Ableism and contours of the attitudinal environment as identified by adults with long-term physical disabilities: A qualitative study

Figure 1, Range of contexts and spectrum of attitudes from Reber et al., International Journal of Environmental Research and Public Health.


Adults with physical disabilities experience a continuum of enabling and disabling attitudes in the environment. This study identified where adults with physical disabilities experience the attitudinal environment, the continuum of those attitudes, and how they impact emotional and psychological health and well-being. Focus groups and interviews were conducted in 2019 and 2020 with adults with physical disabilities in southeastern Michigan in the United States. Participants discussed environmental factors that impact healthy aging. From an initial thematic coding of narratives, the attitudinal environment was identified. Transcripts were recoded and analyzed focusing on societal attitudes. Qualitative analyses revealed that participants did not experience societal attitudes as simply positive or negative, and that the contexts in which these attitudes were expressed were not limited to interpersonal interactions. Rather, these attitudes were also experienced in the built environment and through social institutions and organizations and their programs, systems, and structures that provide or deny needed accommodations, resources, and support. The spectrum of overlapping attitudes that participants articulated ranged from understanding and supportive, to not understanding, to being viewed and treated as less than human. Societal structures reflect and influence societal attitudes and have material consequences on the lives of adults with physical disabilities.

International Journal of Environmental Research and Public Health


  • Is this paper peer reviewed? This paper is published in the International Journal of Environmental Research and Public Health. This journal uses double-blind peer review, where the authors and the reviewers do not know each other’s identities.

  • Who paid for this project? This research was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 90RTHF0001. This project was partially funded by the Mcubed program from the University of Michigan.

  • Are there any conflicts of interest? There are no conflicts of interest.