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The original content for this article was contributed by The National Institute for Genealogical Studies in June 2012. It is an excerpt from their course United States: Institutional Records  by Amy Johnson Crow, CG. The Institute offers over 200 comprehensive genealogy courses for a fee ($).


America: the land of opportunity. With available land, abundant natural resources, and an entrepreneurial minded society, it is easy to have an idyllic vision of life for our ancestors. However, not everyone realized the American dream.

Poverty was also part of the American landscape. Urban slums were rife with disease due to overcrowded, unsanitary conditions. Medical science had barely begun to understand the role of microorganisms in the spread of disease.

Our rural ancestors were not immune to poverty or disease. Bad weather could wipe out an entire crop—and with it the bulk of the family’s income. Doctors were few; access to trained medical care was scarce.

Whether through circumstance or choice, through nature or nurture, some of our ancestors became dependent upon others for care and support. In this module we will look at institutions which served the sick, the poor, and orphans.

Brief History of Almshouses and Poor Farms

In colonial New England, the poor and indigent who tried to settle in another town were not welcomed with open arms. Instead, towns “warned out” such people, ordering them to return to their town of residence.

In the early years of the United States, communities dealt with the issue of the poor in two basic ways. In the ‘outdoor relief’ method, a local official (or office) could give money or goods from the public coffers directly to the needy. In some communities, this might be a function of the Overseers of the Poor, Township Trustees, County Commissioners, or City Council.

Another method of support required the poor to provide services to an individual. Paupers could be auctioned to the lowest bidder. The ‘winner’ of would be paid their bid by the office conducting the auction. Similarly, the office overseeing paupers in the area might have contracts with a group of people in the community who would take paupers for a set fee. In either case, the pauper was then bound to that person for a specific period of time. What the pauper was required to do and what level of support the contractor was to provide depended upon the contract and, often, the amount of oversight by the government. Instances of contractors abusing the situation—cheap labor—were not uncommon.

By the 1820s, there was a shift away from servitude and to community institutions where the poor could be supported in one place. These ‘almshouses’ or ‘poor farms’ became not only shelters for the poor, but also hospitals and orphanages. By the 1850s most counties had their own government poor farm or contracted with a neighboring county to provide such services.

The mid 1800s saw changes to this ‘all purpose’ institution. In 1846, the New York legislature debated a bill to create and build an institution for the care of the insane (a bill which ultimately failed). An ‘experimental’ school for the insane opened in South Boston in 1851. New York opened the State Asylum for Idiots in 1855. Connecticut, Kentucky, and Ohio opened similar institutions in the years shortly following.

Throughout this period, children were housed in the same facilities as adults. Beginning in the 1870s, a move took hold to move children into separate institutions. It is at this point that you will see children going to a ‘children’s home’. Such institutions served both orphans and children who had parents unable to provide for them. Finding a child in a children’s home is not proof that his or her parents were deceased.

The American Civil War saw a generation of men return to civilian life with physical and psychological scars. They and their families greatly added to the population of those needing assistance of some sort. Numerous facilities for poor and sick veterans and their families opened in the last quarter of the 19th century.

Tuberculosis, or consumption as our ancestors called it, was prevalent in America in the 1800s. This highly-contagious disease spread like wildfire through overcrowded urban centers. In the mid-1800s, it was discovered that the disease spread from person to person. In 1885, the first tuberculosis hospital opened in the United States.

By the turn of the 20th century, tuberculosis hospitals and sanatoriums were operating in most states. These hospitals closed or converted to other types of patient care in the post-World War II period with the advent of streptomycin as an effective treatment. Because of the relatively recent time period these hospitals were open and the medical information in the records, researchers are usually not permitted to examine records of these hospitals.


Public and private institutions for the poor, infirm, or aged have been called various names—county homes, infirmaries, almshouses, poor farms, and poor asylums. Be aware of these different terms as you search for records.

In the 1900s, many institutions changed their name to something more ‘pleasing’. For example, the Allen County (Indiana) Poor Asylum is now called Byron Health Care Center. It is interesting to note how the name of the Athens Lunatic Asylum in Athens, Ohio has changed from the time it opened in 1874:

  •  Athens Lunatic Asylum (1874)
  •  Athens Asylum for the Insane (1911)
  •  Athens State Hospital (c1945)
  •  Southeastern Ohio Mental Health Center (1968)
  •  Southeastern Ohio Mental Health and Retardation Center (1975)
  •  Athens Mental Health and Development Center (1980)
  •  Athens Mental Health Center (1981) 


Information in this Wiki page is excerpted from the online course US: Institutional Records offered by The National Institute for Genealogical Studies. To learn more about this course or other courses available from the Institute, see our website. We can be contacted at

We welcome updates and additions to this Wiki page.