Housing enabler welcomes in dialogue on accessibility
Professor, occupational therapist Susanne Iwarsson has developed the Housing Enabler accessibility assessment methodology from the original idea of Professor Edward Steinfeld.
-Housing Enabler is above all intended for use in occupational therapy but useful for planning and discussion in the building process too, says Iwarsson.
The instrument has proved to be reliable and valid in assessments made by competent raters.
Iwarsson has given Housing Enabler lectures and information in many countries. More substantial developments have been made in the Nordic Countries, Germany, England, Latvia, Hungary and Hong Kong.
-In those countries it has been more like have hands on some action taking. We used this model in the EC-funded ENABLE-AGE Project, too. From this project we have many results that are valid for research and policy targeting home and health in old age in the European context, Iwarsson says.
A study resulting in a list of the most important environmental barriers in older peoples´ housing has recently been accepted for scientific publication.
-And that is really based on a comprehensive and qualified scientific project and that's very important.
Three essential strengths of Housing Enabler
According to Iwarsson, one of the most important characteristics that make Housing Enabler unique is that the method covers both the personal component and environmental component of the concept of accessibility, i.e. it captures an important aspect of person-environment fit.
-Most methods I knew of, even if they were good, they targeted the environmental component only which is not sufficient.
The assessment pays attention to combinations of different functional limitations.
- In real life, people do not only have this or that functional limitation. Many people, at least those in advanced age, do have combinations of several functional limitations.
The third strength is that it is possible to quantify the magnitude of accessibility problems in a way making it possible to use the information both in research and in practice contexts. In addition, ongoing work aims to widen the use of the methodology from assessments of accessibility problems in housing to assessments of public transportation and public places.
A prophet in her own country?
Iwarsson is very modest when it comes to Sweden.
-The model is not so widespread in Sweden. I have had much more attention when it comes to this model in other countries.
However, one project in a Swedish municipality involved all the occupational therapists in using the method.
-This learnt us a lot of what is needed to use this method in such a large scale.
One reason limiting the utilization of Housing Enabler could be whether and how different professions are oriented to work on accessibility.
-I think that in other countries where I have been working, other professions have been more active and more interested while in Sweden, mainly occupational therapists know about the method.
Accessibility is a political question
Iwarsson points out that accessibility always is a political question. Internationally, great variation in values is reflected in national legislation.
-In Sweden and Finland and many other western countries, we only have one body of legislation, targeting the entire population and everything should be accessible. In Hungary, where I have been working with research, they have one legislation for "normal" people and separate legislation for "disabled" people.
-In the US, they have very high accessibility requirements in the public sphere. However in the individual sphere, there are no support possibilities to get an individual home adaptation unless you have private health insurance.
Accordingly, accessibility should be promoted on different levels in politics, legislation, education and business.
-My main mission is that I am a scientist. Thus, I try to reinforce the development by running good scientific studies and try to then inform politics, society, business, and education based on our scientific results, Iwarsson says.
Clear definitions of key terms
Discussing such a political concept as accessibility with various counterparts challenges you to make your definitions clear.
-When it comes to the disability organizations on a general level, they are advancing Universal design and I can acknowledge that. However, based on its original definition, in my opinion Universal design is not really possible to reach but a vision to strive for.
Iwarsson & Ståhl (2003) define the key concepts accessibility, Universal design and usability in the health and societal context. Simply put, accessibility is an objective norm- based approach based on the notion of person-environment relationships whereas usability is subjective approach including the activity component.
-Universal design or Design for All is more about a process changing attitudes throughout society than a definite result, says Iwarsson.
Iwarsson mentions that from the disability movement perspective, an instrument like the Housing Enabler that is based on norms may in that sense be regarded as exclusive. Discussion is required and a reliable and valid method for assessing accessibility helps to us go further.
-So, the Housing Enabler is one tool to make inclusion and exclusion by means of norms visible.
More information
Iwarsson, S & Ståhl, A. 2003. Accessibility, usability and universal design - positioning and definition of concepts describing person-environment relationship. Disability and rehabilitation, 2003. 25(2) 57-66. Taylor & Francis.
Centre for Ageing and Supportive Environments, CASE. Faculty of Medicine. Lund University.
