JMIR Publications

ABSTRACT

Background:

Structural ableism, defined as the processes, policies, and institutions that privilege able-bodied people over disabled people, is a root cause of health inequalities faced by the disability community. A necessary first step to addressing these health inequities is to create validated measures of structural ableism. This development can find parallels from foundational work across other forms of structural oppression, such as structural racism, classism, ageism, sexism, and heterosexism. Here, we outline the methods of an ongoing project to characterize the multiple factors that comprise the construct of structural ableism. This project will improve our understanding of the multidimensionality of structural ableism in ways that support measure development.

Objective:

This work will develop and validate both individual and community-level measures of structural ableism. The resulting individual-level measure will facilitate the identification of relationships between structural ableism and health outcomes at an individual level. Further, novel measures of structural ableism at a community level will be developed using publicly available datasets and used to explore relationships with health outcomes.

Methods:

We will use both participatory and statistical approaches to develop a cross-domain composite measure of structural ableism. The resulting measure will help quantify the relationship between structural ableism and health outcomes at a community level. These methods take an intersectional, interdisciplinary, and community-grounded approach. Our methods purposefully include disabled people across all steps and phases of this work, with a focus on maximizing the diversity of disability perspectives by including people across disability types and intersecting identities (e.g., race/ethnicity, gender identity, geographic location, and other identities and demographics). Most importantly, our approach is deeply community-informed, drawing on multiple community partnerships from local and national organizations, a diverse advisory committee of disabled activists, advocates, and scholars, as well as researchers with expertise in developing measures of structural oppression, such as structural racism.

Results:

This project was funded in August of 2024. As of October 2025, our team has read over 50 texts as part of our historical and policy analysis of the factors that characterize structural ableism. We plan to complete our characterization of structural ableism in the spring of 2026, with individual-level measures of structural ableism being developed by the winter of 2028 and community-level measures created by the winter of 2029.

Conclusions:

The measures developed by this work will lay the foundation for identifying and evaluating novel interventions aimed at dismantling structural ableism, which should be co-created with the disability community.