Who Gets In? Rethinking Systemic Access and Inclusion

A job application is met with silence. A storefront has steps but no ramp. In conversation, attention bypasses the person with a disability and settles instead on the person beside them. Individually, these moments may seem minor—but over time, they add up. They form patterns that reveal who systems were—and were not—designed for.

For individuals with disabilities, these are not merely isolated frustrations. They reflect recurring, systemic barriers that shape daily experiences and limit access to opportunity.

When Systems Fall Short

Barriers to inclusion often emerge not through intentional exclusion, but through subtle, unexamined routines and assumptions. These are built into systems that were not designed to accommodate the full diversity of people’s needs.

Consider an employee who is overlooked for promotion without explanation. Similarly, consider a student who receives minimal guidance, not due to disregard but because of quietly lowered expectations.

The Americans with Disabilities Act (ADA) has led to legal protections and improvements in accessibility. Yet legal compliance alone is not enough to ensure inclusion. Many environments are still built on assumptions about what is “typical,” which can unintentionally exclude those whose needs fall outside that narrow frame.

Accessibility demands more than meeting legal standards. It requires intentional design, inclusive culture, and systems that adapt to the diversity of people’s lives.

Employment: A Complex Landscape

Employment environments can illustrate how access and inclusion vary across different settings. As Wiley’s Walk emphasizes, employment offers more than a paycheck; it can provide structure, purpose, and a sense of connection. Still, subtle and often overlooked barriers may limit full participation for many individuals.

For example, an uncaptioned video meeting can prevent participation by screen-reader users. Rigid attendance policies may not accommodate fluctuating health conditions.

Job descriptions that emphasize nonessential physical demands or require only in-person interviews can unintentionally exclude qualified candidates. These individuals may have the skills and experience needed for the role but are screened out by criteria unrelated to job performance. Similarly, outdated software that does not work with assistive technologies can create avoidable barriers to completing routine tasks.

Recent employment data illustrates these ongoing challenges. In 2024, only 37.4 percent of working-age adults with disabilities were employed. The unemployment rate among people with disabilities was 7.5 percent—nearly twice the national average (U.S. Bureau of Labor Statistics, 2024). These disparities point to the continued impact of cultural norms, organizational practices, and technology design that may unintentionally limit access to meaningful employment.

Criteria designed to be impartial may still lead to unintended barriers. Studies show that candidates who disclose a disability are less likely to receive interview invitations, despite having equivalent qualifications (Bonaccio et al., 2020).

Hiring practices that focus on “culture fit” may unintentionally favor homogeneity and limit diversity in teams (Kandiah & Saiki, 2024). Qualified individuals may be overlooked—not because they lack skill, but because they do not match informal expectations.

Access needs may remain unmet even after hiring. An employee who is deaf may not have interpretation services available for meetings or workplace communication. A colleague with a mobility disability may encounter limited access to adjustable workstations or accessible restrooms. These limitations often stem from a lack of proactive planning rather than intentional exclusion.

Implementing inclusive job design, using accessible workplace tools, and providing proactive accommodations can support individuals while also enhancing team performance and retention.

Education and Healthcare: Early and Ongoing Barriers

Inclusion begins with early exposure and support. Educational settings help establish access to opportunities, influence expectations for achievement, and contribute to a student’s confidence over time.

Although more students with disabilities are being included in general education classrooms, only 66% spend most of their school day there (National Center for Education Statistics, 2023). Factors such as limited resources, gaps in staff training, and unexamined assumptions may reduce access to advanced coursework and enrichment opportunities.

These challenges may become more pronounced when students are not consistently encouraged or supported in their learning. Promoting self-advocacy and creating inclusive learning environments can help build the skills and confidence that support long-term success. Without these supports, students may face greater barriers to accessing further education and employment opportunities.

Healthcare settings can involve additional structural barriers to access. These barriers include obstacles built into physical environments, equipment, and standard procedures that may not accommodate all patients’ needs. For example, fixed-height exam tables may make routine physical exams difficult or inaccessible for individuals with mobility disabilities.

The absence of accessible diagnostic equipment can further affect the quality and completeness of care. In some cases, limited availability of language interpretation services can lead to misunderstandings. Symptoms may also be assumed to relate only to an existing disability, which can result in delayed diagnoses and reduced trust between patients and providers.

These ongoing gaps in access and quality have broader implications for health equity. In 2023, the National Institutes of Health formally recognized people with disabilities as a population experiencing health disparities.

This designation is significant because it acknowledges that individuals with disabilities face persistent, systemic barriers to receiving equitable care. It also signals the need for focused research, investment, and accountability to address these disparities within healthcare systems.

This acknowledgment is a step toward equity, but ongoing improvement will depend on targeted investment, provider training, and shared accountability within the healthcare system.

Conclusion: Rethinking Inclusion as a Collective Responsibility

Persistent barriers in employment, education, and healthcare point to a deeper problem: many systems were never built to support the wide range of people’s lived experiences. These outcomes are seldom the result of intentional choices; more often, they stem from entrenched norms, unexamined assumptions, and institutional inertia. Still, their impact is profound.

Inclusion requires more than policy compliance or technical checklists. It begins by asking: Who is being left out, and how can systems respond more effectively?

When environments and procedures are designed to accommodate a wider spectrum of experience, the result is more equitable access, stronger institutions, and communities that support participation for all. Inclusion isn’t a box to check—it is an evolving practice rooted in awareness, action, and collaboration.

Inclusion begins and expands with awareness and through consistent, intentional effort.

  • Listen with care. Trust lived experiences and seek to understand barriers.
  • Reflect on the environment. Ask: Who might be left out, and what changes could make access easier and more inclusive?
  • Make accessibility part of the norm. Use captions, offer flexibility, and choose inclusive tools.
  • Stay open and engaged. Inclusion grows through reflection, dialogue, and a willingness to adapt.
  • Embrace intentional change. Even small actions can shift systems, remove barriers, and create lasting access.

Inclusion is an ongoing commitment, not a one-time action. Leading with intention insight helps create inclusive spaces where everyone can participate fully and belong.

References

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