Since the Americans with Disabilities Act was passed in 1990, the rights of people with disabilities have become more widely recognized and respected. As more facilities and activities have been made accessible, people with disabilities have become more visible. At the same time, the idea of exercise as both preventative medicine and treatment for secondary conditions has been gaining momentum in the health care community. Despite these facts, the misconception that people with disabilities are sick and cannot or should not exercise persists in the general population, among people with disabilities, and among the fitness professionals who could help them improve their quality of life.
This misconception must be transformed if this country is to adequately address its growing health care crisis. As June Kailes has pointed out, "When health is viewed not as the absence of disability or chronic conditions, but as the ability to function effectively in given environments, to fulfill needs and to adapt to major stresses, then, by definition, most people with disabilities are healthy... Physical exercise, good nutrition, stress-management and social support are important for everyone, but they are actually more critical for people with disabilities who sometimes have been described as having a thinner margin of health." To maintain this margin of health, and prevent the secondary conditions that often result from the limited activity imposed by a primary disability, individuals must have access to facilities and equipment with which to increase their physical activity, and to the knowledgeable staff who can help them learn how to use it.
As the ADA currently stands, any newly constructed health or fitness facility must be accessible. If an existing facility is to be modified, these modifications must include changes to make the facility accessible. A facility may be exempt if making the modifications would cause "undue hardship or significant expense in relation to the size and financial resources of the club." Regardless of legal issues, owners and managers of health and fitness facilities have a moral obligation to make their centers accessible to as many individuals as possible. By increasing the potential pool of members, these centers may realize financial benefits as well. To make a facility truly accessible, several factors must be taken into consideration, including architectural accessibility, equipment accessibility, and social/emotional accessibility.