In the United States, 1 in 4 adults has a disability, according to the Centers for Disease Control and Prevention.

Mobility disabilities that limit movement are the most common kind, impacting 1 in 7 adults.

Yet much of the nation’s housing lacks basic accessibility features that ensure anyone can enter and navigate the home or fully use bedrooms, bathrooms and kitchens.

More than a fifth of households with a disabled resident had trouble navigating or using their homes in 2019, according to a recent report from the Joint Center for Housing Studies of Harvard University.

Those residents may have trouble reaching sinks, stoves, thermostats or getting in and out of tubs and showers.

Lower-income, older, Black and Hispanic residents with disabilities were more likely to live in homes that didn’t meet their needs, the study found. For households with incomes under $30,000, 1 in 10 lived in homes that didn’t fit their needs.

And renters are often on the hook for paying for changes that make rental units more accessible. Sometimes, requesting those changes results in renters being evicted, which is illegal under the Fair Housing Act.

“A lot of rental housing isn’t accessible,” said Jennifer Molinsky, a co-author of the report and project director for the Housing an Aging Society Program at the Harvard Joint Center for Housing Studies. “The stock that tends to be accessible is larger, more recently built buildings.”

Housing advocates say new construction can still lack basic accessibility features, and the rent for those buildings often prices out low-income tenants with disabilities.

“There’s not enough affordable housing to begin with, and adding accessibility as a feature—it’s just another bridge people have to cross,” Molinsky said.

Funding and community support in this area tend to focus on low-income people. That leaves behind people at slightly higher and middle incomes, said Beth Glas, executive vice president of nonprofit housing provider Maximum Accessible Housing of Ohio.

“It can be very challenging to find a unit if you don’t qualify for affordable housing, and finding an affordable, accessible unit is even harder,” she said.

Renters cope with a lack of accessible, affordable housing

Since 1991, the Fair Housing Act has required multifamily buildings with four or more units to meet certain accessibility guidelines, including providing accessible entrances, routes into the building and reinforced walls for grab bars that aid mobility.

Kris Keniray is the associate director of the Fair Housing Center for Rights and Research, based in Cleveland, Ohio. She said many homes in the city were built before accessible housing construction requirements went into effect, and although some properties have made changes to increase accessibility, it remains a huge issue.

“There’s a significant unmet need, and I would say anecdotally our organization hears a lot from folks who are looking for affordable housing options that are accessible and struggling to locate options that meet people’s needs,” Keniray said.

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High-end, luxury housing also isn’t fully accessible. It may have narrow doorways or steps inaccessible to wheelchairs. Kitchens and bathrooms may have difficult-to-reach faucets or designs that make it challenging to use sinks for cooking, cleaning and hygiene. For renters who use mobility aids, some layouts don’t allow them to close bathroom doors or navigate around a bed.

Because of the shortage of accessible, affordable housing, renters may be forced to leave neighborhoods where they’ve lived for years, potentially pushing them further from family, friends and health care providers.

Keniray said her organization has recently worked with an individual who struggled to find an accessible rental that also would accept a Section 8 housing voucher through the US Department of Housing and Urban Development (HUD). Another client’s mobility situation changed, and without adjustments to common areas in their building, they couldn’t leave their home.

Conversations about housing and disabilities tend to focus on people with physical disabilities, said Kevin Truitt, legal advocacy director for Disability Rights Ohio. Those discussions leave out people with other types of disabilities, including mental health and substance abuse disabilities.

“Stable, affordable housing is huge for people who are struggling with a mental illness or addiction issues,” Truitt said. “If they’re not able to have housing stability, it makes life harder and makes recovery more challenging.”

Glas said housing that’s both affordable and accessible is usually developed with older renters in mind.

“Communities developed for seniors may welcome people with disabilities at any age, but they might not be as socially welcoming or appropriate for a younger person with a disability,” she said.

[ Read more: Climate disasters worsen the affordable housing crisis ]

In some communities, nonprofit housing providers are filling the gap.

Maximum Accessible Housing of Ohio operates five HUD-subsidized apartments designed for renters with physical mobility disabilities who may use a mobility aid, like a wheelchair or cane. The units are designed with low counters, roll-in showers and lever handles that are easier to grasp than doorknobs.

Glas said the organization’s average tenant earns about $12,000 per year, and most receive income through Social Security benefits.

Housing seekers apply to rent the units. Each property has its own waiting list, which can last several years.

Traditional developers of multifamily housing are building with the most common type of renter in mind and typically making design choices geared toward what’s considered trendy or luxurious, Glas said. Architects and building developers focused on making a profit on uniform rental units tend to design homes without accessibility features because they aren’t the norm.

“When designing an accessible unit, there’s a creativity and an art to it,” Glas said. “Every accessible unit is accessible in different ways, and that’s a challenge that does not get along very well with the nature of multifamily housing.”

Some renters are denied service animals, accessible parking

Renters with a disability can request two types of changes to make their homes more accessible.

They can request an accommodation, or a change to policies and practices, such as allowing service animals when a building doesn’t permit pets.

They can also request a modification, or a structural change to the property itself, including adding ramps, grab bars or lowering mailboxes.

[ Read more: Why renters are paying more for substandard homes ]

Federally-subsidized housing providers are required to pay for reasonable accommodations to make homes more accessible.

Otherwise, renters are generally responsible for paying for modifications, Truitt said.

“If you have to pay out of pocket for modifications like that, it’s going to be an obstacle for a lot of people, especially if they’re low-income or on a fixed income,” he said.

Under the Fair Housing Act, landlords can’t refuse reasonable requests for accommodations or modifications. However, those requests sometimes result in evictions that violate the Fair Housing Act, Truitt said.

“We’ve gotten so many calls about housing providers, landlords, either not granting accommodations, which could be illegal, or not allowing a physical modification to their apartment, even at that person’s own expense, which could be illegal under the Fair Housing Act,” he said.

Some of the most common disputes he hears about involve landlords not allowing renters with mental health diagnoses to have service animals and refusing to provide accessible parking to renters with mobility impairments.

Truitt worries that the number of obstacles for renters with disabilities have serious consequences.

“We want people with disabilities to be integrated into our communities. We want diverse communities,” he said, “And if people can’t find housing, where are they going to live? Are they going to become homeless? Are they going to wind up in institutional settings?”

Contact BigIfTrue.org editor Mollie Bryant at 405-990-0988 or bryant@bigiftrue.org. Follow her on Twitter.

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Correction: This article has been updated to correct the average annual income of Maximum Accessible Housing of Ohio’s tenants. It is $12,000.