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Structural ableism and institutionalization of disabled people
1Council on Quality and Leadership.
Rehabilitation Psychology
|March 26, 2026
Summary
Historical institutionalization in the U.S. is linked to current rates of disability institutionalization and implicit bias. States with more institutions in 1860 show higher rates of institutionalization and worse attitudes towards disabled people today.
Area of Science:
- Sociology of disability
- Public health policy
- History of social justice
Background:
- Structural ableism, encompassing policies and norms, perpetuates discrimination against disabled individuals.
- Institutionalization has historically defined and mistreated disabled populations in the United States.
- Understanding the long-term impacts of historical practices is crucial for addressing present-day inequities.
Purpose of the Study:
- To investigate the connection between historical institutionalization and contemporary disability institutionalization.
- To explore the relationship between historical institutionalization and current implicit disability bias.
- To analyze the enduring effects of past ableist structures on present-day societal attitudes and policies.
Main Methods:
- Analysis of 1860 U.S. Census data on institutionalization.
- Examination of 2022 Medicaid data concerning current institutionalization rates.
- Assessment of state-level implicit disability bias data from 2004-2022.
Main Results:
- States with higher numbers of institutions and greater institutionalization of disabled people in 1860 exhibit higher institutionalization rates in 2022.
- A correlation exists between the prevalence of historical institutions and negative implicit disability attitudes in contemporary times.
- The legacy of historical institutionalization appears to influence current societal biases and practices.
Conclusions:
- Structural ableism poses significant risks to the health, well-being, and equitable treatment of disabled people.
- Historical patterns of institutionalization have lasting repercussions on disability discrimination and bias.
- Addressing structural ableism requires confronting its historical roots and contemporary manifestations.
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