Accessible America

A History of Disability and Design

Bess Williamson

• Publisher: NYU Press
• Year: 2019
• ISBN:
  9781479807222
• Topic: Design
• Subtopic: Graphic Design

A history of design that is often overlooked—until we need it Have you ever hit the big blue button to activate automatic doors? Have you ever used an ergonomic kitchen tool? Have you ever used curb cuts to roll a stroller across an intersection? If you have, then you’ve benefited from accessible design—design for people with physical, sensory, and cognitive disabilities. These ubiquitous touchstones of modern life were once anything but. Disability advocates fought tirelessly to ensure that the needs of people with disabilities became a standard part of public design thinking. That fight took many forms worldwide, but in the United States it became a civil rights issue; activists used design to make an argument about the place of people with disabilities in public life. In the aftermath of World War II, with injured veterans returning home and the polio epidemic reaching the Oval Office, the needs of people with disabilities came forcibly into the public eye as they never had before. The U.S. became the first country to enact federal accessibility laws, beginning with the Architectural Barriers Act in 1968 and continuing through the landmark Americans with Disabilities Act in 1990, bringing about a wholesale rethinking of our built environment. This progression wasn’t straightforward or easy. Early legislation and design efforts were often haphazard or poorly implemented, with decidedly mixed results. Political resistance to accommodating the needs of people with disabilities was strong; so, too, was resistance among architectural and industrial designers, for whom accessible design wasn’t “real” design. Williamson provides an extraordinary look at everyday design, marrying accessibility with aesthetic, to provide an insight into a world in which we are all active participants, but often passive onlookers. Richly detailed, with stories of politics and innovation, Bess Williamson’s Accessible America takes us through this important history, showing how American ideas of individualism and rights came to shape the material world, often with unexpected consequences.

1

Progress through Prosthetics

Limbs, Cars, Houses, and the American Dream

Public discussions of design and disability often focus not on spaces and objects of public life, but on a very personal, intimate technology: the prosthetic limb. Prosthetics have played a distinctive role in the history of disability, not only as a category of tools that replace the function of a body part (including arms, legs, eyes, fingers, breasts, and even skin), but also as a symbol of the possibilities of technology to replace or extend human capabilities.1 These limbs have been particularly prominent in discussions of disability during and after modern wars, visibly and tangibly representing both a soldier’s sacrifices and a government’s response to it.2 So perhaps it is not surprising that while much of design related to access is of a more public nature—involving architecture, sidewalks, or mass-market products—“artificial limbs” (as they were often called in midcentury America) were central to early policy moves to regulate design and technology for the sake of inclusion and access. As this chapter shows, in the post–World War II years, the U.S. government’s support of prosthetic limb research and provision directly led to the first public provisions for other, everyday aspects of design as a means of bridging the gap between disabled bodies and the material world around them.

In a period when American technology and the nation’s expanding global power seemed nearly synonymous, prosthetic limbs linked the individual disabled body to technology of a national scale.3 The Second World War was a showcase for what Henry Ford called the “arsenal of democracy,” when civilian industries produced tanks and airplanes to supply the conflict, and then transformed wartime technical innovations into a new crop of novel and convenient consumer goods after the war’s resolution in 1945.4 Government officials, medical professionals, and other observers described prosthetics as tools of transformation from military to civilian life, symbolizing the successful return of all soldiers, including disabled veterans.5 In news stories, government messages, and popular films, including the Oscar-winning The Best Years of Our Lives, Americans saw veterans donning prosthetics with a sense of pride and accomplishment. Congress made this message official through the largest veterans’ compensation package in history, the Servicemen’s Readjustment Act of 1944 (popularly known as the GI Bill), which extended provisions for medical care to include long-term support to move veterans into stable, productive lives. In the years that followed, Congress also extended rehabilitation coverage to include customized automobiles and house renovations. These policies foreshadowed the accessible design laws that appeared starting in the 1960s in that they engaged government in the everyday barriers that disabled citizens encountered. These veterans’ policies also carried a message of self-reliance that would resonate in later moments when policy makers questioned and pushed back against measures that they saw as excessive support.

The prosthetics program incorporated a number of principles that shaped the later development of access in the United States. First, prosthetic limbs, cars, and houses all started with the individual veteran. While cars and houses may be used by more than one person, the explicit goal in government support was to support a veteran in occupying the role of head of household. Second, this was a distinctly masculine individualism in which both medical technologies (prosthetics) and domestic ones (cars and houses) assured one’s freedom from dependence on caretaking women. In future policies, this gendered aspect of technology was not always made explicit; however, advocates often raised the specter of dependence as a point of argument. Third, in each of these areas of technological support, veterans were given the freedom to choose for themselves among available options, acting as consumer-citizens in constructing lives of middle-class masculinity. In succeeding decades, as access became linked to a broadening agenda of disability inclusion, these characteristics of individual focus and consumer orientation remained present even in public forms of design.

A fourth and final aspect of political discussions of veterans’ technological benefits was the underlying oppositional argument. As some members of Congress moved to expand measures for disabled veterans, others expressed concern about an excess of social benefits. Even for the most honored members of society who had been injured in military service, there was a feeling of hesitance around government support, particularly when these programs seemed to have any hint of luxury and excess. The fear that providing cars and houses would give an unwarranted “bonus” to veterans enters these technological benefits into the longer history of skepticism, surveillance, and denial when it comes to public benefits for disabled people.6 In these early moves of support for accessibility, the figure of the independent, masculine user of technology was always balanced with the figure of a lazy or coddled disabled person, a threat to the best of American citizenship rather than a figure of accomplishment through rehabilitation. Much of the history of creating access in America can be found in the narrow space between these polarized figures.

The GI Bill and Prosthetic Policies

In the economically powerful society of post–World War II America, technological support for disabled veterans aligned with the overall goals of the GI Bill to grant returning servicemembers access to the best of American society: jobs, education, and houses in model middle-class, mobile, and self-directed lives. Whereas previous veterans’ entitlement programs had provided medical care, job training, and occasionally housing, the GI Bill included previously unheard-of measures to pay for education and provide home mortgages.7 In the robust economy of postwar America, Lizabeth Cohen argues in A Consumer’s Republic, the GI Bill was a component of a new form of “consumer citizenship,” in which access to consumption became a proxy for democratic inclusion. The bill also reproduced or magnified existing inequalities, as people already on the margins of society were doubly removed from the bill’s benefits: African American veterans had few opportunities for mortgages, education, or job mobility, particularly in the Jim Crow South; women faced difficulty obtaining mortgages or entering upper-level job training; and soldiers who had been revealed as gay carried dishonorable discharges that precluded them from eligibility.8 For those disabled veterans who were able to claim the benefits of the GI Bill, measures of technological and consumer access were constructed within clear categories of race, class, and gender.

Public discussions of prosthetics in the post–World War II era reflect the power of the prosthetic limb as a symbol—as well as the material realities that depart from that ideal.9 As disability scholars have noted, the science-fiction view of a magic prosthetic limb replacing and surpassing human function has little to do with the actual material experience of acquiring or wearing one.10 Artificial limbs tend to be cumbersome, failing their human users in a variety of mechanical and material ways: simultaneously heavy and fragile; sweaty, smelly, or chafing; requiring attention in movement and in rest. Further, choices about what aspects of prosthetics to enhance through design research often reflect ideologies about what a body does. Prosthetic limbs after World War II, David Serlin has written, were developed in an era of almost constant effort “to correlate the male American worker with the qualities of a certain brand of normative masculinity: independence, reliability, efficiency, resiliency.”11 These characteristics linked veterans’ capacity to return to society as men to their ability to make things work for themselves. Indeed, from the start, discussions of prosthetics circled around veterans’ special status, on the one hand, and their responsibility to fend for themselves, on the other. Congress, in hearings and statements, warned that with too much assistance, disabled veterans might not complete the process of rehabilitation by struggling through the barriers society presented them.

Twentieth-century rehabilitation, Henri-Jacques Stiker writes in A History of Disability, contained a “flagrant contradiction” in its practices of labeling and goal setting. As a new approach to disability of the twentieth century, rehabilitation was a part of a rupture with past views of the disabled: rather than the permanently designated “infirm, invalid, incapable, impotent” came a new view of motion and progress, or the idea of a “return” to a previous state.12 Rehabilitation is a “passport,” Stiker writes, a labeling system that simultaneously allows the disabled person access to the world of the normal—to be “like the others”—and yet labels them, stamping their history and identity as disabled into this passport.13 The prosthetic limb is a particularly visible aspect of the disabled experience of being “designated, pointed at, and pointed out,” but this assessment could also apply to many forms of accessible and rehabilitative design that call attention to disability even as they also present normative values of imperceptibility.14

As the U.S. government established programs to support disabled veterans beyond the hospital, its efforts followed Stiker’s definition of rehabilitation in terms of the return to an imagined “prior situation.” As subjects of constant attention and functional fascination, prosthetic limbs helped authorities, as well as the disabled themselves, fine-tune the very definition of “normal,” specifying new qualities such as smoothness of gait, convincingness of handshake, or ability to perform a range of social and personal activities associated with American masculinity as markers of success. When Congress extended prosthetic limb subsidies to cover cars and houses as well, it clarified that the end goal of rehabilitation was a normative middle-class home life. By continuing to frame these things in terms of “prosthetics,” lawmakers also reinforced that even when it included a technology not literally attached to a body, rehabilitation was still an individual process designed to produce an independent, self-reliant person.

Prosthetics and Postwar Rehabilitation

The history of prosthetics follows the modern history of war and recovery from war. Just as each generation of policy makers renewed efforts to support veterans of their era’s wars (however they defined “support” for their time), each war spawned a new industry of limb designers and makers sure that they would be the ones to conquer problems of design, distribution, and ultimate function for injured servicemembers.15 When it came to the end of World War II, Americans once again focused on the problem of limbs and whether veterans were receiving equipment commensurate with their heroic status. Veterans’ groups expressed concern over the quality and supply of prosthetic limbs from the beginning of the war, as returning soldiers encountered an industry of scattered, small producers and overall poor design.16 Many manufacturers had adopted weaker metal alloys during materials rationing, creating limbs that collapsed under their wearers’ weight.17 Prosthetic arms of the period were heavy steel contraptions with either a cosmetic hand or a “split hook”—two curved “fingers” that opened and closed (figure 1.1)—that moved through a manipulation of cords threaded through a shoulder harness.18 Specialists lamented the disappointments of these devices. Dr. Howard Rusk, one of the foremost advocates for rehabilitation, described shortfalls in the prosthetic supply as unpatriotic. “A common remark,” Rusk wrote, was that “it doesn’t seem right that a nation capable of developing the atom bomb and radar shouldn’t be able to develop better artificial legs and arms.”19 Dr. Henry Kessler, a prominent surgeon, recounted the shame of hearing parents say, “My boy has given his arm [or leg] for his country, and you have done nothing for him” (original bracket).20

Figure 1.1. Film still published in Helpful Hints to Those Who Have Lost Limbs, War Department pamphlet, 1944. World War I veteran Sgt. Charles McGonegal, captured looking into a bathroom mirror, shaves and combs his hair using split-hook prosthetic hands. U.S. War Department.

The GI Bill specified that “any veteran entitled to a prosthetic appliance shall be furnished with such fitting and training … whether in a Veterans Administration facility … or by outpatient treatment.”21 This language referred to concerns about the long-term well-being of veterans: rehabilitation, policy makers asserted, would entail not only “fitting” with a prosthetic, but long-term “training” that would improve the chances of success in adaptation. In military hospitals as well as private contexts such as Howard Rusk’s Institute of Physical Medicine and Rehabilitation, this training focused intensively on practical skills, often accompanied by a message that equated bodily recovery with psychological improvement. Rusk described the many real-life activities that servicemembers performed as part of their therapy, from practicing climbing stairs to striking a match, using the telephone,...