The State of Housing Access across the United States

Introduction

Finding accessible housing is one of the biggest barriers that people with disabilities face out in the community. Having an accessible home, or a home that suits one’s needs, enables full community participation. However, little is known about the accessibility of American housing stock. Fortunately, the American Housing Survey included a variety of questions concerning home accessibility for people with disabilities in their 2011 survey. This publicly available data has allowed us to explore the state of housing access across the United States.

Sample

For this analysis we used a sample from the survey of 123,341 households with household members between the ages of 18 and 75 years old. Of these, 11,862 households have an individual who uses some sort of mobility equipment (cane, crutch, manual wheelchair, power wheelchair or scooter). Relative to households without anyone who uses a mobility device these households are:

  • Generally older. Whether you look at the age of the youngest member (41 vs 31), the mean age (51 vs 40), or the age of the oldest member (61 vs 49), households with someone with mobility equipment are about 10 years older.
  • Lower in income. Households with some who uses mobility equipment have much lower income than households where no one uses mobility equipment ($51,800 vs $68,900).
  • Less white. Households with someone who uses mobility equipment are slightly more likely to have at least one non-white person (27% vs 22%)
  • More female. Households with someone who uses mobility equipment are slightly less likely to have at least one male (80% vs 84%).
  • The same size. Households where someone uses mobility equipment have the same number of people (2.9 vs 2.9).

Measures

The American Housing Survey is collected every two years by the Department of Housing and Urban Development and the US Census office. In 2009 the survey added questions about Disability from the ACS. A description of these questions can be found here (link). In 2009 the survey also included a question about home entrance accessibility which asked: “Outside, it is possible to enter this home/apartment WITHOUT climbing up or down any steps or stair? Please consider all entrances and ramps that could be used.”

In 2011 the survey added a temporary module called the Home Modification Module. Questions within this module asked about functional limitations (e.g. difficultly grasping objects), mobility equipment use (e.g. household member uses a cane or wheelchair), and a variety of accessibility features (e.g. wheelchair accessible bathroom).

Results

We explored the rate of housing inaccessibility comparing households which reported having a household member who uses some type of mobility equipment (cane, crutch, manual wheelchair, power wheelchair or scooter) with households which report no one uses mobility equipment. Households without anyone who uses mobility equipment are in general less accessible. This is not surprising as they have less need for accessibility features. What is surprising is the high rates of inaccessibility for households with individuals who use mobility equipment. Particularly the rates of these households with a stepped entrance (57.2%), lack of grab bars in the bathroom (62.3%) and living up a flight of stairs without access to an elevator (70%-apartments only). Results from this analysis are in the table below:

Table 1. Absence of Accessibility Features.

Table 1 compares the absence of accessibility features between households with individuals who use mobility equipment and households without individuals that use mobility equipment.

Beyond this basic comparison we also analyzed the lack of accessibility features (focusing only on households with individuals using a mobility device) by urban-rural location. In general, these households in urban areas were less accessible than those in rural with one notable exception. Of rural households living in apartments above the first floor, 91% do not have access to an elevator, relative to 68.8% in urban. These results are presented in the chart below:

Chart 1. Rate of Inaccessible Housing: Urban Rural Comparison

Chart 1 compares the rate of inaccessible housing between urban and rural options.

* Of apartments

** Of units with more than 1 floor

We also examined differences between urban and rural locations regionally on two key inaccessibility features: presence of a stepped entrance and lack of grab bars in the bathroom. Urban-rural differences were less pronounced at the regional scale with higher rates of stepped entrances in the urban Northeast and rural South. Increased rates of bathrooms without grab bars can be seen in the rural Northeast and urban south. These results are presented in the charts below:

Chart 2. Rate of Stepped Entrances.

Chart 2 compares the rate of stepped entrances in urban vs. rural areas in the Northeast, Midwest, South, and West.

Chart 3. No Grab Bars in the Bathroom.

Chart 3 compares the rate of having grab bars in the bathroom in urban areas vs. rural areas in the Northeast, Midwest, South, and West.

Discussion

The data presented above make it clear that a large percentage of people with mobility impairments (specifically those who use mobility equipment) living in homes that do not meet their needs. Though we see some urban and rural variation, this problem is pervasive throughout the United States. We find these results most concerning across two areas of the home: the bathroom and the entrance. Over half of these households report they do not have grab bars in their bathrooms (a critical accessibility and safety feature for someone with a mobility impairment). In addition, significant numbers of households with individuals who use mobility equipment have a step or even a flight of stairs leading to their home entrance.  Both of these home spaces are critical for community participation. First, being able to manage self-care activities such as bathing, toileting and grooming are critical elements of independent living. The lack of grab bars in bathrooms across this sample is concerning as grab bars are a key accessibility and safety feature that facilitates self-care activities in the bathroom. Beyond the bathroom, in order to participate in the community, you must first be able to leave home. The presence of steps or stairs at the home entrance can limit an individual’s ability to do so.

Data Limitations

Defining Accessibility. There are some significant limitations with the data from the American Housing Survey. First, there are concerns about the definitions and use of the term “accessible”. The questions contain no objective comparison or definition for a “wheelchair accessible bathroom”. Cognitive testing found that many respondents did not have a clear understanding of the questions stating “many respondents reported that aspects of their home could possibly be utilized by those in a wheelchair, though they were unsure whether their homes were designed with wheelchair accessibility in mind…this resulted in over-report of wheelchair accessibility features (p. 35; DeMaio, T., & Freidus, R. 2011).”

In light of these limitations, it is clear that the problem of inaccessible housing (at least among households without individuals who use mobility equipment) is under represented in this data. Based on these limitations, it can be reasonably assumed that the state of accessible housing within the general housing stock is even worse than our data reveals.

Defining Rural and Urban Areas. The data also has considerable limitations for classifying respondents from rural areas. The definitions used within the dataset are inconsistent. The AHS uses Office of Management and Budget (OMB) metropolitan and nonmetropolitan classifications to identify households within urban and rural areas. However, different OMB definitions, from either 1980, 1990 and 2000, are used depending on the unit and when the unit was added to the survey. In addition, there is limited data available for conducting a robust analysis on rural housing units as the sample sizes are much smaller.

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