My research project is ‘Interior Design Wellness Solutions for the Visually Impaired.” If you would like to follow along, I will begin discussing topics on the right side of my poster, moving down, to left, and then back up. My hypothesis is: “Improving aspects of the built environment—to accommodate for the visually impaired—will correlate to improved mental & physical wellbeing within that community.” My methods are both qualitative and quantitative.

I came to this conclusion, based on statistics about depression, anxiety, and injury among the visually impaired—these are my findings. From the Investigative Ophthalmology & Visual Science Journal, researchers conducted a study among 615 visually impaired adults. Results concluded that 5% had major depressive disorder and 8% had anxiety disorders. In comparison, 32% of participants had subthreshold depression and 16% had subthreshold anxiety. To further compare, 61% of all visually impaired participants showed symptoms of anxiety or depression.

https://iovs.arvojournals.org/article.aspx?articleid=2212840

Moving on to causes of depression among the visually impaired – Perhaps the most relevant article in my research was done by BMC. They published an article titled: Loneliness among adults with visual impairment: prevalence, associated factors, and relationship to life satisfaction. The study found that Loneliness was associated with blindness, unemployment, bullying, lower life satisfaction, and more. In all, reasons for depression among the visually impaired ranged from vision loss, unemployment, loss of hobbies, social withdrawal, fear, social stigma, and finally, to difficulty wayfinding.

https://hqlo.biomedcentral.com/articles/10.1186/s12955-019-1096-y

In a medical risk assessment from NCBI, research estimated that 55% of falls happen within the home, 22% near the home, and 23% in the community.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6309321/

From Emerald Insight, an article was published titled: Accessible park environment and facilities for the visually impaired. Researchers surveyed visually impaired park users and concluded that if a space or facility did not have adequate wayfinding, users would simply not use such facilities due to lack of independence opportunities, lack of inclusivity, and fear of injury.

https://www.emerald.com/insight/content/doi/10.1108/f-10-2011-0079/full/html

The provided research creates connections between the built environment and mental & physical health disparities within the visually impaired community. How does the built environment affect one’s ability to maneuver the world if one also has a visual impairment? What aspects of the built environment exclude the visually impaired? Is social withdrawal related to difficulty wayfinding? Does social stigma relate to one’s inability to maneuver adequately within social settings? Is unemployment related to inability to function within work environments?

In an article published by NCBI titled: Sounds that people with visual impairment want to experience, research found that sounds such as fire alarms, ringing, electronic buttons, doorbells, etc. were especially important in deciphering a situation or outcome—and this coincided with their design intent… a fire alarm—to indicate a fire. However, sounds, such as a cat meowing, the opening of a door, a coffee machine, birds chirping, and thunder were equally important to participants. Alarms indicated necessary information, but the second group of sounds improved quality of life and sense of space.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967530/

An article, published by science daily, found a link between level of vision impairment and audio accuracy. The study concluded that the severely visually impaired were the least accurate in judging distance of close sounds, potentially putting them more at risk of injury. Acoustics are an aid to such concerns.

https://www.sciencedaily.com/releases/2020/06/200603194433.htm

Acoustics absorb ambient sound and improve ability to hear. For example, an auditorium with good acoustics absorbs sound from the audience while amplifying sound being produced on stage. Acoustics, in the form of drop ceilings or wall panels, can be placed in classrooms or a lobby to optimize sound. Sound optimization within interiors creates comfort and ease for all hearing abilities. Acoustics, for the visually impaired, can also be an indicator of space and a landmark for wayfinding. Take this hallway elevation, for example: varying ceiling heights and acoustic levels create variation in space which help the visually impaired to recognize and differentiate space while improving wayfinding. Acoustic and sound analysis is optimal for an array of users.

Vision is a spectrum and not all visual impairments are the same. Based on the World Health Organization’s Global Data on visual impairment (2011), 285 million people worldwide are visually impaired, while 39 million people are entirely blind: meaning they see nothing. Eye conditions range from cataract, uncorrected refractive error, glaucoma, age related macular degeneration, corneal opacity, Trachoma, and Diabetic retinopathy. One visually impaired individual may have light perception, but no depth perception: meaning they may be able to see windows and overhead lights, but they cannot see the depth of the stairs. Another individual may have blue-yellow deficient color blindness with full light and depth perception.

https://www.who.int/blindness/publications/globaldata/en/

From Castellón, Design & Development of Flooring for the Sight-Impaired, researchers analyzed wayfinding materials within public spaces and found that contrast was the single most important factor for visibility. Extensive research concluded that combinations of black & white, yellow & black, blue & yellow, and finally red & yellow were the best combinations for reading and perception. Specifically, the shade combinations shown on the left side of the poster. A general rule is to provide colors which are complementary to each other, and again considering contrast as most important. Pavers should involve these color combinations for optimal viewing, while also indicating texture: straight lines indicate “GO” and dots indicate “STOP”.

https://www.qualicer.org/recopilatorio/ponencias/pdfs/0062307e.pdf

Using the above rendering examples: the top is a blurred image which loosely resembles what a visually impaired individual might see when entering this space. Most obviously, the sculpture against the black partition becomes much more obvious due to contrasting colors; in comparison, the tan sculpture against the white wall fades into the background and becomes much less defined.

When applying such contrast to dangers, like: stairs, sharp edges, height differences, etc. Contrast becomes less about convenience and more about injury prevention. Such preventative measures can be compounded with audio and textile warnings for optimal effectiveness.

Contrast also can be applied to luminance or lighting. Found in the British Journal of Occupational Therapy: exploring preferred and actual lighting levels for reading adults with visual impairment—the preferred lighting level varied among individuals but ranged from 3000-6,500 kelvins. From designforsight: a multitude of issues can arise from poor lighting. Uncontrolled light can contrast with dark surfaces, sunlight and point source lights can create glare. Moreover, poor lighting plans can create uneven luminance and shadows. Solutions from both sources include individual task lighting, low sheen materials, adjustable window shades, and ambient or diffuse lighting.

https://journals.sagepub.com/doi/full/10.1177/0308022620946642

http://www.designforsight.com/luminanceplacement.html

Further considering lighting, transitional spaces are especially important for the visually impaired. Users who move from bright areas into dim interiors, and vice versa, may experience moderate to severe discomfort. Interior areas which commonly lack lighting are elevators and halls. A provided transition space with seating can allow users to successfully adjust their eyes before maneuvering the facility, which creates greater success at doing so efficiently.

Texture is important to those with visual impairments for a myriad of reasons, but it is often an overlooked supplement to wayfinding. Wayfinding maps are often provided in large shopping malls or office complexes—and are rarely 3D. For someone with a visual impairment, a wayfinding map can be imperative to understanding a floor plan and efficiently maneuvering it. When considering 3d wayfinding maps, having a consistent plan throughout levels, consistent restroom locations, labeled transition areas and labeled elevators are important indications to include.

Published by the NCBI, an article titled “the effectiveness of an interactive audio-tactile map for the process of cognitive mapping and recall among people with visual impairments” discusses effectiveness between tactile maps and maps with supplemental audio. With fourteen participants exposed to the interactive-audio-tactile maps, and a control group, researchers found that the audio-textile group recalled wayfinding routes significantly better than the control group. The experiment concluded that providing multiple means of education offered individuals with freedom to learn a map in several ways and did not restrict them to one approach of learning—an issue often forced upon people with impairments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375097/

Lastly, green space is undoubtedly one of the most important aspects of health opportunities within the built environment. In article by BJPsych International, quote: “It is clear that engagement with greenspaces offers benefits in terms of mental health and well-being, and thus greenspaces can function as an upstream preventive mental health promotion intervention.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663018/

To reiterate from an earlier point made, Researchers concluded that visually impaired park users are often unable to use green space environments—for lack of wayfinding information and inclusive design. When considering the positive attributes of green space towards mental health, excluding the visually impaired—a demographic of people with mental health disparities upwards of 60%—is a serious issue within green space design. Designers can better integrate the visually impaired with aspects I’ve referred to thus far: visual contrast, wayfinding maps, tactile pavers, audio options, and lighting. It is important that the visually impaired not only are able to use green space but enjoy it. A quote, by Hellen Keller, that I often refer to is this: “…they have no idea how fair the flower is to the touch, nor do the appreciate its fragrance, which is the soul of the flower.” Greenspace is much more than sight: integrating scented plants like chocolate cosmos, lavender, and honeysuckle—or even edible plants like mint and dandelion—can involve the various senses. Furthermore, tactile plants, like wooly thyme, can further involve a visually impaired individual into green space.

Wayfinding is one of the most obvious issues related to the useability of the built environment by those with visual impairments. If a space does not provide particular lighting, temperature, textile, contrast, etc. then the space may be entirely unusable, excluding this demographic, and further hindering mental health within the community. At its worst, design which lacks adequate wayfinding techniques can physically injure users, while increasing fear and anxiety. In contrast, if provided such features, those with visual impairments are able to get a sense of space, are less distracted by bad design, and much more likely to use facilities, explore new areas, become employed, and socialize—therefore lowering the rates of physical and mental health disparities within the community, as well as social stigma and social exclusion.

Discrimination obviously exists in our environment. Public spaces that are not inclusive clearly state: “this space is for a certain kind of person, and it is NOT for you.” As urban planners, designers, and architects: we must recognize the message of our creations.

To conclude, from Disability and the Built Environment, a lecture at Glosgow Caledonian University, quote:

“Design professions have generally been more concerned with the abstract values of their craft than with creating structures which are sensitive to the diverse needs of their users. Only by explicitly embracing difference can a system of justice be truly just. It is the exclusion, in itself, that we fear as much as the impairments. Indeed, if we view disability from a social model perspective, it is clear that society actually creates the thing it fears.”

http://homepages.phonecoop.coop/vamos/work/lecturenotes/sun/LectureNotes/city/