of limitation, up to 28.6% of the population with disabilities experience barriers. The two most frequently reported types of barriers were building design and attitudes of other people.

This analysis provides an indication of how the environment is experienced by adults with disabilities and identifies perceived barriers found in the home, the work/school environment and the community. It starts to provide a baseline for understanding of the environment as experienced by persons with disabilities and suggests the most pressing areas for attention.

To our knowledge, this is among the first nationally representative analysis of barriers that interfere with daily activities experienced by adults in the United States. It highlights the experience of adults with disabilities and describes numerous types of potential barriers.

In response to recent calls to better understand the brain’s role in organizational behavior, we propose a series of theoretical tests to examine the question “can brains manage?” Our tests ask whether brains can manage without bodies and without extracranial resources, whether they can manage in social isolation, and whether brains are the ultimate controllers of emotional and cognitive aspects of organizational behavior. Our analysis shows that, to accomplish work-related tasks in organizations, the brain relies on and closely interfaces with the body, interpersonal and social dynamics, and cognitive and emotional processes that are distributed across persons and artifacts. The results of this “thought experiment” suggest that the brain is more appropriately conceived as a regulatory organ that integrates top-down (i.e., social, artifactual and environmental) and bottom-up (i.e., neural) influences on organizational behavior, rather than the sole cause of that behavior. Drawing on a socially situated perspective, our analysis develops a framework that connects brain, body and mind to social, cultural, and environmental forces, as significant components of complex emotional and cognitive organizational systems. We discuss the implications for the emerging field of organizational cognitive neuroscience and for conceptualizing the interaction between the brain, cognition and emotion in organizations.

Studies repeatedly have found social disparities of health at many levels of spatial aggregation. A second body of empirical research, demonstrating relationships between an area's racial and class composition and its environmental conditions, has led to the rise of an environmental justice movement. However, few studies have connected these two sets of findings to ask whether social disparities in health outcomes are due to local environmental disparities. This chapter investigates whether the association between racial and socioeconomic composition and multiple health conditions across New York City zip codes is partly mediated by neighborhood physical, built, and social environments.

This chapter explores the process through which one's moral career proceeds as one acquires a physical disability later in life. The author, who acquired a disability later in life, explores Goffman's notion of “moral career” as a process constructed from one's experience with both physical access and social access to the environment in which everyday interaction takes place. Using the extant literature and his personal experience, the author argues that one's identity as a person with a disability is always in a state of evolution. Rather than stable and fixed, it is unstable, although the rate of change is quite variable.

This chapter introduces how the built environment and walking are connected. It looks at the interrelationships within the built environment, and how those are changing given planning and policy efforts to facilitate increased walking for both leisure activity and commuting. Using a broad review and case-based approach, the chapter examines this epistemological development of walking and the built environment over time, reviews the connections, policies and design strategies and emerging issues. The chapter shows many cases of cities which are creating a more walkable environment. It also reveals that emerging issues related to technology and autonomous vehicles, vision zero and car-free cities, and increased regional policy may play a continued role in shaping the built environment for walking. This dialogue provides both a core underpinning and a future vision for how the built environment can continue to influence and respond to pedestrians in shaping a more walkable world.