The home environment is critical for maintaining health and well-being among the medically ill and people living with disabilities. Access to appropriate supportive care technologies and home health care services depends in part on where homes are located, what sorts of spaces are available for care in the home, and whether basic services (such as utilities) are reliable. These aspects of home environments are difficult to measure, even when features of homes are narrowly defined and only a single attribute, such as safety, is considered (Gitlin, 2003). Measurement challenges become more complex when considering that each of these environmental features also has a cultural or social component. Homes are located in neighborhoods, where home health care providers may not feel welcome or safe because of crime in a low-income neighborhood and discrimination or suspicion in a higher-income one. Homes differ in their spaces available for care but also in the willingness of families to make these spaces available, adapt them as needed, and work with home health staff to provide care. Also, utilities, telephone service, and access to services differ by community, with some communities well serviced and others shortchanged.