Approximately 25% of U.S. adults have some type of disability. People with all types of disabilities need healthcare and health programs for the same reasons anyone else does—to stay well, safe, and engaged as fully participating members of their communities.

Inclusion means to transform communities based on social justice principles in which all community members are presumed competent; are recruited and welcome as valued members of their community; fully participate and learn with their peers; and experience reciprocal social relationships.

National Center on Health, Physical Activity, and Disability

NACCHO strives to improve the health of communities by strengthening the capacity of local health departments across the nation. Disability inclusion is a critical factor in healthy communities, and NACCHO's Health and Disability Technical Assistance (HDTA) Program provides local health departments with the tools and resources needed to successfully include people with disabilities in all local health department activities.

Through this program, NACCHO supports local health departments in outlining an action plan designed to increase inclusivity and accessibility for people with disabilities in their programs, policies, and services.

Inclusion in Public Health Emergency
Preparedness and Response

Local health departments across the country are working to improve inclusiveness within public health emergency preparedness and response. For example, local health departments have requested NACCHO's assistance with increasing partnerships, accessible communication, sheltering, and transportation, as well as conducting exercises and staff training. In addition to the HDTA Program, NACCHO regularly provides and curates other resources to guide inclusion of people with disabilities in emergency preparedness and response efforts.

Here are three of the most comprehensive resources:

1. NACCHO Fact Sheet: Including People with Disabilities in Emergency Preparedness Efforts

2. Capacity-Building Toolkit for Including Aging and Disability Networks in Emergency Planning 

3. Checklist for Integrating People with Disabilities and Others with Access and Functional Needs into Emergency Preparedness, Planning, Response, and Recovery

Case Example: Increasing Emergency Planning Partnerships

Through their participation in NACCHO's HDTA Program, Lincoln County Health Department in Missouri improved the inclusion of their emergency preparedness planning by developing partnerships with a multi-agency group of behavioral health and functional and access needs organizations. They were able to identify resource partners and trusted agents in the community that serve people with disabilities and engage them in emergency planning capabilities. In addition, they recruited volunteers with disabilities for Medical Reserve Corps through a relationship with their county board of developmental disabilities.

Case Example: Addressing Access & Functional Needs during Emergencies

AppHealthCare in North Carolina also improved disability inclusion in emergency preparedness activities by participating in the HDTA program. With resources provided by NACCHO, they were able to use local data to understand the access and functional needs demographics in their community. They used this information to fully integrate inclusion into their emergency plans. They have also been able to test the updated plans through a full-scale exercise. They said that the HDTA Program gave them "that encouragement to go further and to bring the right people to the table, including those with access and functional needs."

Learn more about community organizations that serve people with disabilities in your community with NACCHO's Directory of Community-Based Organizations Serving People with Disabilities. People with disabilities and community-based organization can provide expertise in including people with disabilities in the development of emergency preparedness plans and exercises. 

Inclusion in Community Health

Within the broader area of community health, local health departments have received TA to improve disability inclusion efforts in community health assessment and planning, physical accessibility of spaces and environments, and accessibility of web-based content.

In addition to NACCHO's HDTA Program, take advantage of these comprehensive resources and tools on including people with disabilities in community health activities:

1. NACCHO’s fact sheet -- Five Steps for Inclusive Communication: Engaging People with Disabilities

2. NCHPAD’s guide -- Community Health Inclusion Index

3. NACCHO’s resource guide -- MAPP Resource Guide for Disability Inclusion

Case Example: Developing Internal Inclusiveness Policies

The Lewis and Clark County Public Health Department in Montana formed an inclusiveness working group engaging staff at all levels of the organization—from top administration to front-line staff—as well as people with disabilities and partners from a state independent living organization. The group continues meeting to this day, and they have prioritized the creation of a health department inclusiveness policy. They say that the program and NACCHO "helped set [them] on [their] way.”

Case Example: Engaging People with Disabilities as Informants & Staff

Through the HDTA Program, local health departments have improved the inclusiveness of their programs and services by engaging with people with disabilities, both as community informants and as health department employees.

The Lewis and Clark County Public Health Department in Montana has hosted a series of focus groups with people living in their jurisdiction as part of their Community Health Assessment/Community Health Improvement Plan (CHA/CHIP) process. One group included teens with disabilities. The teens created a Wiki map that identified areas of the county (e.g., parks and trails) that had recently been renovated to be accessible spaces to promote health for all citizens. 

The Champaign-Urbana Public Health District in Illinois hired interns with disabilities at the health department. Health department leadership were excited to have people with disabilities on staff to help guide inclusion activities, particularly regarding to the accessibility of the built environment.

Five Years of the Health & Disability TA Program

NACCHO's HDTA Program began in 2014 and has supported 54 local health departments nationwide. Through this program, NACCHO and local health departments work together to outline an action plan focused on improving disability inclusion. Since the creation of the program, NACCHO staff and fellows have provided more than 300 hours of technical assistance, including sharing recommendations and resources to promote inclusion.

For NACCHO as an organization to ...
provide this TA shows recognition of its importance for everybody.

Lewis and Clark County Public Health Department,
HDTA Program recipient

Helping to Build Local Capacity and Inclusion

In 2019, NACCHO conducted key informant interviews with participants from the last five years of the HDTA Program to learn more about how the program supported their continued work towards inclusive programs, policies, and services. In addition, local health departments share feedback with NACCHO about their experience with the HDTA Program after each program year through an evaluation survey.

Findings from these efforts show that over the past five years, NACCHO's HDTA Program has helped local health departments build capacity to develop and grow inclusion-focused partnerships, implement inclusive practices that go above and beyond American with Disabilities Act (ADA) compliance, and bring awareness of inclusion to their staff and community. In addition, participants have become more motivated to work towards inclusion and more knowledgeable about how to engage with the disability community.

of evaluation survey respondents indicated NACCHO's HDTA Program met their expectations

increased their motivated to implement inclusive practices or include people with disabilities in their LHD’s work

increased their knowledge about how to engage with community-based organizations serving people with disabilities

NACCHO thanks the 2018-2019 Health and Disability fellows, TraciAnn Hoglind and Erin Vinoski Thomas, for their efforts on this project.

To learn more about NACCHO's Health & Disability Program, please visit the following resources:

[The program] helped us refocus our lens a little bit... We are always dealing with trying 
to address health inequities through social justice, and so now we're just not looking 
at racism,sexism, [and] classism, but also ableism.

Champaign-Urbana Public Health District, HDTA Program Participant

This publication was supported by the Grant Number 6NU38OT000306-01-01, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.