Estimating eviction prevalence across the United States.

SignificanceSeveral negative effects of forced displacement have been well documented, yet we lack reliable measurement of eviction risk in the national perspective. This prevents accurate estimations of the scope and geography of the problem as well as evaluations of policies to reduce housing loss. We construct a nationwide database of eviction filings in the United States. Doing so reveals that 2.7 million households, on average, are threatened with eviction each year; that the highest eviction filing rates are not concentrated solely in high-cost urban areas; and that state-level housing policies are strongly associated with county-level eviction filing risk. These data facilitate an expanded research agenda on the causes and consequences of eviction lawsuits in the United States.

Eviction from public housing in the United States.

Neither academic researchers nor the U.S. Department of Housing and Urban Development have studied evictions from public housing in national perspective. Combining federal registers of public housing authorities (PHAs) with individual-level records from >25 million eviction filings issued between 2006 and 2016, this is the first national-level study to estimate the prevalence and dynamics of eviction in public housing units. We find that the average PHA files roughly 40 evictions each year or 7.6 cases for every 100 public housing households. Public housing complexes were responsible for approximately 5.8 out of every 100 eviction filings in our sample, while only 3.5 in 100 renting households resided in public housing. Controlling for socioeconomic factors, we show that PHAs with a higher percentage of Black residents have significantly higher eviction filing rates. Eviction filing rates in PHAs are associated with those in the surrounding private rental market, indicating that PHAs do not function independently from the social contexts in which they are embedded. These findings reveal significant variation in eviction filing rates across local PHAs and highlight the need for clear policies on lease terminations and improved documentation of eviction actions in public housing at the federal and local levels.

Spatial Concentration and Spillover: Eviction Dynamics in Neighborhoods of Los Angeles, California, 2005-2015.

The lack of sufficient affordable housing in Los Angeles, California burdens many renter households with the threat of an eviction. Research has identified individual- and neighborhood-level sociodemographic correlates of eviction, but the uneven distribution of sociodemographic characteristics and housing conditions across neighborhoods likely produces broader patterns of spatial clustering in eviction prevalence across local areas. We use spatial autoregressive models to explain the spatial concentration and spillover effects for two types of formal eviction filings-court-based and no-fault Ellis Act petitions-within and across census tracts in Los Angeles. Court-based filings show greater and more persistent spatial concentration, particularly in neighborhoods with higher percentages of Black residents. We find evidence of spatial correlation for both types of eviction, however, suggesting that identifying the spatial distribution of eviction prevalence across local areas is important to understanding how location shapes eviction risk in metropolitan areas.

The Emergence of Spatial Clustering in Medical Vaccine Exemptions Following California Senate Bill 277, 2015-2018.

Objectives. To understand how the elimination of nonmedical vaccine exemptions through California Senate Bill 277 (SB277) may have resulted in increased spatial clustering of medical exemptions.Methods. We used spatial scan statistics and negative binomial regression models to examine spatial clustering in medical vaccine exemptions in California kindergartens from 2015 to 2018.Results. Spatial clustering of medical exemptions across schools emerged following SB277. Clusters were located in similar geographic areas to previous clusters of nonmedical vaccine exemptions, suggesting a spatial association between high nonmedical exemption prevalence and increasing rates of medical exemptions. Regression results confirmed this positive association at the local level. The sociodemographic characteristics of the neighborhoods in which schools were located explained some, but not all, of the positive spatial associations between exemptions before and after SB277.Conclusions. Elimination of nonmedical vaccine exemptions via SB277 may have prompted some parents to instead seek medical exemptions to required school vaccines. The spatial association of these 2 types of exemptions has implications for maintaining pockets of low vaccine compliance and increased disease transmission.

Spatial Clustering of Vaccine Exemptions on the Risk of a Measles Outbreak.

OBJECTIVES: Areas of increased school-entry vaccination exemptions play a key role in epidemics of vaccine-preventable diseases in the United States. California eliminated nonmedical exemptions in 2016, which increased overall vaccine coverage but also rates of medical exemptions. We examine how spatial clustering of exemptions contributed to measles outbreak potential pre- and postpolicy change. METHODS: We modeled measles transmission in an empirically calibrated hypothetical population of youth aged 0 to 17 years in California and compared outbreak sizes under the observed spatial clustering of exemptions in schools pre- and postpolicy change with counterfactual scenarios of no postpolicy change increase in medical exemptions, no clustering of exemptions, and lower population immunization levels. RESULTS: The elimination of nonmedical exemptions significantly reduced both average and maximal outbreak sizes, although increases in medical exemptions resulted in more than twice as many infections, on average, than if medical exemptions were maintained at prepolicy change levels. Spatial clustering of nonmedical exemptions provided some initial protection against random introduction of measles infections; however, it ultimately allowed outbreaks with thousands more infections than when exemptions were randomly distributed. The large-scale outbreaks produced by exemption clusters could not be reproduced when exemptions were distributed randomly until population vaccination was lowered by >6 percentage points. CONCLUSIONS: Despite the high overall vaccinate rate, the spatial clustering of exemptions in schools was sufficient to threaten local herd immunity and reduce protection from measles outbreaks. Policies strengthening vaccine requirements may be less effective if alternative forms of exemptions (eg, medical) are concentrated in existing low-immunization areas.

In utero exposure to threat of evictions and preterm birth: Evidence from the United States.

OBJECTIVE: To estimate county-level associations between in utero exposure to threatened evictions and preterm birth in the United States. DATA SOURCES: Complete birth records were obtained from the National Center for Health Statistics (2009-2016). Threatened evictions were measured at the county level using eviction case filing data obtained from The Eviction Lab (2008-2016). Additional economic and demographic data were obtained from the United States Census Bureau and Bureau of Labor Statistics. STUDY DESIGN: We conducted a retrospective cohort analysis using 7.3 million births from 1,633 counties. We defined threatened eviction exposures as the z-score of average case filings over the pregnancy and by trimester. Our primary outcome was an indicator for preterm birth (born < 37 completed weeks of gestation). Secondary outcomes included a continuous measure for gestational length, a continuous measure for birth weight, and an indicator for low birth weight (born < 2500 g). We estimated within-county associations controlling for individual- and time-varying county-level characteristics, state-of-residence-year-and-month-of-conception fixed effects, and a county-specific time trend. DATA COLLECTION/EXTRACTION: We merged birth records with threatened eviction data at the county-month-year level using mother's county of residence at delivery and month-year of conception. We supplemented these data with information on county-level annual 18-and-over population, annual poverty rate, and monthly unemployment rate. PRINCIPAL FINDINGS: Increased levels of eviction case filings over a pregnancy were associated with an increased risk of prematurity and low birth weight. These associations appeared to be sensitive to exposure in the second and third trimesters. Associations with secondary outcomes and within various population subgroups were, in general, imprecisely estimated. CONCLUSIONS: Higher exposure to eviction case filings within counties, particularly in the latter stages of a pregnancy, was associated with an increased risk of adverse birth outcomes. Future research should identify the causal effect of threatened evictions on maternal and child health outcomes.

The roles of neighborhood composition and autism prevalence on vaccination exemption pockets: A population-wide study.

The number of children entering schools without mandated vaccinations has increased in high-income countries due to the rise of nonmedical exemptions from school vaccination requirements. Herd immunity is threatened when unvaccinated children are concentrated in spatial pockets. Despite the role of vaccine-autism controversy in the current wave of the anti-vaccine movement, we do not know if exemption clusters are associated with local autism rates; it is often assumed that these clusters are merely the result of sociodemographic composition. This study uses data on the number of students with a Personal Belief Exemption reported by schools from 1992 to 2014 and unique data on the locations of children with an autism diagnosis in California to study the correlates of large exemption pockets. Our spatial analysis shows that the prevalence of autism is not associated with the locations of large pockets of vaccination exemptions. Likewise, the spatial distributions of socioeconomic factors and proximity to health care resources have limited roles in explaining these large exemption pockets. Racial/ethnic composition, however, has strong associations with the locations of the large pockets. Our results suggest that community-level interventions are needed to maintain herd immunity as exemption pockets are not merely the result of population composition.