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Why Accessibility Matters: Insights from HealthHub’s Senior UI & Accessibility Designer

September 14, 2020 – Written by Stephen Belyea, HealthHub’s Senior UI and Accessibility Developer, this article has been adapted from the original three-part series published online here.

Since starting out as a web developer in 2012, I’ve been focused on digital accessibility in some form or another. “Why is accessibility important?” is a question I’ve fielded many times over that period. This article an attempt to answer that question and share how businesses can design accessible products and experiences for people.

Part I: What is “Disability”?

Understanding why accessibility is important starts with understanding the scope of what disability genuinely means.

For those who are not personally impacted by it (through themselves or family, friends or co-workers), “disability” can seem like a bucket to contain a very small group of marginalized people: folks with a white cane or guide dog, in a wheelchair, or with a prosthetic limb, etc. While this isn’t entirely false, it is a very limited view.

In fact, based on numbers collected in 2017, Statistics Canada reported that “one in five (22%) of the Canadian population aged 15 years and over… [self-reported as having] one or more disabilities”. Additionally, the impact of disability “increase[s] with age, from 13% for those aged 15 to 24 years to 47% for those aged 75 years and over”. According to the Government of Canada’s report on Action for Seniors, the country’s population is aging rapidly, with “seniors [due to] number over 9.5 million and make up 23 percent of Canadians” by 2030.

One in five Canadians seems like an awful lot of white canes, wheelchairs and prosthetic limbs, no? Well, that’s because disabilities are far more wide-reaching than the most obvious (visible) examples.

Permanent Disability

According to Disabled World’s Disabilities: Definition, Types and Models of Disability, a disability is “a condition or function judged to be significantly impaired relative to the usual standard of an individual or group.” The source expands this with a variety of areas, including “physical impairment, sensory impairment, cognitive impairment, intellectual impairment mental illness, and various types of chronic disease.” Importantly, it also cites disability as a wide-reaching, “multidimensional experience for the person involved.”

Based on that (and the source is consistent with legal definitions world-wide), you can see that an awful lot of people seem to fall directly within, or at least on the spectrum, of what we might consider a disability. As any glasses wearer will tell you, there are an awful lot of “normal” activities that suddenly get tougher when you have a couple of plastic or glass discs floating in front of your eyes at all times (e.g. cold weather, face masks, swimming, rain, and any activity that involves goggles).

Temporary Disability

Through the range of permanent disability, we can already imagine a hefty breadth of humanity. If you include temporary disability, that range just keeps growing.

Based on an insurance-oriented description of short-term disability, the range can include “any sort of injury or illness that renders one unable to do their job.” Pretty broad, no? To expand, the source offers a few examples:

That could include things like childbirth, a major surgery with a long recovery period, an illness that requires frequent treatment, or an injury sustained in some sort of accident.

To be candid, I’ve personally been on short-term disability leave due to mental health crisis. It isn’t fun and it isn’t vacation. I can tell you (as many, many other people can as well) that being in that situation is extremely debilitating and you can’t even begin to function as what you may believe a “normal” person would.

For us at HealthHub, the likelihood of a patient dealing with a temporary disability or other situation in which their physical, mental, or overall abilities are lowered, is much, much higher than the general public. I have encountered few people in my life who visit a hospital when everything’s going great for them.

Age-Related (or Developing) Disability

Canada’s population is aging. With age comes degradation of bodily function, meaning if we live long enough, we’ll all likely face some level of disability.

Added to the developing disability group could be anyone diagnosed with arthritis, muscular dystrophy, cerebral palsy, or any number of other diseases that debilitate people over time. As these conditions grow in severity, they would certainly be considered within the “permanent disability” group — but for someone feeling the first signs of Parkinson’s disease, the effects are frightening and can immediately impact their day-to-day life.

I hope “disability” is starting to sound less like a niche group and more like most of humanity.

Part II: What is “Accessibility”?

Now that we have a somewhat broader idea of what the term “disability” means, let’s define that other frequently misunderstood one: accessibility.

MDN does a nice job of summing this one up, though it is purely in a digital/web context:

Accessibility is the practice of making your websites usable by as many people as possible. We traditionally think of this as being about people with disabilities, but the practice of making sites accessible also benefits other groups such as those using mobile devices, or those with slow network connections.

The first part of that definition seems fairly clear and conventional, no? “Usable by as many people as possible,” is a great way of framing the effort, as it helps shift the context from an act of charity for people with disabilities to recognizing that humans come in a huge variety — and building with that in mind!

The second part (“the practice of making sites accessible…”) helps to reinforce the same wider view while clearly pointing out that the effort “benefits other groups” by citing a couple of examples (mobile users or folks with slow internet). These are fairly common and simple examples, but a nice illustration of the people that you may not immediately consider when designing and building with accessibility in mind.

This extended benefit from accessible practices is not unique to the web and digital products. It is a well-documented phenomena all over architecture, construction, print, transportation, urban development, and any other facet of life.

Digital Curb Cuts

The podcast 99% Invisible had a phenomenal episode in 2018 called “Curb Cuts”, in which they told the story of an activist by the name of Ed Roberts. He was instrumental in pushing his local municipality to adopt curb cuts:

[W]hen an activist named Ed Roberts was young — most urban corners featured a sharp drop-off, making it difficult for him and other wheelchair users to get between blocks without assistance.

The podcast episode weaves a compelling story of how quickly curb cuts were recognized as helpful for everyone when Roberts’ municipality eventually piloted the concept. Parents and caregivers pushing strollers, delivery workers hauling carts, low-mobility people pushing walkers, and even punk kids on skateboards all found curb cuts to be a small but noticeable improvement in their daily movement throughout the city.

Take a quick look around your office (or wherever you’re reading this from) and take stock of the door handle, light switch(es), doorway width, etc. Have you ever tried to move a couch through tiny, narrow doorways? Have you tried turning on an old light switch or opening a round door handle with your hands full? These are all examples of accessibility features that have come to benefit all of us.

Web accessibility can work in exactly the same way. Small improvements, like providing clear labels for navigation or interaction, can help everyone better understand how to get around your product. Images with alt text help anyone with a slow or failed connection, or an SEO crawler, or anyone using a streamlined reader app, to understand the imagery throughout your product — not just people using a screen reader. Easily findable sitemaps help anyone find the grand-child level page they’re after, or help SEO crawlers index your content. SEO comes up a lot in relation to accessibility, in fact, as they both rely on structured, meaningful markup and information architecture.

Who is Accessibility For?

We’ve explored some wider examples of who benefits from accessible practices — but don’t get me wrong: accessibility is primarily for helping people to reach, understand, and make use of whatever product or environment (digital or otherwise) they encounter. This starts with a focus on people with disabilities, who are frequently left out of conversations and consideration, but it does not end there.

Accessibility is for humans.

Part III: What are the Benefits of Accessibility?

We’ve discussed disability, and how vastly more Canadians are impacted than many people realize. We’ve looked at accessibility and explored examples of how efforts to help people with disabilities regularly benefit an even wider range of the population. We know that disability is part of the human experience and accessibility is about recognizing and building for humanity.

For many people, this provides more than enough background to reinforce that accessibility is, unequivocally, the right thing to do.

The reality is that this won’t be enough for everyone, though. You will encounter clients, leadership, and even team-mates who aren’t convinced by the human aspect. There are myriad reasons (or excuses) for this, from tight budgets and timelines, to a landscape analysis of the assumed target demographic, to the pressures of being first-to-market. In her classic piece, Why Bother with Accessibility?, Laura Kalbag outlines four common excuses and builds well-backed arguments to dismantle each. She identifies her four cases as these (italics are mine):

  1. “Accessibility will make your site available to more people — the inclusion case”
  2. “Accessibility will improve your site for all your users — the usability case”
  3. “Accessibility will make you money — the business case”
  4. “Accessibility won’t stop your site from being beautiful — the beauty case”

We’ve covered the inclusion and usability cases. The business and beauty cases both stem from the same core issue: the client, leadership, or team have not bought-in; they aren’t (yet) committed to providing an inclusive, accessible experience.

Making the (Business) Case

Much has been published online in regards to the strong business case behind accessibility, including Laura Kalbag’s piece.

Greg Williams has written a strong, detailed case for Deque, titled The Business Case for Accessibility. He carefully illustrates the immediate and long-term ROI (return on investment) to a company and brand:

What most organizations don’t realize is that accessibility can unlock a huge, overlooked market share, reduce potential legal risk, lower operational costs, and boost brand value…These positive factors end up helping organizations control costs to the extent that the accessibility efforts can pay for themselves. And, if it’s really done right, accessibility can certainly become a competitive advantage, especially in the eCommerce space.

Greg summarizes his business case in four key aspects: “capturing an overlooked market share, risk management, lowering operational costs and boosting brand value”. I would add the value of building and fostering a more empathetic, innovative and quality-oriented team (from sales, through project management, design, development and quality assurance) as a strong selling point, which only adds to the trust and respect from clients, leadership and amongst the team. A driven team like that will do far more for recruitment efforts than all the ping-pong tables and beer kegs you can fit into a loft-office!

Here are a few more well-framed (and nearly identically titled) business cases, for reference:

Moving the Needle

Driven, diverse, empathetic and innovative teams will create beautiful, functional, inclusive and thoughtful products. At the end of the day, if your clients and company leadership can’t see that — on top of the human and business cases — then you may think you’re out of luck!

Fear not. There are still options.

In every discussion around design, ask your team questions like: “How, as a user, would I know what format to enter my phone number?”, or “What if I didn’t understand that icon?

In discussions focused on implementation, try: “How would this work without a mouse?”, or “What if my internet connection is slow?”

For sales, marketing or product management, consider: “What legal requirements do our clients need to support?”, “What is our competition promoting that we aren’t?”, or “How should we track issues and requests from users?”

Find any allies within your team and work with them. Host lunch-and-learns, take over tech talks or invite them to a relevant Meetup. For any conferences or local events, ask about accessibility accommodation.

If you’re involved in your company’s interview process, ask questions about a candidate’s experience in supporting accessibility. If you aren’t directly involved, get to know human resources and your recruiters to add those questions to the script. If you are interviewing for a new role, ask the same of your prospective employer!

None of the above will change everyone’s mind immediately — but each of these will slowly have an impact. I consider it a huge success to hear people ask, “What about AODA?” (Accessibility for Ontarians with Disabilities Act, for anyone outside of Ontario’s context). Cultural shifts happen over the course of time, on the backs of many, many people and small choices. Changing minds can be a daunting and frustrating effort, but you are doing this for humanity!

So, Why is Accessibility Important?

Accessibility is important because people navigate the world in a wide variety of ways, through a range of physical and mental experiences. Whether you’re offering a service, selling a product or providing a public necessity — people are your audience. Building with more people in mind means you have a larger potential audience. It’s a good business decision and it’s the right thing to do.

Refund Policy

Rental orders with HealthHub Patient Engagement Solutions are refundable within the following guidelines:

  • Days that have been paid for (paid days1 ), but cannot be used due to a service interruption3 caused by a qualified technical issue4 may be refunded at the daily rate.

  • A day is considered used 2 hours after rental start time. Rental start time is defined by the rental order.

  • Any free days2 of rental included in a multi-day rental package cannot be exchanged for money or transferred to another patient.

  • If a refund is processed before all paid days are used, any free days are forfeited.

  • Refunds are processed from the time they are requested, and will not be backdated.

  • Once a service interruption is reported, paid days will be either refunded or added to the rental period (the choice is up to the patient). Free days will be added to the rental period, and cannot be refunded or exchanged for money.


1 Paid days = Days of service paid for with your chosen service package. All paid days must be used before the free days in a package begin. There is 1 paid day in the daily package, 5 paid days in the weekly package and 15 paid days in the monthly package. (Please note: some sites may have different rental packages).

2 Free days = Days of service that were gifted to you by HealthHub with your chosen service package. The weekly package includes 2 free days (5 paid days, 2 free days) the monthly includes 15 free days (15 paid days, 15 free days). (Please note: some sites may have different rental packages).

3 Service interruption = Service use disrupted due to a qualified technical issue, or due to being moved to a new room with a missing or damaged HealthHub terminal. (Please note: this policy applies to service delivery problems for which HealthHub is responsible; it does not apply to those for which the hospital is responsible).

4 Qualified technical issue = A technical problem that impacts service delivery or enjoyment of services on your device.