Arthritis & the Environment

What do disability researchers mean when they talk about the effect of the environment on peoples’ daily lives?

Often the term environment is assumed to refer to the built environment, or one’s immediate physical surroundings. While the built environment is increasingly recognized by practitioners and researchers as an important influence on the extent to which older adults and people with disabilities can participate in their communities, other aspects of the environment are emerging as important. Such features include community, institutional, and cultural elements such as social support, the home environment, attitudes of others, and the accessibility of transportation and public events or locations.

ENACT and the Environment
: The Walkability Project
Currently, ENACT is working on the development of a short arthritis-specific assessment tool for use by communities to evaluate their communities’ walkability for people with arthritis. The project, called the Walkability Project, is a partnership with the Osteoarthritis Action Alliance (OAAA), the Centers for Disease Control and Prevention (CDC), and the Arthritis Foundation.
Read more about the Walkability project here


The effect of one’s environment on participation outcomes is no less profound for people with arthritis, a condition which often lies at the intersection of aging and disability. As the leading cause of disability in the US, arthritis-related activity limitations can lead to participation restrictions, including declines in physical performance and social engagement, as well as work limitation or loss (for more, see ENACT’s Arthritis Information page). While each person’s individual efforts to become more physically active can benefit their personal health, it is important to create healthy community environments that support full activity and participation for aging and disabled community members, which requires coordination between community members and community leaders.

ENACT and the Environment:
The Home and Community Environment Survey
ENACT Director Dr. Julie Keysor’s previous work has included the development of an instrument to assess environmental barriers called the Home and Community Environment (HACE) survey, which is intended for use in large, epidemiological studies. 
Find the full HACE instrument here


Organizations like the World Health Organization (WHO) and the Centers for Disease Control and Prevention have adopted this more holistic understanding of the environment. The result is the creation of resources, like those listed below,  that community members and city planners can use to make changes that enhance participation of the aging population in all aspects of daily, work, and civic life.

Please review the guides and resources below for more information: