Environmental Barriers

A short, easy version

Words to understand before you start:

Prejudice: not having enough tolerance. People who have a negative feeling toward you for no good reason may be prejudiced.
Environmental Barrier: something, other than the disability, that keeps you from doing what you want to or need to do. It can be something physical or it can be prejudice. It can also be the lack of something -- like the support of someone who matters.
Accessible: easy to move around and function in. An accessible place is one that makes it easier for you to do what you need to do.

What determines how well someone does after a TBI? How severe the injury was plays a big role. Medical care and rehab play a role too. So does the person’s motivation. But what about things that are separate from the person with the TBI? For example:

What if the person’s family is not supportive?
What if other people are prejudiced or treat the person with the TBI badly?
What if teachers or co-workers are not helpful?

It makes sense that things like these could affect how well someone does, too.

Any of these things can make it harder for someone with a TBI. They can make him or her unhappy. When things like these interfere with life, they are called “Environmental Barriers.”

We found five main kinds of environmental barriers that people with TBI and other disabilities can face:

Physical barriers – Physical barriers can be at home, at school or work, or in the community. Stairs are an example. So are things like hills, doorways, or even the weather and climate. Physical barriers make your environment less accessible. Is your home accessible? Can you move around it easily? What about work or school, and the public places you go?
Attitude barriers – These have to do with prejudice and discrimination. Do bad attitudes from people around you keep you from doing what you need to do?
Assistance barriers – Assistance barriers keep you from getting help you need. Do you need information or medical care that you are not getting? Do you need better transportation than you already have? Are people in your community helpful enough?
Policy barriers – Can you find the educational, employment, and service programs you need? Do their rules stop you or get in your way? Does a lot of “red tape” slow you down?
Work and School Barriers – Are people you interact with at school or work positive and helpful? Do they support you?

Barriers and TBI

We made a survey that covers 25 common barriers. It has a few examples of each of the five types. We gave the survey to a group of people with TBI. Each had been injured about a year. Here’s what we learned:

Most people with TBI don’t report a lot of barriers. But, some groups do have more barriers than others:
- Women say they face more barriers than men. However, men report more barriers that had to do with work.
- People who were married when they were injured seem to report more environmental barriers.
- People who are African-American or Hispanic have more barriers than white people. So do people in other minority groups. But, white people reported more barriers that had to do with bad attitudes or lack of support from others.
- Physical barriers, like stairs, hills and buildings were more of a problem for older people.
- People who were working before they were injured had fewer barriers after injury. The same was true for people who were in school when they got hurt.
- People who do need help from others because of their TBI are also more likely to report barriers.
These were the biggest and most common barriers reported:
- Not having good transportation
- Physical things – like poor lighting, too much noise, or crowds. Also things in nature – like cold temperatures, too much rain, steep hills, etc.
- Government rules and policies, like Medicaid, home health care and work rules that make life harder
- Bad attitudes of family members
People who had a lot of barriers were affected in sevral ways:
- They were less happy and less satisfied with their lives.
- They didn’t get out of the house as much.
- Many were also less independent People who faced bad attitudes or prejudice didn’t go out as much. They were less independent, too.
- People who did not work or go to school said they had more barriers.

What does this mean to you?

Chances are good that you are not facing a lot of environmental barriers. If you are not, good for you! But if you are facing barriers, figure out if they are making a difference in your life. Go to the back page of the other brochure in this packet, and think about taking the Barriers Survey that is there.

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