Book Review
Accessibility in America Past and Present

Accessibility in America Past and Present

Lara Freidenfelds

Bess Williamson’s Accessible America: A History of Disability and Design is a thought-provoking and edifying look at the shifting culture around disability and the design of our built environment in the United States from post-World War II to the present. I was interested to read the book both because I have a longstanding scholarly interest in the history of bodies and technology, and because I have been personally forced to confront issues of disability and the built environment since becoming visually impaired six years ago. Accessible America was enlightening on both counts. In all of the ways the design of my house, my neighborhood, and the tools in my kitchen drawers do and don’t help me thrive, I now see layers of history.

Williamson, a scholar of art and design history, begins her story after World War II, when many of the technologies and architectural features we now designate as “accessible” originated. Soldiers returned from wartime service with missing limbs or spinal damage that left them unable to walk. Regarded as heroes, and pictured in the popular imagination as young, virile, otherwise-healthy, and archetypically white, these disabled veterans benefited from robust government programs offering newly-designed prosthetics and other technological supports. They also successfully lobbied for innovative cars and homes adapted for disability. These supports were aimed at restoring these young men to social and economic roles as heads of heterosexual, nuclear-family-based households. It was a notable expansion of popular and state support for people with disabilities, made possible by the high social standing and sheer numbers of people with battle-related disabilities.

While veterans called upon an ideal of manly independence to demand new adaptive technologies, critics of generous government programs thought veterans should prove their manhood by dealing with their disabilities with personal grit and determination rather than government assistance. Williamson notes the irony: the very ideology that justified funding for adaptive technology also set limits on just how generously funded it would be.

A book cover with the title at the top, and colorful rectangles, each featuing a sketch of various ramps in architectural renderings
Accessibility in America cover. (©NYU Press)

The vision of a worthy disabled person as determined, independent-minded, and able to achieve self-sufficiency with the minimum possible public support fed into a movement to create technological design for civilians as well. Williamson closely examines two midcentury rehabilitation programs – Dr. Howard Rusk’s Institute of Physical Medicine and Rehabilitation in New York and Timothy Nugent’s Division of Rehabilitation-Education at the University of Illinois at Urbana-Champaign – showing how an emphasis on changing the person, rather than changing the environment, shaped mid-century design for disability. These programs added wheelchair ramps to some buildings, for example, but allowed them to be quite steep and inconveniently-placed, and expected wheelchair users to build the physical strength to manage them. They focused more on training people with disabilities to MacGyver their way through an inaccessible world more than adapting the environment to be disability-friendly.

Williamson spends a wonderful chapter on the publications of a growing mid-century disability community consisting largely of veterans and polio survivors, showing how the work of design was done not just by professional designers and engineers, but also by ordinary people tinkering with their belongings and their environment to adjust them to their needs. In the pages of the disability community’s volunteer-edited Toomey J Gazette, homemakers exchanged tips for altering kitchen table heights and cabinet arrangements for wheelchair accessibility, using rubber bands to improve drawer pull grips, and creating a tool to assist with knob-twisting out of a wooden spoon and four nails. I would have enjoyed even more examples of this process, perhaps from an additional source such as oral histories, though the publications Williamson analyzes are valuable and fascinating sources. Williamson shows how, again, the development of accessible design was determined by middle-class whites, who designed accessible tools to fulfill the gendered social roles of economic provider and homemaker.

Moving into the 1960s and 1970s, Williamson examines the Independent Living movement, centered in Berkeley, California. The movement was started by disability activists such as Ed Roberts and Herb Willsmore of the Rolling Quads, who demanded that disabled people be the principal architects of urban designs, and that the full experiences of disabled people’s interactions with their environments and desires for their lives be taken into account. They had more than average success implementing access, and Williamson takes note of Berkeley’s continuous attention to issues of access.

The 1970s and 1980s brought new legal requirements for access, with mandates, for example, to make public transportation accessible. As more public resources were invested in accessible buses and stations and as wheelchair ramps were added to buildings, a vocal backlash developed. Too often, accessibility measures only went half way and were therefore rendered almost unusable—accessible buses didn’t necessarily drop passengers at accessible stations, for example—and critics complained that too few riders with disability took advantage of the re-designs to be worth the cost. Nineteenth-century edifices with ramps slapped on the sides offended aesthetic sensibilities and created frustrating, circuitous access routes.

One response, in the 1990s, was the principle of “universal design,” i.e., design meant to fit the needs of a wide variety of users in the first place, rather than adaptations of designs meant for the able-bodied person of average white male height. This approach was commercially appealing, of course, and produced innovations such as OXO Good Grips kitchen tools, comfortable for the majority of home chefs and widely used for the safety and accessibility by users managing conditions from arthritis to multiple sclerosis to visual impairment. The downside of universal design, though, as Williamson points out, was that it downplayed the genuine need for specialized adaptation for people whose needs fall outside the reach of so-called “universal” design.

In her final chapter, Williamson examines “crip design,” an instantiation of the disability rights movement as it evolved in the 2000s. Designers and users worked together to create beautiful designs which frankly acknowledged disabilities and reflected the aesthetic sensibilities and desires of users—sleek, brightly-colored wheelchairs, for example, and elegant prosthetic limbs meant to be seen and admired as integral components of their users’ identity and self-presentation. Voices from a robust and multivocal disability studies contributed to an explosion of possibilities and robust conversation and critique. The book itself is an important contribution to this generation of design critique, with its thorough exploration of the contributions and blind spots of each successive iteration of accessible design.

One important challenge within the movement for accessibility is that disabilities are extremely varied, and the same design element can improve one person’s access while worsening another’s. Williamson points to this briefly. For example, Berkeley created sidewalk cutouts that worked for people who use wheelchairs and were marked with a rough surface to interact properly with canes for the blind, but were problematic for some people who used crutches or canes as walking support. One of Williamson’s illustrations shows a disabled parking sign for which designer and professor Sara Hendren developed a transparent sticker with a re-designed wheelchair symbol, the rider leaning forward athletically rather than sitting bolt upright and passive. I can appreciate the meaning of the sticker, which allows both views of the wheelchair user to be visible in the sign. But to me, as a visually-impaired viewer, the sign is also confusing, befuddling my vision and creating frustration. It’s interesting art, but it is not an accessible design for someone with my disability. I wonder if the next chapter of this history, unfolding in the coming years, will be about the necessary negotiations and compromises when accessibility needs collide.

While Accessible America is a work of history, I was struck by the degree to which attitudes and ideas about disability have not replaced each other over the decades so much as accreted, so that all of the attitudes and design trends Williamson describes can still be seen in action today. Dealing with sudden visual impairment six years ago, I ran the gamut of this history. I did therapy exercises and forced myself to practice navigating Penn Station to train my body to cope with a reduced visual field and visual processing damage. I purchased specialized products from a catalog for the visually impaired, and I also cobbled together a new lighting plan for my house. Some people told me to try to forget that I had a disability, and tried to encourage me by assuring me that nobody could tell I had a disability. Others advised me to mark myself with reflective clothing for my evening walk home from the train station—some assuming I would be willing to forsake stylishness, others sending me ads for ultrastylish (and ultaexpensive) reflective styles. I returned to my old neighborhood in Berkeley for a visit and conversed with a Deaf friend about what aspects of Berkeley did and didn’t work well for disability access these days. I listened uncomfortably to an acquaintance complain about ADA requirements for public-facing website design to accommodate visual impairment at the large company where she worked. People who live with disabilities today can attest that the past 75 years of disability history remains fresh and relevant to daily experiences.

Accessible America, therefore, serves as a fascinating history lesson, an accessible introduction to disability studies, and a panoramic look at the ideas and designs that continue to structure the lives of people with disabilities today.

Featured image caption: Hard-surfaced walkways and ramps lead to all publicly accessible facilities. (Courtesy National Park Service)

Lara Freidenfelds is a historian of health, reproduction, and parenting in America. She is the author of The Myth of the Perfect Pregnancy: a History of Miscarriage in America and The Modern Period: Menstruation in Twentieth-Century America. Sign up for her newsletter and find links to her op-eds and blog essays at