ADA Compliance and Accessibility of Fitness Facilities in Western Wisconsin

Almost 1 in 5 people living in the United States have a disability, a substantial number of whom have spinal cord injury (SCI).1,2 Available data suggest that the number of individuals with a disability will continue to increase among all ages, but especially among the “baby boom” generation as they reach retirement age.2,3 As the numbers of individuals with a disability continue to increase, there is an urgent need to provide appropriate programs that service their specific needs, particularly for those with physical disabilities such as SCI. When compared to adults without a disability, a smaller proportion of adults with a disability met national recommendations for physical activity.4,5 Nationwide, 25.6% of persons with a disability reported being physically inactive during a usual week compared with 12.8% of those without a disability.3 According to the Healthy People 2010 (HP 2010) report, significantly more people with disabilities reported having no leisure time physical activity when compared to people without disabilities (56% vs 36%).1 When compared to people without disabilities, people with disabilities have higher rates of chronic conditions, for example, diabetes, depression and sadness, elevated blood pressure and blood cholesterol, obesity, tooth loss, and vision and hearing impairments.1,2 The odds ratio for obesity in adults with lower extremity paralysis is 2.5 times higher compared to adults without disabilities.6 Physical activity programming opportunities may aid in offsetting the decline in health and functioning for people with disabilities. More specifically, physical activity can assist in improving or maintaining stamina, muscle strength, and flexibility, all of which contribute to functional ability and possibly to prevention of secondary conditions.4,7,8 However, there are few physical activity programs that specifically promote the health of this population, especially those with SCI.9 Due to the paucity of specific programs that target this population, it has been suggested that health and fitness professionals make a conscious effort to include individuals with disabilities into existing physical activity programs available to persons without disabilities.4,8 Previous research has indicated that the low incidence of physical activity participation observed among persons with disabilities is due to a multitude of factors,10 but the most influential factors may be the built and social environments.8,11 Barriers within the built environment include outdoor and indoor opportunities, lack of accessible facilities and programs, and lack of accessible exercise equipment. Outdoor physical activity environments have an inherently high level of inaccessibility for individuals with physical and sensory disabilities and therefore indoor fitness facilities may be the only viable alternative for physical activity participation.12 Barriers within the social environment include poor attitudes of facility staff and members without disabilities, as well as the lack of staff/owner awareness of the needs of people with disabilities.11 Many people with disabilities also perceive that fitness facilities are unfriendly environments for them.2 The American with Disabilities Act (ADA) protects against discrimination on the basis of disability in employment, government, public accommodations, commercial facilities, transportation, and telecommunication.13 Title III of the ADA covers businesses and nonprofit service providers that are public accommodations, which include fitness facilities and similar entities.2,13 The public accommodations must comply with specific requirements pertaining to architecture, policies, practices, and other accessibility requirements. Access into the initial built environment is one thing, but being able to use the fitness facility exercise equipment, programs, and policies contributes to an environment that promotes equal access and use by all members.10,14 There is an urgent need for, and right of, people with disabilities to participate independently in physical activity.4,11 Fitness facilities can play a significant role in the social and behavioral patterns of health and physical activity for individuals with disabilities.11,15 Previous fitness facility accessibility research has been conducted in Kansas,7,16 Oregon,17 and a small national representative sample.12 There is a need for studies in other geographic regions to provide a better picture of fitness facility accessibility and accurate normative information for future benchmarking.12,17 The estimated adult (aged 18+ years) population living in Wisconsin with a disability is 18%.18 Currently, there are very limited data on the accessibility of fitness facilities in this geographic region. Western Wisconsin is unique because it consists of one smaller urban area (>50,000 people) that is surrounded by many smaller rural areas. Given the geographic makeup of this region, one would expect less fitness facility availability when compared to more metropolitan areas, making access to these limited fitness facilities paramount. Previous research also suggests that rural areas have lower advocacy rates and are less accessible for individuals with disabilities.15 The purpose of this study was to determine ADA compliance of fitness facilities in western Wisconsin.