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Boston (ca. 1685), Philadelphia, and New York (the 1730s) were the first cities in the United States to establish almshouses (also called poorhouses). Almshouses were initially supported with a combination of poor taxes and private donations and originally intended to temporarily house community members who were of good character but who were “unfortunate” and who had no family to support them: the poor, the elderly, abandoned or illegitimate children, the injured, or the insane or mentally defective. Almshouses supplemented, and occasionally replaced, the older “outdoor” relief system of payments in cash or goods to relatives of the afflicted or to community members who offered to take responsibility for paupers' support. In some areas (e.g., New York City's outlying counties, and in parts of New Jersey), ...

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