Three hundred and twenty-nine subjects (aged 17-70 years) residing in an institution (N = 184), group home (N = 39), or with one or more family members (N = 106) were evaluated on body composition, blood lipids, and health behaviors. Subjects in the institutional group had lower body weights than those in the group home and natural family settings (p < .001) and also had lower BMIs and percent body fat levels compared to those in the natural family (p < .001). The institutional group also had lower total cholesterol and LDL-C levels than the group home and natural family groups (p < .001) and lower TG and ratio of total cholesterol to HDL-C than the natural family group (p < .01). Although overall use was quite limited, residents in the group home setting smoked more cigarettes, drank more alcohol and coffee, and exercised less than those in the institution and natural family (p < .001). Group home residents also exercised less. Health promotion and disease prevention initiatives for persons with mental retardation living in group homes, in supported living placements, and with their natural families should be undertaken and carefully evaluated. © 1995.