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1.
JAMA ; 331(7): 592-600, 2024 02 20.
Article in English | MEDLINE | ID: mdl-38497697

ABSTRACT

Importance: Residential evictions may have increased excess mortality associated with the COVID-19 pandemic. Objective: To estimate excess mortality associated with the COVID-19 pandemic for renters who received eviction filings (threatened renters). Design, Setting, and Participants: This retrospective cohort study used an excess mortality framework. Mortality based on linked eviction and death records from 2020 through 2021 was compared with projected mortality estimated from similar records from 2010 through 2016. Data from court records between January 1, 2020, and August 31, 2021, were collected via the Eviction Lab's Eviction Tracking System. Similar data from court records between January 1, 2010, and December 31, 2016, also collected by the Eviction Lab, were used to estimate projected mortality during the pandemic. We also constructed 2 comparison groups: all individuals living in the study area and a subsample of those individuals living in high-poverty, high-filing tracts. Exposures: Eviction filing. Main Outcomes and Measures: All-cause mortality in a given month. The difference between observed mortality and projected mortality was used as a measure of excess mortality associated with the pandemic. Results: The cohort of threatened renters during the pandemic period consisted of 282 000 individuals (median age, 36 years [IQR, 28-47]). Eviction filings were 44.7% lower than expected during the study period. The composition of threatened renters by race, ethnicity, sex, and socioeconomic characteristics during the pandemic was comparable with the prepandemic composition. Expected cumulative age-standardized mortality among threatened renters during this 20-month period of the pandemic was 116.5 (95% CI, 104.0-130.3) per 100 000 person-months, and observed mortality was 238.6 (95% CI, 230.8-246.3) per 100 000 person-months or 106% higher than expected. In contrast, expected mortality for the population living in similar neighborhoods was 114.6 (95% CI, 112.1-116.8) per 100 000 person-months, and observed mortality was 142.8 (95% CI, 140.2-145.3) per 100 000 person-months or 25% higher than expected. In the general population across the study area, expected mortality was 83.5 (95% CI, 83.3-83.8) per 100 000 person-months, and observed mortality was 91.6 (95% CI, 91.4-91.8) per 100 000 person-months or 9% higher than expected. The pandemic produced positive excess mortality ratios across all age groups among threatened renters. Conclusions and Relevance: Renters who received eviction filings experienced substantial excess mortality associated with the COVID-19 pandemic.


Subject(s)
COVID-19 , Housing Instability , Mortality , Social Determinants of Health , Adult , Humans , COVID-19/epidemiology , COVID-19/mortality , Pandemics/statistics & numerical data , Retrospective Studies , Social Determinants of Health/statistics & numerical data , Poverty/statistics & numerical data , Middle Aged
2.
Soc Sci Med ; 340: 116398, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38007965

ABSTRACT

Investments in stable, affordable housing may be an important tool for improving population health, especially in the context of rising costs and evictions for American renters. Still, a lack of longitudinal data linking these exposures to health outcomes has limited prior research. In this study, we use linked administrative data to estimate the associations of rent burden and eviction with all-cause mortality. We constructed a novel dataset linking renters in the long-form 2000 Census (N = 6,587,000) to mortality follow-up through 2019 from the Census Numident file. To measure exposure to eviction, we further linked this dataset to 38 million eviction records between 2000 and 2016 using names and addresses. For a subsample of renters, we also measured within-individual changes in rent burden between 2000 and 2008-2012 by linking to the American Community Survey. We estimated the associations of rent burden and eviction with mortality using Cox proportional-hazards models and discrete-time hazard models adjusted for individual, household, neighborhood, and state characteristics, examining varying associations by cohort, race, gender, and eviction risk. Higher baseline rent burden, increases in rent burden during midlife, and evictions were all associated with increased mortality. Compared to a baseline rent burden of 30%, a burden of 70% was associated with 12% (95% confidence interval = 11-13%) higher mortality. A 20-point increase in rent burden between 2000 and 2008-2012 was associated with 16% (12-19%) higher mortality through 2019. An eviction filing without judgment was associated with a 19% (15-23%) increase in mortality and an eviction judgment was associated with a 40% (36-43%) increase. Associations were larger for those at lower predicted risk of eviction. These findings reveal how rising costs and evictions are shaping mortality for American renters. Policies designed to increase the supply of affordable housing and prevent eviction may lead to widespread improvements in population health.


Subject(s)
Family Characteristics , Housing , Humans , United States/epidemiology , Data Collection , Policy
3.
Proc Natl Acad Sci U S A ; 120(41): e2305860120, 2023 10 10.
Article in English | MEDLINE | ID: mdl-37782792

ABSTRACT

Millions of American renter households every year are threatened with eviction, an event associated with severe negative impacts on health and economic well-being. Yet we know little about the characteristics of individuals living in these households. Here, we link 38 million eviction court cases to US Census Bureau data to show that 7.6 million people, including 2.9 million children, faced the threat of eviction each year between 2007 and 2016. Overall, adult renters living with at least one child in their home were threatened with eviction at an annual rate of 10.4%, twice that of adults without children (5.0%). We demonstrate not only that the average evicted household includes one child, but that the most common age to experience eviction in America is during childhood. We also find that previous studies have underestimated racial disparities in eviction risk: Despite making up only 18.6% of all renters, Black Americans account for 51.1% of those affected by eviction filings and 43.4% of those evicted. Roughly one in five Black Americans living in a renter household is threatened with eviction annually, while one in ten is evicted. Black-White disparities persist across levels of income and vary by state. In providing the most comprehensive description to date of the population of US renters facing eviction, our study reveals a significant undercount of individuals impacted by eviction and motivates policies designed to stabilize housing for children and families.


Subject(s)
Family Characteristics , Housing , Adult , Child , Humans , United States , Income , Americas
4.
Demography ; 56(1): 345-365, 2019 02.
Article in English | MEDLINE | ID: mdl-30607778

ABSTRACT

We examine the long-term outcomes for a population of teenage mothers who give birth to their children around the end of high school. We compare the mothers whose high school education was interrupted by childbirth (because the child was born before her expected graduation date) with mothers who did not experience the same disruption to their education. We find that mothers who gave birth during the school year are 5.4 percentage points less likely to complete their high school education, are less likely to be married, and have more children than their counterparts who gave birth just a few months later. The wages for these two sets of teenage mothers are not statistically different, but with a lower likelihood of marriage and more children, the households of the treated mothers are more likely to fall below the poverty threshold. Although differences in educational attainment have narrowed over time, the differences in labor market outcomes and family structure have remained stable.


Subject(s)
Educational Status , Pregnancy in Adolescence , Schools , Adolescent , Adult , Employment/statistics & numerical data , Female , Humans , Longitudinal Studies , Pregnancy , Salaries and Fringe Benefits/statistics & numerical data , Surveys and Questionnaires , Time Factors , Young Adult
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