According to the 2017 – 2021 American Community Survey, 12% of the population statewide has some type of disability, amounting to just over 800,000 people. (Disability is defined by the Census Bureau as having one of the following six disabilities: Ambulatory disability, cognitive disability, hearing disability, independent living disability, self-care disability, and vision disability. People may report multiple disabilities.) An additional 45,000 residents living in institutionalized settings have a disability. Around one-third of the population 65+ has a disability. Currently, two in five people with a disability are age 65 and older. The aging of the Baby Boomers and the projected increase in older adult population will push up the number of people with a disability.
Approximately one in four (24%) households statewide have a member with some type of disability, which is approximately 650,000 households. Households with a disability are more likely to have lower incomes compared to all households in Massachusetts. 36% of households with a disability make $35,000 or less, compared to 21% of all households in the state. 60% of households with a disability have an income less than $75,000, which is below the state’s median household income. Households with a disability are more likely to be renters: 41% of households with a disability are renters compared to around 36% in the state
Regions in Western Massachusetts have a higher share of the population with a disability. Over 15% of people in the Berkshire (BRPC) and Pioneer Valley (PVPC) regions have some type of disability, compared to 12% overall in the state. This is likely due to the older populations in these regions. Some of the RPAs in the eastern part of the state have a lower share than the state; Old Colony (OCPC), Metropolitan Area (MAPC) (10%), and Merrimack Valley (MRPC) (11%). Due to the size of the population, MAPC still has the highest number of people with a disability. PVPC has the highest share of households with a disability at 30%, higher than the 24% in the state overall.
In terms of type of disability, the most common disability among households in the state is an ambulatory disability. This is also the most common disability among older adults. 19% of the 65+ population has an ambulatory disability, which is over 200,000 individuals. Around 335,000 households (12% of the total) have a household member with an ambulatory disability, meaning they have a condition that substantially limits one or more basic physical activities, such as walking, climbing stairs, reaching, lifting, or carrying. Ambulatory disabilities can affect the type of housing needed as the person may not be able to climb stairs, etc.
An independent living disability is another type that could affect the type of housing needed. This includes physical, mental, or emotional conditions lasting six months or more that makes it difficult or impossible to perform basic activities outside the home alone such as shopping or going to a doctor’s appointment. 10% of households, or 264,000 households, have a member with an independent living disability. Similarly, this is more common among older adults. 13% of the 65+ population has an independent living disability, which is around 150,000 people.
Another type of disability that could affect the type of housing needed is self-care disability. This means they have a physical or mental health condition that has lasted at least six months and makes it difficult for them to take care of their own personal needs, such as bathing, dressing, or getting around inside the home. 5% of households in the state have a member with a self-care disability, which is an estimated 143,000 households. Self-care disabilities are also more common in older adults; however, they are not as common as ambulatory or independent living disabilities. 7% of the 65+ population have a self-care disability.
Many people with disabilities do not require much, if any, accommodation or accessibility features in their homes. For example, a resident with a hearing disability may require only visual smoke alarms or doorbells. 7% of households in the state have a member with a hearing disability, which is around 200,000 households.
There is a broad range of cognitive disabilities, including difficulties learning, remembering, concentrating, or making decisions because of a physical, mental, or emotional condition. This can range from mental health conditions like depression to intellectual disabilities and autism spectrum disorders. The type of accommodations needed for this population likely depends on other disabilities they might have such as self-care or independent living disabilities. Many may not need accessible housing, per se, but need affordable housing with support services. 10% of households in the state have a member with a cognitive disability (270,000 households.)
People with disabilities in Massachusetts face multiple barriers to housing. It’s nearly impossible to find a housing unit that is affordable, accessible, and available. Stories collected by the Massachusetts Statewide Independent Living Council highlight the real-life challenges of households with a member that has a disability that are living in spaces that do not meet their needs, such as spaces that are too small or not on the first floor. Elevators help, but only if they are well maintained and reliable.
Housing affordability and housing security is worse for people with disabilities who need long-term services and support (LTSS). This population is more likely to have severe cost burden, be behind in paying rent or mortgage, and live in poor-quality housing. These households also face other disparities such as living in neighborhoods with higher rates of serious crime and risk of natural disaster.
Existing federal support for people with disabilities is not adequate in supporting their needs; 84% of people with disabilities in the U.S. who are low-income and eligible for housing assistance are not receiving public housing or rental assistance. The number of very low-income older adult households that qualify for HUD housing assistance is rising fast.5 As the population ages, the number will likely continue to grow.
These national trends are seen in Massachusetts. There is a lack of accessible, affordable housing units across the state. These challenges will be compounded by the state’s aging population and older housing stock that may need modification to support the diverse needs of people with disabilities.
The 1999 U.S. Supreme Court decision in Olmstead v L.C. (1999) maintains that states have a legal obligation to administer programs and activities in an integrated setting appropriate to the needs of qualified individuals. This decision recognizes that States may satisfy this obligation through the development of a comprehensive working plan for placing individuals with disabilities in less restrictive settings—known as the Olmstead Plan. First completed in 2008, Massachusetts’ Olmstead Plan encompasses efforts across government agencies to support individuals with disabilities access community living options. Updated every five years, the State plan recognizes the specific housing needs of this population and measures efforts to do.
In 2024, the Executive Office of Health and Human Services (EOHHS) announced a settlement had been reached in a class action, Marsters v. Healey, to expand opportunities for individuals in nursing facilities, including the plaintiffs and thousands of people like them (“class members”), to receive the services they need to live in their communities of choice. EOHHS, in coordination with the Executive Office of Housing and Livable Communities, shall expand subsidized housing capacity targeted to elder and disabled MassHealth members transitioning from a nursing facility to the community by adding 800 new subsidized housing opportunities over the term of this Agreement.
Since disability and access needs present in so many ways and changes over time for individuals, it is difficult to create a definitive estimate of disability needs or inventory of units with accessibility and visitability features. What we define as “accessible housing” has not been updated to meet our current understanding of the ways in which disabilities require varying accessibility needs (i.e., vision impairment, neurodivergent).