that contribute to disability and to improve the overall health, well-being, independence, and productivity of people with existing disabilities. Previous chapters of this report have detailed projections of a significant increase in the number of people at the highest risk of disability and have discussed the scope and magnitude of issues related to disability that are facing this country. These issues present broad and costly challenges to Americans, but a delay in tackling these issues will only exacerbate the problems and increase the costs of future actions.

Evidence continues to grow that disability is not an unavoidable consequence of injury and chronic disease but results, in part, from actions that society takes—both in the public arena and in commerce and other private domains. This report argues that American society should take explicit responsibility for defining the future of disability in this country. How it does so will reflect the country’s deepest values. The record of the past 17 years offers reasons for serious concern, especially given the cost projections for public programs that are critical to people with disabilities and their families.

Although they are not comprehensive, this report presents a varied set of recommendations for improving the future health and well-being of people with disabilities and for preventing many of the health and environmental conditions that contribute to disability. Some recommendations are new, whereas others recall recommendations in earlier reports that remain compelling. Taken together, they challenge Americans to commit to fully integrating people with disabilities into community life and to making the investments that will generate the knowledge, policies, technologies, and public understanding needed to support that goal.