Inclusive housing responses to the needs of adults with physical disabilities: a qualitative meta-synthesis

Housing is a critical determinant of health, yet evidence remains fragmented on how the built environment enables or constrains autonomy and everyday functioning for adults with physical disabilities. The gap persists despite increasing policy attention to accessibility and inclusion. This review examined how design features of inclusive housing respond to the needs and experiences of adults with physical disabilities. A systematic qualitative meta-synthesis was undertaken using the JBI meta-aggregative approach, and 42 peer-reviewed qualitative studies were included. The synthesis suggested that inclusion is shaped through the interaction of three interrelated dimensions of housing: environmental design features reported to support safe, coherent, and autonomous daily routines; participatory and experience-informed processes associated with a sense of belonging and psychosocial well-being; and governance and regulatory conditions that shape how inclusive design is delivered, implemented, and sustained over time. These dimensions operated across interior, interface-zone, and neighbourhood scales and interpreted as influencing how people navigate, use, and inhabit their homes. The evidence indicates that strengthening inclusion requires integrating lived-experience insights into routine design practice, aligning standards with demonstrated functional needs, and improving coherence across planning, building, and disability-policy systems. More geographically diverse qualitative research is needed to clarify how these mechanisms operate in different housing contexts and to inform context-sensitive policy and practice.