RISP Data Bytes

Institutionalized Adults with IDD, 1967 to 2021, November 2025 RISP Data Byte

Background

In 1967, there were about 298,976 adults with intellectual and developmental disabilities (IDD) in the U.S. (Haber, 1969). Of those, 86,976 (29.1%) lived in state-run IDD facilities of 16 or more people (Larson et al., 2024). Nearly all people with IDD who did not live in institutions lived with family members. Few people with IDD received publicly funded services outside of state-run institutions.

Key Finding

By 2021 of the estimated 2,251,177 adults with IDD in the U.S, 14,896 (0.7%) lived in state-run IDD facilities of 16 or more people. An additional 48,879 adults (2.2%) lived in non-state IDD facilities of 16 or more people, nursing homes, or psychiatric facilities. Of the 1,007,735 adults getting services through state IDD systems in 2021 (45% of all adults with IDD), 6.3% lived in state or non-state IDD institutions, nursing homes or psychiatric facilities (Larson et al., in press).

Bar graph titled Percent of US adults with IDD living in large state-run IDD facilities in 1967 and 2021. In 1967, 29.1% of adults with IDD lived in state-run IDD facilities. In 2021, 0.7% of adults with IDD lived in state-run IDD facilities. — Percent of Adults with IDD in Large State-Run IDD Facilities 1967 and 2021

Recommendations

People with IDD live better lives in community homes than in institutions (Larson, Lakin, & Hill, 2012). We have made progress over the last sixty years helping people with IDD move from institutions. But some people with IDD still live in institutions. We need to help those who want to move from institutions to do so. We also need to help those who need support to avoid moving to institutions by developing and funding a sufficient supply of home and community options with enough direct support workers to provide needed support.

Data Source

Larson, S. A., Neidorf, J., Pettingell, S., & Sowers, M. (2023). Long-term supports and services for persons with intellectual or developmental disabilities: Status and trends through 2019. Minneapolis: University of Minnesota, Research and Training Center on Community Living, Institute on Community Integration.

Authors

Sheryl A. Larson and Jon Neidorf. The authors acknowledge the contributions by Jerry Smith, Sarah Curtner and John Smith to this product.

References

Haber, L. D. (1969). Epidemiological factors in disability: I. Major disabling conditions (Vol. 2). Department of Health, Education, and Welfare, Social Security Administration, Office of Research and Statistics.

Larson, S., Lakin, C., & Hill, S. (2012). Behavioral Outcomes of Moving from Institutional to Community Living for People with Intellectual and Developmental Disabilities: U.S. Studies from 1977 to 2010. Research and Practice for Persons with Severe Disabilities, 37(4), 235–246. https://doi.org/10.2511/027494813805327287

The RISP project gets funds from the Administration on Community Living, U.S. Department of Health and Human Services, Cooperative Agreement #90DNPA0006 with supplemental funding from the National Institutes on Disability, Independent Living and Rehabilitation Research Grant #90RTCP0011.

Abbreviations used: IDD Intellectual or Developmental Disabilities; HCBS Home and Community Based Services