Age and a sedentary lifestyle combine to increase chronic diseases that cause disability

If theres one thing Americans have in common, its a high rate of disability. In fact, more than 1 in 4 over 70 million Americans reported having a disability in 2022. If you consider that each of those people has relatives, friends and family members, disability touches nearly everyone in the U.S.

These perhaps alarming stats come from the U.S. Centers for Disease Control and Prevention (CDC), which conducts an annual survey of the disability rate. The Social Security Administration, meanwhile, maintains a list of disabilities that are so severe they qualify for quick approval for financial assistance.

The list is on the agencys Compassionate Allowance page and has recently been expanded to include several new diseases, including being on the heart transplant waiting list and having histiocitic malignancies.

The rising rate of disability may sound far-fetched but when you consider that the average age of Americans is growing steadily (increasing to 38.9 years in 2022, up from 37 in 2011), it starts to make sense, because while anyone can become disabled, disability occurs most often in older people.

Older adults reported a higher disability prevalence (43.9% of people aged 65 years and older) compared to other age groups in the latest CDC survey.

Besides aging, long COVID and other after-effects of the pandemic are also pushing the disability rate higher. Some states have higher disability rates than others.

The rise in chronic diseases like diabetes, heart disease, and arthritis, also helps push the disability rate higher. Though often associated with age, these conditions are increasingly affecting younger people, thanks in part to a sedentary lifestyle and poor nutrition.

What to do about it

For yourself, staying fit, eating a healthy diet and avoiding heavily polluted areas may help you live a longer and more vigorous life, if youre lucky. Yes, luck still plays a role; anyone, no matter have healthy, can become disabled in a moment. All it takes is a wrong step off a curb, a car accident or a sudden stroke or heart attack to make a permanent dent in your life.

While you cant guard against every possibility, there are steps you can take that may make it easier for you, your family and friends to deal with disability. Making your home easier and safer to navigate is an obvious step that can come in handy now and serve you well in the future.

Infrastructure matters

But governmental action is also necessary to provide the infrastructure that can make it easier for disabled people to function. Thirty-four years ago, Congress passed the Americans With Disabilities Act, which was intended to make buildings and public spaces safer and more accessible. Although it doesnt apply to private homes, you can use its guidelines to make your own home safer and to help you insist that businesses you patronize do the same.

Here are some areas that need more attention:

Rental housing

Whether its an apartment, a hotel room or an AirBNB unit, public rentals should be safe for everyone but often arent. The Fair Housing Act (FHA) already requires landlords to make "reasonable accommodations" for tenants with disabilities, and new multi-family housing with four or more units must comply with certain ADA standards. However, the FHA does not require that all existing rental properties be ADA compliant, so everyone else is on their own.

Short-term rentals, like hotels, AirBNB and VRBO, are notorious for failing to provide detailed and accurate information about accessibility features, such as step-free entrances, wide doorways, roll-in showers and grab bars. When they do provide information, its often inaccurate.

We rented an expensive whole-house unit on Long Island and it was so inaccessible, I had to sit down on the stairs and push myself up or down, one step at a time. No grab bars, slippery bathtubs, ceiling fans with on-off strings I couldnt reach, it was barbaric, said Joan, a retired attorney about a vacation trip that was cut short because the supposedly accessible house wasnt even close to being safe for her or others with movement issues.

Public transportation

Public transportation systems across the United States still fall short of meeting ADA standards in many ways, leading to significant barriers for people with disabilities. With most public transit systems chronically short of funds, its hard to see how this changes anytime soon. So-called paratransit systems are required by the ADA for individuals who cannot use fixed-route public transportation, but these services are often underfunded, unreliable, and have limited hours of operation.

And, say disabled people, dont even think of calling an Uber or Lyft. Marshall, a retired Los Angeles radio personality blinded by macular degeneration cant use the Uber app because he cant see it. The apps are also tricky for hard-of-hearing users and generally dont offer closed-captioning.

There are workarounds, but they're not cheap. Marshall uses a service called GoGoGrandparent which, for $30 per month, provides telephone operators who will take his calls and dispatch an Uber or Lyft to his location. It's not cheap. Besides the $30 per month, GoGo charges 27 cents per mile on top of the usual Uber/Lyft fee but, he says, it can be a lifesaver when, for example, he has a doctor's appointment.

But, of course, the whole idea of the ADA is that disabled people should have the same access to services at the same cost as those who don't have a disability. Lawsuits have been filed against Uber and Lyft alleging violations of the ADA due to inaccessible apps and services, with varying degrees of success.

Restaurants

Many eateries, both luxe and ordinary, don't have ADA-approved restrooms and many restrooms are on another floor, accessible only via stairs. Also, restroom stalls may be too narrow to accommodate wheelchairs or other mobility aids. Toilets may be too low, sinks may be too high, and grab bars may be missing or improperly installed.

The ADA requires restaurants to provide accessible restrooms in new construction and when undergoing renovations. However, many older restaurants are exempt from these requirements if making modifications would be structurally infeasible or pose an "undue burden."

Cars

Newer cars with digital controls and screens can be treacherous for people with limited eyesight. Traditional knobs and buttons offered tactile feedback, allowing drivers to easily locate and operate controls by touch. Digital interfaces often lack this tactile feedback, making it difficult for people lacking perfect vision to find and adjust settings without looking away from the road.

Also, glossy touchscreens can create glare and reflections, further hindering visibility and digital displays often use small fonts and icons, making them difficult to read for people with low vision.

My car, a new Acura, is a safety nightmare, one consumer said. You have to be a computer scientist to do anything and even if you know what youre doing, the font sizes are too small and the contrast is often not adequate. Just try adjusting the air conditioning or radio when youre driving next to a truck at 85.

Consumer action needed

Its easy to shrug and say that governments need to do more, but the hard truth is that most government agencies are bogged down by budgetary issues, staffing shortages and lack of cooperation by businesses and local residents.

So, its up to consumers to speak up. If you go to a restaurant that expects you to clamber down a dimly-lit rickety staircase to get to the bathroom, complain about it. Loudly. Tell the manager, post a bad review on OpenTable and on ConsumerAffairs. Contact your local government and insist they enforce existing regulations.

Governments respond to pressure only when theres a lot of it. Businesses respond much more quickly than they used to. Before ConsumerAffairs and similar sites came along, many businesses responded with a shrug or worse when consumers complained.

I once told a Volkswagen dealer how rude and uncooperative his finance manager had been and recited how many cars I had bought from him over the years. He didnt care. If you dont buy a car from me today, somebody else will, so what do I care? he said.

This attitude has pretty much disappeared after a quarter century of review sites. Governments need similar consumer pushback when they fail to do their jobs. Social issues and culture wars may hog the headlines but consumers have the power to change things but they have to use it.

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Dieter Holger contributed graphics to this article.