The information contained in this report highlights the trade-offs that people with disabilities are forced to make each day, says Bonnielin Swenor, PhD, MPH, the director of the Johns Hopkins University Disability Health Research Center and an associate professor of ophthalmology at Hopkins Medicine in Baltimore. “When you have a disability, it impacts every area of life — where you spend your money, buy your groceries, access healthcare, take your kids to school, and much more,” she says.

The Top 10 Best and Worst Cities for People With Disabilities

For its 2021 Best & Worst Cities for People With Disabilities report, the personal finance website WalletHub evaluated 182 U.S. cities using several different data sources pertaining to issues such as employment, healthcare, percentage of people living with disabilities in the area, percentage of people with disabilities living at the poverty level, walkable park access, per capita physicians, and cost of living. The report also included information on how each city was handling the COVID-19 pandemic, since many people with a disability may be at higher risk of more severe infection. The best cities for people with a disability: And the bottom of the list for living with disabilities:

The Average Disability Benefit Is Slightly Above the Federal Poverty Level

The average monthly Social Security disability benefit as of August 2021 was $1,152.37, which adds up to $13,828.44 a year, only slightly higher than the federal poverty guidelines for an individual, which is $12,880 a year. Overland Park, Kansas, has the lowest share of people with disabilities living in poverty, at 8.70 percent. In Rochester, New York, close to half — 44.90 percent — of people with disabilities live below the poverty level. Depending on where you live, the cost of getting in-home help can more than double. El Paso and Brownsville, Texas, have the lowest median annual cost of in-home services, at $34,320, which is 2.3 times lower than in Seattle and Tacoma, Washington, the cities with the highest cost, at $80,034. For people with a disability, especially if they are unable to work, the cost of accessibility can be out of reach, says Dr. Swenor. “Living in an accessible home in an accessible community is expensive; housing options that are close to public transportation or in a safe walkable area are usually not found in a low cost of living area — and that creates an inequity,” she says.

One in 4 Americans Lives With a Disability

One in 4 adults — an estimated 61 million Americans — live with a disability that impacts major life activities, according to the Centers for Disease Control and Prevention (CDC). The most common disability is immobility, and it affects about 40 percent of adults age 65 and older. Issues of inclusiveness and accessibility don’t just impact the individual with disabilities; the trade-offs and challenges affect everyone in their family, too, says Swenor.

Disabilities Report Can Help People Make Informed Decisions 

This kind of information can help people can make the best and most informed decisions for themselves, says Bari Talente, the executive vice president of advocacy and healthcare access for the National MS Society. “It includes criteria that are important to many people with disabilities that others may not pay close attention to,” she says. “Some examples, and things we hear from people with MS, include accessible public transportation, affordable and accessible housing, accessible public space like parks and social places and access to home and community-based services,” says Talente. Because each person is different and people living with disabilities includes a broad range of disabilities, it’s important for individuals to review the criteria used in the survey that are most important to them, she adds.

Seek Out People and Organizations to Find Out if a Community Is Disability-Friendly

Connecting with other people with the same lived experience is a great way to figure out how welcoming, accessible, and inclusive a city is for people with disabilities, says Swenor. “I don’t think that people outside the disability community fully understand the important role all these factors can play in where a person decides where to go to school, get a job, or raise a family,” she says. There are lots of fantastic disability advocacy groups on a national and local level, says Swenor. “Identify and contact a group in the community where you’re considering relocating or ask people in your current community if they know anyone living in that area,” she suggests.

More Cities and Communities Need to Include People With Disabilities in All Aspects of Planning and Decision-Making

Cities and communities that get it right when it comes to accessibility and livability are often the ones that include people with disabilities at every stage of decision making, policy making, in urban planning and design, says Swenor. “People with disabilities should be represented in all facets of community life, not just for a few select areas that are considered ‘disability issues,’” she says.

Not Able to Relocate? Advocate in Your Own Community

Advocating for what you need and what will make an inclusive environment within the city itself or in private businesses within the city can make an impact, says Talente. “People with MS have advocated for accessible bathrooms in a restaurant, an accessible push door opener at a bank, accessible trails in public parks, accessible transportation, and much more,” she says.