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Kim MH, Schwartz GL. Foreclosure, memory decline, and dementia probability: A longitudinal cohort study. Alzheimers Dement 2024. [PMID: 39072906 DOI: 10.1002/alz.14145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 06/18/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Housing insecurity is rising among older adults; health researchers know little about how this may impact their cognitive health. We investigated links between foreclosure and older adults' memory and probability of dementia. METHODS Using the Health and Retirement Study (2008 to 2018), we fit mixed models comparing the memory and dementia probability scores of 249 older adults who experienced foreclosure (treated) with 15,645 who did not. Baseline covariates included sociodemographics, health, and cognition. Models were stratified by age group. RESULTS Foreclosure was associated with faster memory decline among middle-aged (50 to 64) older adults (-0.007 standard deviations/year, 95% confidence interval: -0.13, -0.001). Compared to average memory decline among middle-aged older adults who were stably housed, foreclosure equated to 3.7 additional years of aging over 10 years. Among those 65+, differences between those who were and were not foreclosed upon were short-lived and less clear, potentially driven by depletion-of-susceptibles bias. DISCUSSION Foreclosure may endanger older adults' memory. HIGHLIGHTS Housing instability is a key determinant of cognitive aging. We examined foreclosure and levels and changes in memory and dementia probability scores in the US older adult population. Foreclosure was associated with faster memory decline among middle-aged (50 to 64) older adults, equivalent to 3.7 additional years of cognitive aging over 10 years. Foreclosure yielded sharp memory declines and increases in dementia probability among older adults 65 and above. Foreclosure imposes a greater risk for older adults' cognitive decline.
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Affiliation(s)
- Min Hee Kim
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA
| | - Gabriel L Schwartz
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, USA
- Urban Health Collaborative and Department of Health Management & Policy, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA
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2
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Reyes A, Macaya Munell I, Borrell C, Carmezim Correia JP, Fernández A, Vásquez-Vera C, Pérez K, Carrere J, Daví L, Novoa AM. Cooperative housing under a grant-of-use in Catalonia and health: pre-post analysis. BMC Public Health 2024; 24:1835. [PMID: 38982448 PMCID: PMC11234659 DOI: 10.1186/s12889-024-19214-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/20/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Housing is considered a social determinant of health. In Catalonia and Spain, ensuring affordable housing is challenging and cooperative housing under a grant-of-use emerges as an alternative, challenging traditional housing models. This study aims to quantify its impact on health before and after moving to the cooperative house. METHODS A longitudinal study of individuals in cooperative housing projects in Catalonia (July 2018-April 2023) was conducted. Data, including sociodemographic, housing information, and health-related details, were collected through baseline and follow-up surveys. RESULTS Seventy participants (42 women, 28 men) showed positive changes in housing conditions during follow-up. Improved perceptions of health, mental health, and social support were observed. Despite limitations in sample size and short follow-up, initial findings suggest improvements in health. CONCLUSIONS Cooperative housing under a grant-of-use in Catalonia appears promising for improving health and living conditions. Further research is warranted to explore its full potential as an alternative amid housing challenges in the region.
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Affiliation(s)
- Alexia Reyes
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain.
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain.
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain.
| | - Irene Macaya Munell
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
- Dinamo Fundació, C. d'en Blanco 73, bx, Barcelona, 08028, Spain
| | - Joao Pedro Carmezim Correia
- Biostatistics Support and Research Unit, Germans Trias i Pujol Research Institute and Hospital (IGTP), Barcelona, Catalonia, Spain
| | - Ana Fernández
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Constanza Vásquez-Vera
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, Barcelona, 08003, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Juli Carrere
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
| | - Lali Daví
- Dinamo Fundació, C. d'en Blanco 73, bx, Barcelona, 08028, Spain
- LaCol Arquitectura Cooperativa, C. Riera d'Escuder, 38, nau 2 Planta 1, Barcelona, 08028, Spain
| | - Ana M Novoa
- Agència de Salut Pública de Barcelona (ASPB), Pl. Lesseps 1, Barcelona, 08023, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), C. Sant Quintí 77, Barcelona, 08041, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, Madrid, 28029, Spain
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Sealy-Jefferson S, Jackson B, Francis B. Neighborhood eviction trajectories and odds of moderate and serious psychological distress during pregnancy among African American women. Am J Epidemiol 2024; 193:968-975. [PMID: 38518207 PMCID: PMC11228836 DOI: 10.1093/aje/kwae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 02/19/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024] Open
Abstract
African American mothers are unjustly burdened by both residential evictions and psychological distress. We quantified associations between trajectories of neighborhood evictions over time and the odds of moderate and serious psychological distress (MPD and SPD, respectively) during pregnancy among African American women. We linked publicly available data on neighborhood eviction filing and judgment rates to preconception and during-pregnancy addresses from the Life-course Influences on Fetal Environments (LIFE) Study (2009-2011; n = 808). Multinomial logistic regression-estimated odds of MPD and SPD during pregnancy that were associated with eviction filing and judgment rate trajectories incorporating preconception and during-pregnancy addresses (each categorized as low, medium, or high, with two 9-category trajectory measures). Psychological distress was measured with the Kessler Psychological Distress Scale (K6) (K6 scores 5-12 = MPD, and K6 scores ≥13 = SPD). MPD was reported in 60% of the sample and SPD in 8%. In adjusted models, higher neighborhood eviction filing and judgment rates, as compared with low/low rates, during the preconception and pregnancy periods were associated with 2- to 4-fold higher odds of both MPD and SPD during pregnancy among African American women. In future studies, researchers should identify mechanisms of these findings to inform timely community-based interventions and effective policy solutions to ensure the basic human right to housing for all. This article is part of a Special Collection on Mental Health.
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Affiliation(s)
- Shawnita Sealy-Jefferson
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, United States
| | - Benita Jackson
- Department of Psychology, Smith College, Northampton, MA 01063, United States
| | - Brittney Francis
- FXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, United States
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
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4
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Murillo J, Garcia B, Regan A. Social Impacts of the COVID-19 Pandemic on Women's Health in the Greater Los Angeles Area. J Womens Health (Larchmt) 2024; 33:938-947. [PMID: 38647552 DOI: 10.1089/jwh.2023.0697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Background: Since the COVID-19 pandemic started, women have experienced more job loss owing to an increase in household and caregiving responsibilities. Gender inequities coupled with pandemic-related stressors have resulted in poor health outcomes among women. Globally, women have reported higher levels of anxiety, depression, and stress in response to the pandemic. Evidence suggests that social determinants of health have contributed to women's poor health outcomes. Materials and Methods: We used the Understanding America Study to describe the social impacts women have experienced during the COVID-19 pandemic when compared with men and to explore the association between partnership status and social impacts in Los Angeles. We hypothesize that women experienced greater social impacts than men and that partnership status modified these social impacts. Results: In a sample of predominantly racial and ethnic minorities, we found that women experienced more social impacts related to housing insecurity compared with men. When exploring how partnership status modified these social impacts, we found that women without partners experienced more social impacts specific to financial hardships when compared with women who were in a partnership. Conclusions: It is likely that the COVID-19 relief efforts helped women mitigate social impacts but not housing or financial security. The overall goal is to inform policies so that better measures can be implemented to prepare for the next public health disaster or global health threat.
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Affiliation(s)
- Jovita Murillo
- School of Public Health & Information Sciences, University of Louisville, Louisville, Kentucky, USA
- School of Nursing and Health Professions, University of San Francisco, San Francisco California, USA
| | - Blanca Garcia
- School of Nursing and Health Professions, University of San Francisco, San Francisco California, USA
| | - Annette Regan
- School of Nursing and Health Professions, University of San Francisco, San Francisco California, USA
- Fielding School of Public Health, University of California Los Angeles, Los Angeles California, USA
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Chen JH, Jones D, Lee J, Yan Y, Hsieh WJ, Huang CH, Yang Y, Wu CF, Jonson-Reid M, Drake B. Do the benefits of homeownership on mental health vary by race and poverty status? An application of doubly robust estimation for causal inference. Soc Sci Med 2024; 351:116958. [PMID: 38759384 DOI: 10.1016/j.socscimed.2024.116958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/12/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024]
Abstract
While empirical studies have observed that homeownership is associated with improved mental health conditions, research indicates that this relationship might vary by race. Moreover, such a White-Black disparity in the impacts of homeownership on mental health could be complexed by poverty status, as maintaining one's homeownership could be a financial burden for people living in poverty status, defined by the US official poverty threshold. We add to the existing literature by analyzing the impacts of homeownership on psychological distress, simultaneously disaggregating by race and poverty status using survey data from the Panel Study on Income Dynamics from the 2017 and 2019 waves (N = 7059). Propensity score weighting and doubly robust estimation are applied to estimate causal inference for the impact of 2017 homeownership on 2019 psychological distress using negative binomial models. First, we found the impacts of homeownership on reducing psychological distress are significant for White Americans, not for Black Americans. Second, we found such a White-Black disparity is only observable for populations not living in poverty. On the other hand, for populations living in poverty, homeownership no longer lowers psychological distress for either race. Findings suggest that financial support and mental health support are needy to address inequality in the impacts of homeownership on mental health, which could simultaneously vary by poverty status and race. Implications are discussed.
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Affiliation(s)
- Jun-Hong Chen
- School of Social Work, Saint Louis University, Tegeler Hall, 3550 Lindell Blvd, St. Louis, MO 63103, USA.
| | - Dylan Jones
- George Warren Brown School of Social Work, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, USA.
| | - Jihye Lee
- George Warren Brown School of Social Work, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, USA.
| | - Yufu Yan
- McKelvey School of Engineering, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, USA.
| | - Wan-Jung Hsieh
- Department of Social Work, National Taiwan University, No.1, Section 4, Roosevelt Road, Taipei 106, Taiwan.
| | - Chieh-Hsun Huang
- Graduate Institute of Educational Psychology and Counseling, Tamkang University, No.151, Yingzhuan Rd., Tamsui Dist., New Taipei City 251301, Taiwan.
| | - Yuanyuan Yang
- George Warren Brown School of Social Work, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, USA.
| | - Chi-Fang Wu
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 W Nevada St, Urbana, IL 61801, USA.
| | - Melissa Jonson-Reid
- George Warren Brown School of Social Work, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, USA.
| | - Brett Drake
- George Warren Brown School of Social Work, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130, USA.
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6
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Mason KE, Alexiou A, Li A, Taylor-Robinson D. The impact of housing insecurity on mental health, sleep and hypertension: Analysis of the UK Household Longitudinal Study and linked data, 2009-2019. Soc Sci Med 2024; 351:116939. [PMID: 38749252 DOI: 10.1016/j.socscimed.2024.116939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/04/2024] [Accepted: 04/30/2024] [Indexed: 06/17/2024]
Abstract
BACKGROUND Housing insecurity is an escalating problem in the UK but there is limited evidence about its health impacts. Using nationally representative panel data and causally focussed methods, we examined the effect of insecure housing on mental health, sleep and blood pressure, during a period of government austerity. METHODS We used longitudinal survey data (2009-2019, n = 11,164 individuals with annual data) from the UK Household Longitudinal Study. Outcomes were probable common mental disorder (GHQ-12), sleep disturbance due to worry, and new diagnoses of hypertension. The primary exposure was housing payment problems in the past year. Using doubly robust marginal structural models with inverse probability of treatment weights, we estimated absolute and relative health effects of housing payment problems, and population attributable fractions. In stratified analyses we assessed potentially heterogeneous impacts across the population, and potential modifying effects of government austerity measures. A negative control analysis was conducted to detect bias due to unmeasured confounding. RESULTS Housing payment problems were associated with a 2.5 percentage point increased risk of experiencing a common mental disorder (95% CI 1.1%, 3.8%) and 2.0% increased risk of sleep disturbance (95% CI 0.7%, 3.3%). Estimates were larger for renters, younger people, less educated, households with children, and people living in areas most affected by austerity-related cuts to housing support services. We did not find consistent evidence for an association with hypertension (risk difference = 0.4%; 95% CI -0.1%, 0.9%). The negative control analysis was not indicative of unmeasured confounding. CONCLUSIONS Housing payment problems were associated with worse mental health and sleep disturbance in a large UK sample. Households at risk of falling into rent or mortgage arrears need more support, especially in areas where housing support services have been diminished. Substantial investment is urgently needed to improve supply of social and affordable housing.
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Affiliation(s)
- Kate E Mason
- Melbourne School of Population and Global Health, The University of Melbourne, Australia; Department of Public Health, Policy and Systems, University of Liverpool, UK.
| | - Alexandros Alexiou
- Department of Public Health, Policy and Systems, University of Liverpool, UK
| | - Ang Li
- Melbourne School of Population and Global Health, The University of Melbourne, Australia
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7
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Leifheit KM, Schwartz GL, Pollack CE, Althoff KN, Lê-Scherban F, Black MM, Jennings JM. Moving Because of Unaffordable Housing and Disrupted Social Safety Net Access Among Children. Pediatrics 2024; 153:e2023061934. [PMID: 38317605 DOI: 10.1542/peds.2023-061934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVES To measure associations between residential moves because of unaffordable housing costs and disruptions in access to the Supplemental Nutrition Assistance Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; and Medicaid in a health care-based sample of families with young children. METHODS We used cross-sectional survey data on social safety net-eligible caregivers and children recruited into the Children's HealthWatch study from emergency departments and primary care clinics in Baltimore and Philadelphia (2011-2019). Children's HealthWatch measured residential moves (cost-driven and noncost-driven) in the past year and disruptions in safety net access. We used logistic regression to estimate associations between each type of move and disrupted access to social safety nets. RESULTS Across 9344 children, cost-driven residential moves were associated with higher odds of disrupted access to at least 1 safety net program (Supplemental Nutrition Assistance Program; the Special Supplemental Nutrition Program for Women, Infants, and Children; or Medicaid; adjusted odds ratio 1.44; 95% confidence interval 1.16-1.80), as well as higher odds of disruption to each program separately. Noncost-driven moves were also associated with disruptions to at least 1 safety net program, but less strongly so (adjusted odds ratio 1.14; confidence interval 1.01-1.29; P value for comparison with cost-driven = .045). CONCLUSIONS Residential moves, particularly cost-driven moves, are associated with social safety net benefit disruptions. The association between these events suggests a need for action to ensure consistent safety net access among children facing cost-driven moves and vice versa (ie, access to housing supports for children with disrupted safety net access).
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Affiliation(s)
- Kathryn M Leifheit
- Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, California
| | - Gabriel L Schwartz
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
| | - Craig E Pollack
- Departments of Health Policy and Management
- Johns Hopkins University School of Nursing, Baltimore, Maryland
- Departments of Medicine
- Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Keri N Althoff
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Félice Lê-Scherban
- Department of Epidemiology and Biostatistics
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Maureen M Black
- RTI International, Research Triangle Park, North Carolina
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jacky M Jennings
- Johns Hopkins University School of Nursing, Baltimore, Maryland
- Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
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8
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Tang S, Bowen DA, Chadwick L, Madden E, Ghertner R. Are Home Evictions Associated with Child Welfare System Involvement? Empirical Evidence from National Eviction Records and Child Protective Services Data. CHILD MALTREATMENT 2024; 29:66-81. [PMID: 36112918 PMCID: PMC10178375 DOI: 10.1177/10775595221125917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This study aimed to understand the relationship between home eviction and child welfare system involvement at the county level. Using administrative data, we examined associations of home eviction and eviction filing rates with child abuse and neglect (CAN) reports and foster care entries. We found one additional eviction per 100 renter-occupied homes in a county was associated with a 1.3% increase in the rate of CAN reports and a 1.6% increase in foster care entries. The association between eviction and foster care entries was strongest among Hispanic children with an 8.1% increase. Assisting parents in providing stable housing may reduce the risk of child welfare system involvement, including out-of-home child placement. Primary and secondary prevention strategies could include housing assistance, increasing access to affordable and safe housing, as well as providing economic support for families (e.g., tax credits, childcare subsidies) that reduce parental financial burden to access stable housing.
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Affiliation(s)
- Shichao Tang
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniel A Bowen
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laura Chadwick
- Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Emily Madden
- Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC, USA
| | - Robin Ghertner
- Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, DC, USA
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Ali MM, Bradford AC, Maclean JC. TennCare Disenrollment Led To Increased Eviction Filings And Evictions In Tennessee Relative To Other Southern States. Health Aff (Millwood) 2024; 43:269-277. [PMID: 38315925 DOI: 10.1377/hlthaff.2023.00973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Previous research suggests that enrolling in Medicaid reduces evictions by improving health and providing financial protection. However, previous studies have not examined whether the loss of Medicaid affects eviction outcomes. We analyzed eviction filings and completed evictions after a large, mandatory Medicaid disenrollment in Tennessee in 2005. We conducted a difference-in-differences analysis using data from the Eviction Lab at Princeton University and found that relative to other southern states, the TennCare disenrollment led to a 27.6 percent greater increase in the average annual number of eviction filings at the county level during the period 2005-09 and a 24.5 percent greater increase in the average annual number of completed evictions at the county level during that same period. Our findings have implications for the housing stability of Medicaid recipients today, many of whom are being disenrolled because of the unwinding of the Medicaid continuous enrollment provision that is occurring across the country. To protect housing stability for people disenrolled from Medicaid, policy makers may wish to consider new initiatives aimed at preventing an increase in eviction.
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Affiliation(s)
- Mir M Ali
- Mir M. Ali, University of Maryland, College Park, Maryland
| | - Ashley C Bradford
- Ashley C. Bradford , Georgia Institute of Technology, Atlanta, Georgia
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10
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Benson-Goldsmith ME, Gildea B, Richards TN, Roley-Roberts ME, Greenberg P, Hobbs A. An Exploratory Analysis of Domestic and Intimate Partner Violence Victimization Among Persons Experiencing Eviction. Violence Against Women 2024:10778012231225231. [PMID: 38213264 DOI: 10.1177/10778012231225231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
A paucity of research has examined the prevalence of domestic and intimate partner violence (DV/IPV) victimization among persons experiencing eviction. The current study uses administrative records for a random sample of evicted adults in Omaha, Nebraska from 2017 to 2019 (n = 306) to assess the prevalence of DV/IPV victimization among evicted persons and differences among the DV/IPV and no DV/IPV groups. Findings indicated over 20% of evicted persons experienced DV/IPV victimization, and DV/IPV often preceded the first eviction. DV/IPV disproportionately impacted Black women. Implications regarding the compounding consequences of eviction and DV/IPV victimization and recommendations for future research are discussed.
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Affiliation(s)
| | - Brian Gildea
- School of Criminology and Criminal Justice, University of Nebraska at Omaha, Omaha, NE, USA
| | - Tara N Richards
- School of Criminology and Criminal Justice, University of Nebraska at Omaha, Omaha, NE, USA
| | | | - Pierce Greenberg
- Department of Cultural and Social Studies, Creighton University, Omaha, NE, USA
| | - Anne Hobbs
- School of Criminology and Criminal Justice, University of Nebraska at Omaha, Omaha, NE, USA
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11
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Marçal K. Housing hardship and maternal mental health among renter households with young children. Psychiatry Res 2024; 331:115677. [PMID: 38113812 DOI: 10.1016/j.psychres.2023.115677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023]
Abstract
Maternal mental health is crucial to healthy family functioning and child well-being. Housing hardship may increase risk for mood disorders among mothers of young children in renter households. The present study used latent class analysis to investigate manifestations of housing hardship during the postpartum year in a sample of renter mothers in the United States (N = 2,329), as well as whether housing hardship types were associated with subsequent maternal depression and anxiety. The majority of mothers were relatively stably housed ("Stable"), one in six made do with governmental rental assistance ("Rent-Assisted"), and more than one in ten struggled to afford or maintain stable housing ("Cost-Burdened" or "Housing Insecure"). The most severe housing hardship was associated with the greatest depression risk, whereas the best determinant of anxiety risk was whether rent was paid each month; mothers whose rent was paid with government assistance did not differ on anxiety risk compared to those who paid their rent independently. Findings suggest that different types of housing hardship are linked with distinct mental health sequelae. Widely available housing assistance may reduce cost burden and prevent displacement, with the potential to reduce mental disorder among low-income mothers of young children.
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Affiliation(s)
- Katherine Marçal
- School of Social Work, Rutgers University, New Brunswick, NJ, USA.
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12
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Schwartz GL, Leifheit KM, Arcaya MC, Keene D. Eviction as a community health exposure. Soc Sci Med 2024; 340:116496. [PMID: 38091853 PMCID: PMC11249083 DOI: 10.1016/j.socscimed.2023.116496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/23/2024]
Abstract
Evidence suggests that being evicted harms health. Largely ignored in the existing literature is the possibility that evictions exert community-level health effects, affecting evicted individuals' social networks and shaping broader community conditions. In this narrative review, we summarize evidence and lay out a theoretical model for eviction as a community health exposure, mediated through four paths: 1) shifting ecologies of infectious disease and health behaviors, 2) disruption of neighborhood social cohesion, 3) strain on social networks, and 4) increasing salience of eviction risk. We describe methods for parsing eviction's individual and contextual effects and discuss implications for causal inference. We conclude by addressing eviction's potentially multilevel consequences for policy advocacy and cost-benefit analyses.
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Affiliation(s)
- Gabriel L Schwartz
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA; Urban Health Collaborative & Department of Health Management and Policy, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Kathryn M Leifheit
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Mariana C Arcaya
- Department of Urban Studies & Planning, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Danya Keene
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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13
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Abdul-Ghani S, Lathan EC, Miao A, Gibbons R, Eghbalzad L, Powers A, Fani N. Contributions of Trauma and Economic Insecurity to Psychological Distress in Response to the COVID-19 Pandemic. MENTAL HEALTH SCIENCE 2023; 1:222-230. [PMID: 38707932 PMCID: PMC11068086 DOI: 10.1002/mhs2.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/18/2023] [Indexed: 05/07/2024]
Abstract
Background Racially minoritized women with limited socioeconomic resources are at increased risk for adverse psychological outcomes in response to the COVID-19 pandemic. Disproportionate rates of trauma exposure and economic insecurity likely heighten risk for these outcomes among socioeconomically vulnerable individuals, but the unique contributions of these factors are poorly understood. As such, we examined trauma and economic factors as predictors of pandemic-related psychological distress and symptoms. Methods Ninety-six women recruited for a trauma research study (91.7% Black, Mage=38.3 years, SDage=11.8 years) completed measures of trauma exposure, economic insecurity, and several items assessing psychological distress and symptoms related to the COVID-19 pandemic. We examined concern for mental and physical health impacts of COVID-19 as well as changes in self-reported levels of anxiety and anhedonia from the three months prior to the pandemic to the past two weeks. Linear regression analyses were used to assess contributions of trauma exposure and economic insecurity to COVID-19-related distress. Results Childhood maltreatment and lifetime trauma exposure did not predict COVID-19-related distress; however, financial concern significantly contributed to concern for the physical health impact of COVID-19 (B = .30, p < .05). Food insecurity emerged as the only significant predictor of concern for mental health impact of COVID-19 (B=.91, p < .01). Housing instability was the only significant predictor of COVID-19-related increases in anhedonia (B = -.30, p < .05). Conclusions Economic insecurity, namely self-reported financial concern, food insecurity, and housing instability, was related to COVID-19-related psychological distress in a sample of predominately Black American women living in under-resourced communities. Findings may help identify populations at risk for COVID-19-related psychological distress and symptoms and develop effective interventions, such as expanding access to nutritious food sources and housing support, for minoritized community members.
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Affiliation(s)
- Sarah Abdul-Ghani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Emma C Lathan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Amanda Miao
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Rebecca Gibbons
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | | | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
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14
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Keene DE, Blankenship KM. The Affordable Rental Housing Crisis and Population Health Equity: a Multidimensional and Multilevel Framework. J Urban Health 2023; 100:1212-1223. [PMID: 37991605 PMCID: PMC10728029 DOI: 10.1007/s11524-023-00799-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 11/23/2023]
Abstract
The US is facing a severe affordable rental housing crisis that contributes to multiple forms of housing insecurity including homelessness, crowded and poor quality housing conditions, unstable housing arrangements, and cost burdens. A considerable body of evidence finds that housing insecurity is an important determinant of health. However, the existing literature may fall short of conceptualizing and measuring the full impact of housing insecurity on population health and on racial health equity. In this paper, we seek to expand the conceptualization of housing as a determinant of population health equity by considering housing insecurity as a manifestation of structural racism that intersects with other manifestations and impacts of structural racism to affect, not only the health of housing insecure individuals, but also the health of the networks and communities in which these individuals live. First, we situate the current housing crisis within larger systems of structural racism. We extend prior work documenting the confluence of ways that racist policies and practices have created unequal burdens of housing insecurity to also discuss the ways that the meanings and impacts of housing insecurity may be shaped by racism. Next, we consider how the health impacts of this unequal burden of housing insecurity can extend beyond individual households to affect networks and communities. Ultimately, we provide a multilevel framework that can inform research, policy, and practice to address housing and health equity.
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Affiliation(s)
- Danya E Keene
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA.
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15
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Brown EM, Moineddin R, Hapsari A, Gozdyra P, Durant S, Pinto AD. Eviction filings during bans on enforcement throughout the COVID-19 pandemic: an interrupted time series analysis. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:745-754. [PMID: 37581748 PMCID: PMC10485221 DOI: 10.17269/s41997-023-00813-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/12/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE Bans on evictions were implemented to reduce the spread of COVID-19 and to protect vulnerable populations during a public health crisis. Our objective was to examine how three bans on eviction enforcement impacted eviction filings from March 2020 through January 2022 in Ontario, Canada. METHODS Data were derived from eviction application records kept by the Ontario Landlord and Tenant Board. We used segmented regression analysis to model changes in the average weekly filing rates for evictions due to non-payment of rent (L1 filings) and reasons other than non-payment of rent (L2 filings). RESULTS The average number of weekly L1 and L2 applications dropped by 67.5 (95% CI: 55.2, 79.9) and 31.7 (95% CI: 26.7, 36.6) filings per 100,000 rental dwellings, respectively, following the first ban on eviction enforcement (p < 0.0001). Notably, they did not fall to zero. Level changes during the second and third bans were insubstantial and slope changes for L2 applications varied throughout the study period. The L1 filing rate appeared to increase towards the end of the study period (slope change: 1.3; 95% CI: 0.1, 2.6; p = 0.0387). CONCLUSION Our findings suggest that while the first ban on eviction enforcement appeared to substantially reduce filing rates, subsequent bans were less effective and none of them eliminated eviction filings altogether. Enacting upstream policies that tackle the root causes of displacement would better equip jurisdictions during future public health emergencies.
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Affiliation(s)
- Erika M Brown
- California Policy Lab, Institute for Research on Labor & Employment, University of California, Berkeley, Berkeley, CA, USA
- Social Interventions Research & Evaluation Network, University of California, San Francisco, San Francisco, CA, USA
| | - Rahim Moineddin
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ayu Hapsari
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Gozdyra
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Steve Durant
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Andrew D Pinto
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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16
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McIntosh A, Anguelovski I, Cole H. "The trauma machine expands faster than our services": Health risks for unhoused people in an early-stage gentrifying area. Health Place 2023; 83:103035. [PMID: 37331113 DOI: 10.1016/j.healthplace.2023.103035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 06/20/2023]
Abstract
While homelessness continues to be a prevalent problem throughout the United States, many urban neighborhoods are also concurrently experiencing an influx of affluent neighbors through gentrification, exposing the stark inequalities in housing access nationwide. Gentrification-induced changes in neighborhood dynamics have also been shown to affect the health of low-income and non-white groups, with high risks of trauma from displacement and exposure to violent crime and criminalization. This study addresses risk factors for health among the most vulnerable, unhoused individuals, and provides a detailed case study on the potential exposures to emotional and physical traumas for unhoused people in early-stage gentrifying areas. By conducting 17 semi-structured interviews with people who work with the unhoused community - health providers, nonprofit employees, neighborhood representatives, and developers - in Kensington, Philadelphia, we analyze how early-stage gentrification impacts the risks for negative health consequences among unhoused groups. Results show that gentrification impacts the health of unhoused people in four main areas that, all together, create what we identify as a "trauma machine" - that is compounding traumas for unhoused residents by 1) reducing and compromising spaces of safety from violent crime, 2) decreasing public services, 3) threatening the quality of healthcare, and 4) increasing the likelihood of displacement and associated trauma.
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Affiliation(s)
- Andrea McIntosh
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain.
| | - Isabelle Anguelovski
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain; Institución Catalana de Investigación y Estudios Avanzados (ICREA), Passeig de Lluís Companys, 23, 08010, Barcelona, Spain.
| | - Helen Cole
- Universitat Autònoma de Barcelona (UAB), Plaça Cívica, 08193, Bellaterra, Barcelona, Spain; Institu de Ciència I Tecnologia Ambientals (ICTA), Edifici ICTA-ICP, Carrer de Les Columnes S/n, Campus de La UAB, 08193, Cerdanyola Del Vallès, Barcelona, Spain.
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17
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Bradford AC, Maclean JC. Evictions and psychiatric treatment. JOURNAL OF POLICY ANALYSIS AND MANAGEMENT : [THE JOURNAL OF THE ASSOCIATION FOR PUBLIC POLICY ANALYSIS AND MANAGEMENT] 2023; 43:87-125. [PMID: 38249438 PMCID: PMC10798266 DOI: 10.1002/pam.22522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Stable housing is critical for health, employment, education, and other social outcomes. Evictions reflect a form of housing instability that is experienced by millions of Americans each year. Inadequately treated psychiatric disorders have the potential to influence evictions in several ways. For example, these disorders may impede labor market performance and thus the ability to pay rent, or increase the likelihood of risky and/or nuisance behaviors that can lead to a lease violation. We estimate the effect of local access to psychiatric treatment on eviction rates. We combine data on the number of psychiatric treatment centers that offer outpatient and residential care within a county with eviction rates in a two-way fixed-effects framework. Our findings imply that 10 additional psychiatric treatment centers in a county lead to a reduction of 2.1% in the eviction rate.
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Affiliation(s)
- Ashley C. Bradford
- Georgia Institute of Technology, School of Public Policy, Atlanta, GA, United States
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18
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Yao Z, Tsai J, Liu W, Levy DA, Druhl E, Reisman JI, Yu H. Automated identification of eviction status from electronic health record notes. J Am Med Inform Assoc 2023; 30:1429-1437. [PMID: 37203429 PMCID: PMC10354775 DOI: 10.1093/jamia/ocad081] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/07/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE Evictions are important social and behavioral determinants of health. Evictions are associated with a cascade of negative events that can lead to unemployment, housing insecurity/homelessness, long-term poverty, and mental health problems. In this study, we developed a natural language processing system to automatically detect eviction status from electronic health record (EHR) notes. MATERIALS AND METHODS We first defined eviction status (eviction presence and eviction period) and then annotated eviction status in 5000 EHR notes from the Veterans Health Administration (VHA). We developed a novel model, KIRESH, that has shown to substantially outperform other state-of-the-art models such as fine-tuning pretrained language models like BioBERT and Bio_ClinicalBERT. Moreover, we designed a novel prompt to further improve the model performance by using the intrinsic connection between the 2 subtasks of eviction presence and period prediction. Finally, we used the Temperature Scaling-based Calibration on our KIRESH-Prompt method to avoid overconfidence issues arising from the imbalance dataset. RESULTS KIRESH-Prompt substantially outperformed strong baseline models including fine-tuning the Bio_ClinicalBERT model to achieve 0.74672 MCC, 0.71153 Macro-F1, and 0.83396 Micro-F1 in predicting eviction period and 0.66827 MCC, 0.62734 Macro-F1, and 0.7863 Micro-F1 in predicting eviction presence. We also conducted additional experiments on a benchmark social determinants of health (SBDH) dataset to demonstrate the generalizability of our methods. CONCLUSION AND FUTURE WORK KIRESH-Prompt has substantially improved eviction status classification. We plan to deploy KIRESH-Prompt to the VHA EHRs as an eviction surveillance system to help address the US Veterans' housing insecurity.
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Affiliation(s)
- Zonghai Yao
- Manning College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Jack Tsai
- National Center on Homelessness among Veterans, U.S. Department of Veterans Affairs Homeless Programs Office, Washington, District of Columbia, USA
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Weisong Liu
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Center for Biomedical and Health Research in Data Sciences, Miner School of Computer and Information Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Health Care, Bedford, Massachusetts, USA
| | - David A Levy
- Center for Biomedical and Health Research in Data Sciences, Miner School of Computer and Information Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Emily Druhl
- Center for Healthcare Organization and Implementation Research, VA Bedford Health Care, Bedford, Massachusetts, USA
| | - Joel I Reisman
- Center for Healthcare Organization and Implementation Research, VA Bedford Health Care, Bedford, Massachusetts, USA
| | - Hong Yu
- Manning College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
- Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Center for Biomedical and Health Research in Data Sciences, Miner School of Computer and Information Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Health Care, Bedford, Massachusetts, USA
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19
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Lotfata A, Georganos S. Spatial machine learning for predicting physical inactivity prevalence from socioecological determinants in Chicago, Illinois, USA. JOURNAL OF GEOGRAPHICAL SYSTEMS 2023:1-21. [PMID: 37358962 PMCID: PMC10241140 DOI: 10.1007/s10109-023-00415-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 05/04/2023] [Indexed: 06/28/2023]
Abstract
The increase in physical inactivity prevalence in the USA has been associated with neighborhood characteristics. While several studies have found an association between neighborhood and health, the relative importance of each component related to physical inactivity or how this value varies geographically (i.e., across different neighborhoods) remains unexplored. This study ranks the contribution of seven socioecological neighborhood factors to physical inactivity prevalence in Chicago, Illinois, using machine learning models at the census tract level, and evaluates their predictive capabilities. First, we use geographical random forest (GRF), a recently proposed nonlinear machine learning regression method that assesses each predictive factor's spatial variation and contribution to physical inactivity prevalence. Then, we compare the predictive performance of GRF to geographically weighted artificial neural networks, another recently proposed spatial machine learning algorithm. Our results suggest that poverty is the most important determinant in the Chicago tracts, while on the other hand, green space is the least important determinant in the rise of physical inactivity prevalence. As a result, interventions can be designed and implemented based on specific local circumstances rather than broad concepts that apply to Chicago and other large cities. Supplementary Information The online version contains supplementary material available at 10.1007/s10109-023-00415-y.
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Affiliation(s)
- Aynaz Lotfata
- School of Veterinary Medicine, Department of Veterinary Pathology, University of California, Davis, USA
| | - Stefanos Georganos
- Geomatics, Department of Environmental and Life Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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20
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Gilmore AB, Fabbri A, Baum F, Bertscher A, Bondy K, Chang HJ, Demaio S, Erzse A, Freudenberg N, Friel S, Hofman KJ, Johns P, Abdool Karim S, Lacy-Nichols J, de Carvalho CMP, Marten R, McKee M, Petticrew M, Robertson L, Tangcharoensathien V, Thow AM. Defining and conceptualising the commercial determinants of health. Lancet 2023; 401:1194-1213. [PMID: 36966782 DOI: 10.1016/s0140-6736(23)00013-2] [Citation(s) in RCA: 117] [Impact Index Per Article: 117.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 10/13/2022] [Accepted: 12/23/2022] [Indexed: 04/07/2023]
Abstract
Although commercial entities can contribute positively to health and society there is growing evidence that the products and practices of some commercial actors-notably the largest transnational corporations-are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity; these problems are increasingly referred to as the commercial determinants of health. The climate emergency, the non-communicable disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed food, fossil fuel, and alcohol) already account for at least a third of global deaths illustrate the scale and huge economic cost of the problem. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so. Consequently, as harms to human and planetary health increase, commercial sector wealth and power increase, whereas the countervailing forces having to meet these costs (notably individuals, governments, and civil society organisations) become correspondingly impoverished and disempowered or captured by commercial interests. This power imbalance leads to policy inertia; although many policy solutions are available, they are not being implemented. Health harms are escalating, leaving health-care systems increasingly unable to cope. Governments can and must act to improve, rather than continue to threaten, the wellbeing of future generations, development, and economic growth.
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Affiliation(s)
| | - Alice Fabbri
- Department for Health, University of Bath, Bath, UK
| | - Fran Baum
- Stretton Health Institute, University of Adelaide, Adelaide, SA, Australia
| | | | - Krista Bondy
- Stirling Management School, University of Stirling, Stirling, UK
| | - Ha-Joon Chang
- Department of Economics, School of Oriental and African Studies University of London, London, UK
| | - Sandro Demaio
- Victorian Health Promotion Foundation, Melbourne, VIC, Australia
| | - Agnes Erzse
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Nicholas Freudenberg
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Acton, ACT, Australia
| | - Karen J Hofman
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Paula Johns
- ACT Health Promotion, Rio de Janeiro, Brazil
| | - Safura Abdool Karim
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | | | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, University of Sydney, NSW, Australia
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21
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Thomson H, Zeff HB, Kleiman R, Sebastian A, Characklis GW. Systemic Financial Risk Arising from Residential Flood Losses. EARTH'S FUTURE 2023; 11:e2022EF003206. [PMID: 37151608 PMCID: PMC10162782 DOI: 10.1029/2022ef003206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Direct damage from flooding at residential properties has typically been categorized as insured, with liabilities accruing to insurers, or uninsured, with costs accruing to property owners. However, residential flooding can also expose lenders and local governments to financial risk, though the distribution of this risk is not well understood. Flood losses are not limited to direct damages, but also include indirect effects such as decreases in property values, which can be substantial, though are rarely well quantified. The combination of direct damage and property value decrease influences rates of mortgage default and property abandonment in the wake of a flood, creating financial risk. In this research, property-level data on sales, mortgages, and insurance claims are used in combination with machine learning techniques and geostatistical methods to provide estimates of flood losses that are then utilized to evaluate the risk of default and abandonment in eastern North Carolina following Hurricane Florence (2018). Within the study area, Hurricane Florence generated $366M in observed insured damages and an estimated $1.77B in combined uninsured damages and property value decreases. Property owners, lenders, and local governments were exposed to an additional $562M in potential losses due to increased rates of default and abandonment. Areas with lower pre-flood property values were exposed to greater risk than areas with higher valued properties. Results suggest more highly resolved estimates of a flooding event's systemic financial risk may be useful in developing improved flood resilience strategies.
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Affiliation(s)
- Hope Thomson
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Center on Financial Risk in Environmental Systems, Gillings School of Global Public Health and UNC Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Corresponding author: Hope Thomson ()
| | - Harrison B. Zeff
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Center on Financial Risk in Environmental Systems, Gillings School of Global Public Health and UNC Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
| | - Rachel Kleiman
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Center on Financial Risk in Environmental Systems, Gillings School of Global Public Health and UNC Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
| | - Antonia Sebastian
- Department of Earth, Marine, and Environmental Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
| | - Gregory W. Characklis
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
- Center on Financial Risk in Environmental Systems, Gillings School of Global Public Health and UNC Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA 27599
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22
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Huggard L, Murphy R, O'Connor C, Nearchou F. The Social Determinants of Mental Illness: A Rapid Review of Systematic Reviews. Issues Ment Health Nurs 2023; 44:302-312. [PMID: 36972547 DOI: 10.1080/01612840.2023.2186124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Previous research agendas have prioritised the role of biological determinants in mental illness aetiology. This is of particular concern, as endorsing biological determinants has been shown to promote negative attitudes towards people with mental illness. The aim of this review was to provide an overview of high-quality evidence of the social determinants of mental illness. A rapid review of systematic reviews was conducted. Five databases were searched: Embase, Medline, Academic Search Complete, CINAHL Plus, and PsycINFO. Systematic reviews or meta-analyses that described any social determinant of mental illness, were published in peer-review journals in English, and focussed on human participants were included. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were applied for the selection procedure. Thirty-seven systematic reviews were deemed eligible for review and narrative synthesis. Determinants identified included conflict, violence and maltreatment, life events and experiences, racism and discrimination, culture and migration, social interaction and support, structural policies and inequality, financial factors, employment factors, housing and living conditions, and demographic factors. We recommend that mental health nurses ensure adequate support be provided to those affected by the evidenced social determinants of mental illness.
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23
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Residential mobility and mental health. SSM Popul Health 2022; 21:101321. [PMID: 36660175 PMCID: PMC9843485 DOI: 10.1016/j.ssmph.2022.101321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
We examine the extent to which residential relocation within and between tenure types is associated with changes in mental health. We focus on four types of housing transition - rent-to-own, own-to-rent, own-to-own, and rent-to-rent - using Australian and UK panel data sets from 2001 to 2017. In both countries, transitions into homeownership and moves away from the mortgaged edges toward the unburdened mainstream of outright ownership are positively associated with mental health. On the other hand, shifts by mortgagors towards more precarious positions on the edges of ownership precipitate dips in mental health when there is exposure to high levels of payment and investment risks. Clearly, residential moves can both alleviate and introduce different kinds of risks that affect affordability. Moreover, tenure transitions have impacts on mental health beyond the impacts of payment and investment risks. However, we observe some cross-national differences in findings. In Australia, loss of homeownership has a negative impact on mental health that outweighs the mental health impacts of attaining ownership. In the UK, these findings are reversed. Acute housing affordability problems following moves in Australia, but not in the UK, are a significant driver of mental health outcomes. These differences have institutional explanations.
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24
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Prevalence of eviction, home foreclosure, and homelessness among low-income US veterans: the National Veteran Homeless and Other Poverty Experiences study. Public Health 2022; 213:181-188. [PMID: 36444823 DOI: 10.1016/j.puhe.2022.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/13/2022] [Accepted: 10/14/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Housing stability is essential for health and social well-being, and the United States is focused on preventing homelessness among veterans, so this study examined the prevalence of different events related to housing instability among low-income US veterans. STUDY DESIGN This was a nationally representative survey. METHODS Using a sample of 1004 low-income veterans in 2021, this study examined the lifetime prevalence and characteristics associated with eviction, home foreclosure, and homelessness among low-income US veterans. RESULTS In the total sample, 10.9% reported a lifetime history of eviction, 8.0% reported a lifetime history of home foreclosure, and 19.9% reported a lifetime history of homelessness. Among those with a history of homelessness, 39.2% also reported a history of eviction, and 13.9% reported a history of home foreclosure. Hierarchical logistic regression analyses found that for eviction, sociodemographic characteristics (e.g. being Hispanic, having private insurance, and being from the Northeast was associated with lower risk of eviction) together explained 26% of the variance, and clinical characteristics explained an incremental 12% additional variance. For homelessness, sociodemographic characteristics explained 18% of the variance, and clinical characteristics explained an incremental 20% (e.g. diagnosis of schizophrenia or bipolar disorder, any history of suicide attempt, and lower physical health scores were associated with higher risk of homelessness). For home foreclosure, sociodemographic, clinical, and psychosocial variables together only explained 14% of the variance. CONCLUSION Evictions, home foreclosures, and homelessness are discrete events and occur at relatively high rates among low-income veterans. In addition, homelessness was more associated with biosocial dysfunction, whereas eviction was more closely associated with socio-economic vulnerability, which may inform intervention efforts for both events.
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Rao S, Essien UR, Powell-Wiley TM, Maddineni B, Das SR, Halm EA, Pandey A, Sumarsono A. Association of US County-Level Eviction Rates and All-Cause Mortality. J Gen Intern Med 2022; 38:1207-1213. [PMID: 36344645 PMCID: PMC9640832 DOI: 10.1007/s11606-022-07892-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Housing instability is a key social determinant of health and has been linked to adverse short- and long-term health. Eviction reflects a severe form of housing instability and disproportionately affects minority and women residents in the USA; however, its relationship with mortality has not previously been described. OBJECTIVE To evaluate the independent association of county-level eviction rates with all-cause mortality in the USA after adjustment for county demographic, socioeconomic, and health-related characteristics. DESIGN Cross-sectional. PARTICIPANTS Six hundred eighty-six US counties with available 2016 county-level eviction and mortality data. EXPOSURE 2016 US county-level eviction rate. OUTCOME 2016 US county-level age-adjusted all-cause mortality. KEY RESULTS Among 686 counties (66.1 million residents, 50.5% [49.7-51.2] women, 2% [0.5-11.1] Black race) with available eviction and mortality data in 2016, we observed a significant and graded relationship between county-level eviction rate and all-cause mortality. Counties in the highest eviction tertile demonstrated a greater proportion of residents of Black race and women and a higher prevalence of poverty and comorbid health conditions. After adjustment for county-level sociodemographic traits and prevalent comorbid health conditions, age-adjusted all-cause mortality was highest among counties in the highest eviction tertile (Tertile 3 vs 1 (per 100,000 people) 33.57: 95% CI: 10.5-56.6 p=.004). Consistent results were observed in continuous analysis of eviction, with all-cause mortality increasing by 9.32 deaths per 100,000 people (4.77, 13.89, p<.0001) for every 1% increase in eviction rates. Significant interaction in the relationship between eviction and all-cause mortality was observed by the proportion of Black and women residents. CONCLUSIONS In this cross-sectional analysis, county-level eviction rates were significantly associated with all-cause mortality with the strongest effects observed among counties with the highest proportion of Black and women residents. State and federal protections from evictions may help to reduce the health consequences of housing instability and address disparities in health outcomes.
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Affiliation(s)
- Shreya Rao
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Utibe R Essien
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.,Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Bhumika Maddineni
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sandeep R Das
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ethan A Halm
- Department of Medicine, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Ambarish Pandey
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Andrew Sumarsono
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA. .,Division of Hospital Medicine, Parkland Memorial Hospital, Dallas, TX, USA.
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Chen KL, Miake-Lye IM, Begashaw MM, Zimmerman FJ, Larkin J, McGrath EL, Shekelle PG. Association of Promoting Housing Affordability and Stability With Improved Health Outcomes: A Systematic Review. JAMA Netw Open 2022; 5:e2239860. [PMID: 36322083 PMCID: PMC9631101 DOI: 10.1001/jamanetworkopen.2022.39860] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE Housing insecurity-that is, difficulty with housing affordability and stability-is prevalent and results in increased risk for both homelessness and poor health. However, whether interventions that prevent housing insecurity upstream of homelessness improve health remains uncertain. OBJECTIVE To review evidence characterizing associations of primary prevention strategies for housing insecurity with adult physical health, mental health, health-related behaviors, health care use, and health care access. EVIDENCE REVIEW Pairs of independent reviewers systematically searched PubMed, Web of Science, EconLit, and the Social Interventions Research and Evaluation Network for quantitative studies published from 2005 to 2021 that evaluated interventions intended to directly improve housing affordability and/or stability either by supporting at-risk households (targeted primary prevention) or by enhancing community-level housing supply and affordability in partnership with the health sector (structural primary prevention). Risk of bias was appraised using validated tools, and the evidence was synthesized using modified Grading of Recommendations Assessment, Development, and Evaluation criteria. FINDINGS A total of 26 articles describing 3 randomized trials and 20 observational studies (16 longitudinal designs and 4 cross-sectional quasi-waiting list control designs) were included. Existing interventions have focused primarily on mitigating housing insecurity for the most vulnerable individuals rather than preventing housing insecurity outright. Moderate-certainty evidence was found that eviction moratoriums were associated with reduced COVID-19 cases and deaths. Certainty of evidence was low or very low for health associations of other targeted primary prevention interventions, including emergency rent assistance, legal assistance with waiting list priority for public housing, long-term rent subsidies, and homeownership assistance. No studies evaluated health system-partnered structural primary prevention strategies. CONCLUSIONS AND RELEVANCE This systematic review found mixed and mostly low-certainty evidence that interventions that promote housing affordability and stability were associated with improved adult health outcomes. Existing interventions may need to be paired with other efforts to address the structural determinants of health. As health care systems and insurers respond to increasing opportunities to invest in housing as a determinant of health, further research is needed to clarify where along the housing insecurity pathway interventions should focus for the most effective and equitable health impact.
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Affiliation(s)
- Katherine L. Chen
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Fielding School of Public Health, University of California, Los Angeles
| | - Isomi M. Miake-Lye
- Fielding School of Public Health, University of California, Los Angeles
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California
| | - Meron M. Begashaw
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California
| | | | - Jody Larkin
- RAND Corporation, Southern California Evidence-Based Practice Center, Santa Monica, California
| | - Emily L. McGrath
- Health Equity and Population Health, Humana Inc, Louisville, Kentucky
| | - Paul G. Shekelle
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California
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Harville EW, Wallace ME, Theall KP. Eviction as a social determinant of pregnancy health: County-level eviction rates and adverse birth outcomes in the United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5579-e5587. [PMID: 36065610 DOI: 10.1111/hsc.13983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/10/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Access to housing is an important manifestation of structural racism and discrimination, and birth outcomes show wide health disparities, but few studies have examined eviction and birth outcomes. This multilevel study merged data from the Eviction Lab on 2015 eviction judgements and records with the National Center for Health Statistics natality dataset. The analytic sample included 2,950,965 births across 5924 counties in 45 states. Outcomes of interest were low birthweight (<2500 g; LBW) and preterm birth (<37 weeks gestation; PTB). We fit generalised estimating equations to account for clustering within county and a logistic distribution to estimate the odds ratio of LBW or PTB associated with the county-level eviction rate, with control for individual- and county-level characteristics. Results were calculated separately for non-Hispanic white, non-Hispanic black and Hispanic mothers. After adjustment for covariates, living in the counties in the highest quartile of eviction was associated with a 12-13% increased odds of LBW. The magnitude of association with PTB was not as large. Non-Hispanic black women were more likely to live in counties in the highest quartile of eviction rate (43%, vs. 23% for white women and 23% for Hispanic women) or filing rate (44%, vs. 23% for white and 18% for Hispanic). The association between eviction rate and LBW/PTB was strongest for black women, while there was essentially no association among Hispanic women. Housing instability may be a key social determinant of poor birth outcomes and should be considered in state and local maternal and child health policy and programming.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Maeve E Wallace
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Katherine P Theall
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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Ali AK, Wehby GL. State Eviction Moratoriums During The COVID-19 Pandemic Were Associated With Improved Mental Health Among People Who Rent. Health Aff (Millwood) 2022; 41:1583-1589. [DOI: 10.1377/hlthaff.2022.00750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - George L. Wehby
- George L. Wehby , University of Iowa; and National Bureau of Economic Research, Cambridge, Massachusetts
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Phillips S, Raskin SE, Harrington CB, Bishop D, Gany FM. "Like pouring salt in a wound": A qualitative exploration of the consequences of unmet housing needs for cancer patients and survivors in New York City. J Psychosoc Oncol 2022; 41:411-433. [PMID: 36271879 PMCID: PMC10322638 DOI: 10.1080/07347332.2022.2136025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To identify consequences of unmet housing needs in the period following cancer diagnosis. DESIGN Qualitative descriptive design. PARTICIPANTS New York City-based cancer patients and survivors (n = 21) who reported experience of unmet housing needs while receiving cancer treatment. Key informants (n = 9) with relevant expertise (e.g. oncology social workers). METHODS One-time semi-structured telephone or in-person interviews were conducted with all participants. Inductive thematic coding was conducted using a pragmatic paradigm. FINDINGS Four categories of consequences emerged: 1) cancer management and health (rest and recovery, illness/injury risk, medical care); 2) psychological (stress and anxiety, lack of control and independence, self-esteem/pride, sadness/depression, cancer coping); 3) social (relationships, consequences for others, isolation); and 4) standard of functional living. CONCLUSION The simultaneous experience of cancer and unmet housing needs is broadly burdensome. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Screening and resources for addressing unmet housing needs must be prioritized to holistically care for patients.
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Affiliation(s)
- Serena Phillips
- Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, USA
| | - Sarah E. Raskin
- L. Douglas Wilder School of Government and Public Affairs, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Darla Bishop
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Francesca M. Gany
- Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Santaularia NJ, Osypuk TL, Ramirez MR, Mason SM. Violence in the Great Recession. Am J Epidemiol 2022; 191:1847-1855. [PMID: 35767881 PMCID: PMC10144667 DOI: 10.1093/aje/kwac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 02/01/2023] Open
Abstract
Substantial evidence suggests that economic hardship causes violence. However, a large majority of this research relies on observational studies that use traditional violence surveillance systems that suffer from selection bias and over-represent vulnerable populations, such as people of color. To overcome limitations of prior work, we employed a quasi-experimental design to assess the impact of the Great Recession on explicit violence diagnoses (injuries identified to be caused by a violent event) and proxy violence diagnoses (injuries highly correlated with violence) for child maltreatment, intimate partner violence, elder abuse, and their combination. We used Minnesota hospital data (2004-2014), conducting a difference-in-differences analysis at the county level (n = 86) using linear regression to compare changes in violence rates from before the recession (2004-2007) to after the recession (2008-2014) in counties most affected by the recession, versus changes over the same time period in counties less affected by the recession. The findings suggested that the Great Recession had little or no impact on explicitly identified violence; however, it affected proxy-identified violence. Counties that were more highly affected by the Great Recession saw a greater increase in the average rate of proxy-identified child abuse, elder abuse, intimate partner violence, and combined violence when compared with less-affected counties.
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Affiliation(s)
- N Jeanie Santaularia
- Correspondence to Dr. Jeanie Santaularia, Carolina Population Center, 123 West Franklin Street Chapel Hill, NC 27516 (e-mail: )
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Smith PD, Groves AK, Langellier BA, Keene DE, Rosenberg A, Blankenship KM. Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT. Prev Med Rep 2022; 29:101956. [PMID: 36161139 PMCID: PMC9502672 DOI: 10.1016/j.pmedr.2022.101956] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 08/05/2022] [Accepted: 08/14/2022] [Indexed: 11/22/2022] Open
Abstract
We sought to examine whether and how landlord-related forced moves (inclusive of, but not limited to, legal eviction) were associated with emergency department (ED) use over time. We used survey data collected between 2017 and 2019 among 283 low-income participants in New Haven, CT to examine whether experiencing a legal eviction or other landlord-related forced move (T0) was associated with increased odds of ED use 6 months (T1) and 12 months (T2) later. We conducted bootstrapped mediation analyses to examine indirect effects of post-traumatic stress symptoms. One-fifth of participants (n = 61) reported a recent forced move at baseline (T0); half of these were legally evicted. Landlord-related forced moves were associated with ED use at T1 (AOR = 2.06, 95 % CI: 1.04-4.06) and T2 (AOR = 3.05, 95 % CI: 1.59-5.88). After adjustment for sociodemographic factors and other health-related confounders, legal eviction was not significantly associated with ED use at T1 (AOR = 1.61, 95 % CI: 0.68-3.81), but was significantly associated with ED use at T2 (AOR = 3.58, 95 % CI: 1.58-8.10). Post-traumatic stress symptoms accounted for 15.1% of forced moves' association with ED use (p <.05). Landlord-related forced moves are positively associated with subsequent ED use, and post-traumatic stress symptoms are one factor that may help explain this association. Structural interventions that promote housing stability are needed to advance health equity, and they may also help to reduce preventable ED use. Such interventions are imperative in the context of the COVID-19 pandemic, which has strained health system capacity and exacerbated housing instability for many low-income renters. Results underscore the relevance of trauma-informed care and integrated care management to clinical practice in emergency settings.
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Affiliation(s)
- Patrick D. Smith
- Drexel University Dornsife School of Public Health, Department of Community Health and Prevention, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA
- Corresponding author at: Drexel University Dornsife School of Public Health, 3215 Market St, Office 718, Philadelphia, PA 19104, USA.
| | - Allison K. Groves
- Drexel University Dornsife School of Public Health, Department of Community Health and Prevention, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA
| | - Brent A. Langellier
- Drexel University Dornsife School of Public Health, Department of Health Management and Policy, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA
| | - Danya E. Keene
- Yale University School of Public Health, Department of Social and Behavioral Sciences, 60 College Street, New Haven, CT 06510, USA
| | - Alana Rosenberg
- Yale University School of Public Health, Department of Social and Behavioral Sciences, 60 College Street, New Haven, CT 06510, USA
| | - Kim M. Blankenship
- American University, Department of Sociology, 4400 Massachusetts Avenue, Washington, DC 20016, USA
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Acharya B, Bhatta D, Dhakal C. The risk of eviction and the mental health outcomes among the US adults. Prev Med Rep 2022; 29:101981. [PMID: 36161138 PMCID: PMC9502670 DOI: 10.1016/j.pmedr.2022.101981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/18/2022] [Accepted: 09/02/2022] [Indexed: 11/21/2022] Open
Abstract
Perceived risk of eviction among people living with rent arrears is associated with elevated mental health problems. Prevalence of depression, anxiety, and pyschotropic medication use is higher in the at-risk of eviction group compared to the non-risk group. Addressing the housing crisis is crucial in decreasing the mental health burden among people living in rented residences.
Although past studies establish a link between residential instability and poor mental health, studies investigating the association between perceived risk of eviction and mental health with nationally representative data are largely lacking. This study examines the association between self-reported risk of eviction and anxiety, depression, and prescription medication use for mental or emotional health reasons. This is a retrospective observational study using the repeated-cross sectional data (n = 14548; unweighted) using the US Census Bureau’s Household Pulse Survey from July 2021 to March 2022. Survey respondents aged 18 years and above who lived in rented residences and were not caught up with the rent payments at the time of the survey were included in the analysis. The descriptive summary shows a higher prevalence of depression (59.33 % vs 37.01 %), anxiety (67.01 % vs 43.28 %), and prescription medication use (26.57 % vs 23.68 %) among the respondents who are likely to face eviction in the next two months compared to the reference group not at the risk of eviction. When adjusted for demographic characteristics, family context, and socioeconomic setting, the odds of depression, anxiety, and prescription medication use in the at-risk eviction group were significantly higher than in the reference group. Specifically, odds ratios (ORs) [95 % CI] for depression, anxiety, and prescription medication use are 2.366 [2.364, 2.369], 2.650 [2.648, 2.653], and 1.172 [1.171, 1.174], respectively. These results suggest that the perceived risk of eviction is associated with elevated mental health problems. Addressing the housing crisis may help decrease the mental health burden among rented households.
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Affiliation(s)
- Binod Acharya
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, Philadelphia, PA 19014 USA
| | - Dependra Bhatta
- Behavioral and Primary Health Analytics, Northeast Delta Human Service Authority, Louisiana Department of Health, Monroe, LA 71202 USA
| | - Chandra Dhakal
- Department of Agricultural and Applied Economics, University of Georgia, Athens, GA 30602 USA
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Characteristics of Tenants Who Delayed Rent Payments during Eviction Moratoria in 2020. J Urban Health 2022; 99:936-940. [PMID: 36123570 PMCID: PMC9484717 DOI: 10.1007/s11524-022-00684-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/25/2022]
Abstract
This study examined the characteristics of US tenants who reported delaying rent payments during the eviction moratoria in 2020 in respond to the coronavirus disease 2019 (COVID-19) pandemic. A nationally representative sample of 3393 US tenants was assessed from May to June 2020 during a period that eviction moratoria were issued across the country. In the total sample, 22.9% of US tenants reported they delayed paying rent because of the eviction moratoria. Tenants who delayed paying rent were nearly 7 times as likely to be at risk of eviction, more than 3 times as likely to endorse recent suicidal ideation, and 1.6 times as likely to report recent illicit drug use compared to tenants who did not delay paying rent. These findings highlight the health and social needs of tenants in the aftermath of the COVID-19 pandemic.
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Reconsidering the definition of trauma. Lancet Psychiatry 2022; 9:608-609. [PMID: 35843252 DOI: 10.1016/s2215-0366(22)00196-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 11/21/2022]
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Sonik RA, Herrera AL. Associations between inspections for unsafe housing conditions and evictions in New York City public housing buildings . J Community Health 2022; 47:849-852. [PMID: 35794300 PMCID: PMC9258459 DOI: 10.1007/s10900-022-01114-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
Poor housing conditions and evictions are both associated with poor physical and mental health outcomes, such as increased risks for cardiovascular disease, depression, and injuries. However, the relationship between these two negative housing outcomes has received little quantitative study, including in public housing where exposure to these factors and to negative health outcomes are elevated. We therefore sought to examine the relationship between evictions and formal housing safety inspections triggered by tenant complains about poor conditions. We estimated a hierarchical logistic regression model assessing associations between housing quality inspections and evictions using data from January 2017 and March 2020 on 3,746 residential buildings within 299 New York City Housing Authority (NYCHA) developments, adjusting for development size, funding type, and area-level social vulnerability indicators. The average Social Vulnerability Index percentile for the buildings included in this study was 0.90 (SD = 0.12), indicating that these buildings were in areas with greater social vulnerability than 90% of other census tracts in the state. Adjusted predicted probabilities of an eviction increased from 34 to 43% in the presence of a rodent inspection and from 34 to 46% in the presence of an indoor environmental inspection (p < 0.001 for both), indicating that inspections for unsafe housing conditions were associated with evictions at the building level. Substandard housing quality and evictions are important public health concerns. Policies to enhance protections for tenants against both of these social ills simultaneously may be needed to improve community health outcomes.
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Affiliation(s)
- Rajan Anthony Sonik
- AltaMed Institute for Health Equity, AltaMed Health Services, 2035 Camfield Ave, 3rd Floor, 90040, Los Angeles, CA, United States.
| | - Ana L Herrera
- Strategic Prevention Solutions, Oakland, CA, United States
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Groves AK, Smith PD, Gebrekristos LT, Keene DE, Rosenberg A, Blankenship KM. Eviction, intimate partner violence and HIV: Expanding concepts and assessing the pathways through which sexual partnership dynamics impact health. Soc Sci Med 2022; 305:115030. [PMID: 35594760 PMCID: PMC9332133 DOI: 10.1016/j.socscimed.2022.115030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022]
Abstract
Over 2 million renters in the United States are legally evicted annually, and even more renters experience other landlord-related forced moves each year. While past research has documented an association between legal eviction and HIV risk, no studies have examined the relationship between forced moves and sexual partnership dynamics longitudinally, or the pathways through which forced moves impact such risk. Addressing this gap is imperative, particularly given inequities that place Black renters and women at disproportionate risk of eviction. This study leverages data from a longitudinal cohort study of 282 adults in New Haven to examine whether landlord-related forced moves reported at baseline (including, but not limited to, legal eviction) is associated with HIV sexual risk reported six months later. We use bootstrapped path analyses to examine intimate partner violence (IPV) victimization and perpetration as potential mediators. One-fifth of participants (21.2%) had experienced a landlord-related forced move at baseline. At follow up, nearly two-thirds (63.8%) reported at least one HIV sexual risk factor, one in seven (14.2%) reported IPV victimization, and one in ten (10.3%) reported IPV perpetration. Individuals who reported landlord-related forced moves were more likely to report IPV victimization (standardized β = 0.19, SE = 0.08, p = .02) and IPV perpetration (β = 0.25, SE = 0.09, p = .003). Both IPV victimization and perpetration mediated the association between landlord-related forced moves and HIV sexual risk (indirect victimization effect, β = 0.09, SE = 0.05, p = .06; indirect perpetration effect, β = 0.16, SE = 0.07, p = .02), though IPV victimization was only marginally significant. In conclusion, IPV is itself a negative consequence of forced moves that also contributes to other negative health effects, like HIV risk. Therefore, providers should offer violence screening and referral for clients who have recently faced a forced move. Simultaneously, policy-level solutions to prevent eviction and increase housing affordability are urgently needed to address the rising burden - and inequitable distribution - of evictions among low-income renters.
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Affiliation(s)
- Allison K Groves
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, 19104, 267 359 6274, USA.
| | - Patrick D Smith
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, 19104, 267 359 6274, USA.
| | - Luwam T Gebrekristos
- Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, 19104, 267 359 6274, USA.
| | - Danya E Keene
- Yale University School of Public Health, Department of Social and Behavioral Sciences, 60 College Street, New Haven, CT, 06510, USA.
| | - Alana Rosenberg
- Yale University School of Public Health, Department of Social and Behavioral Sciences, 60 College Street, New Haven, CT, 06510, USA.
| | - Kim M Blankenship
- American University, Department of Sociology, 4400 Massachusetts Avenue, Washington DC, 20016, USA.
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Bhat AC, Almeida DM, Fenelon A, Santos-Lozada AR. A longitudinal analysis of the relationship between housing insecurity and physical health among midlife and aging adults in the United States. SSM Popul Health 2022; 18:101128. [PMID: 35652088 PMCID: PMC9149198 DOI: 10.1016/j.ssmph.2022.101128] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/26/2023] Open
Abstract
Rationale A large body of work demonstrates the impact of housing instability on health by exploring the effects of evictions and homelessness on psychological wellbeing of young adults and children. However, limited research leverages national longitudinal data to examine whether and how experiences of a range of housing insecurity events, rather than just eviction or homelessness, affect physical health among midlife and older adults. Objective The current study examines (1) prevalence of housing insecurity among midlife and older adults by age and race, (2) linkages between housing insecurity experiences and facets of physical health, and (3) age and race moderations on these effects. Method This study employs regression models to examine whether experiences of housing insecurity affect self-rated physical health and chronic physical conditions among midlife and older adults (N = 2598) leveraging two waves of the National Study of Midlife in the United States (MIDUS). Results Models revealed that housing insecurity experiences predicted poorer self-rated physical health and additional chronic conditions, even when controlling for previous physical health. Moderation analyses indicated that housing insecurity has a stronger relationship with chronic conditions among midlife adults as compared to older adults, and among Black adults as compared to white adults. These results suggest that experiences of housing insecurity leave adults vulnerable to compromised physical health, and that housing insecurity experiences may be particularly detrimental to the health of midlife Black adults. Conclusions This research adds to the extant literature by introducing a comprehensive measure of housing insecurity experiences, and contributes to a life course perspective regarding how housing insecurity can affect physical health. This research has implications for policy that addresses housing insecurity as a public health concern, especially in the aftermath of the 2008 recession and the economic and housing crisis caused by the COVID-19 pandemic.
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Affiliation(s)
- Aarti C. Bhat
- Department of Human Development and Family Studies, The Pennsylvania State University, 405 Biobehavioral Health Building, University Park, PA, 16802, USA
| | - David M. Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, 403 Biobehavioral Health Building, University Park, PA, 16802, USA
| | - Andrew Fenelon
- School of Public Policy and Department of Sociology and Criminology, The Pennsylvania State University, 331 Pond Laboratory, University Park, PA, 16802, USA
| | - Alexis R. Santos-Lozada
- Department of Human Development and Family Studies, The Pennsylvania State University, 226 Health and Human Development Building, University Park, PA, 16802, USA
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Brown P, Newton D, Armitage R, Monchuk L, Robson B. Locked down: Ontological security and the experience of COVID-19 while living in poor-quality housing. JOURNAL OF COMMUNITY PSYCHOLOGY 2022:10.1002/jcop.22883. [PMID: 35611443 PMCID: PMC9347395 DOI: 10.1002/jcop.22883] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/17/2022] [Accepted: 05/14/2022] [Indexed: 06/15/2023]
Abstract
The aim of the paper is to illustrate how the housing system in the United Kingdom (UK) has contributed to creating vulnerabilities during the COVID-19 pandemic. Drawing on the concept of ontological security we look at how living with housing insecurity whilst enduring poor housing conditions has impacted the lives of those living in households. The paper draws on semi-structured interviews with 50 residents and 8 housing professionals. The findings outline the grinding impact of the pandemic on the ontological security of residents and the coping strategies adopted by a wider range of households who are now increasingly vulnerable. A number of people went into lockdown in vulnerable situations, experiencing deep inequalities and living in poorly maintained homes. This has weakened the ontological security experienced by many households. These represent significant failings of the housing system and housing policy impacting on the health and wellbeing of a wider cohort of people creating additional vulnerabilities.
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Affiliation(s)
- Philip Brown
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Dillon Newton
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Rachel Armitage
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Leanne Monchuk
- School of Human and Health SciencesUniversity of HuddersfieldHuddersfieldUK
| | - Brian Robson
- Policy & Public AffairsNorthern Housing ConsortiumSunderlandUK
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Sulkers E, Loos J. Life Satisfaction among the Poorest of the Poor: A Study in Urban Slum Communities in India. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00657-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AbstractThis study investigates the level and predictors of life satisfaction in people living in slums in Kolkata, India. Participants of six slum settlements (n = 164; 91% female) were interviewed and data on age, gender, poverty indicators and life satisfaction were collected. The results showed that the level of global life satisfaction in this sample of slum residents did not significantly differ from that of a representative sample of another large Indian city. In terms of life-domain satisfaction, the slum residents were most satisfied with their social relationships and least satisfied with their financial situation. Global life satisfaction was predicted by age, income and non-monetary poverty indicators (deprivation in terms of health, education and living standards) (R2 15.4%). The current study supports previous findings showing that people living in slums tend to report higher levels of life satisfaction than one might expect given the deprivation of objective circumstances of their lives. Furthermore, the results suggest that factors other than objective poverty make life more, or less, satisfying. The findings are discussed in terms of theory about psychological adaptation to poverty.
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Gold S, Wagner B. Acute care utilization and housing hardships in American children. CHILDREN AND YOUTH SERVICES REVIEW 2022; 136:106447. [PMID: 35342214 PMCID: PMC8955135 DOI: 10.1016/j.childyouth.2022.106447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Millions of families in the United States are economically vulnerable: one shock can lead to hardship. We use data from the Fragile Families and Child Wellbeing Study to examine the association between acute healthcare utilization - emergency room visits or hospitalizations - and subsequent housing hardships, such as being evicted for financial reasons. Further, we explore whether this association differs by who in the family utilized the care and whether perceived social support protects against hardship when these experiences occur. Using lagged dependent variable regression models, we find that families that visited the emergency room or were hospitalized, regardless if it was a child or parent with this experience, were five percentage points more likely to experience any housing hardship than families that did not use acute care. Among families in which a child utilized acute care, perceived social support buffered the impact of using acute care. That perceived social support is associated with a lower likelihood of housing hardship among families that experienced acute care utilization for a child, but not parent, suggests that social support may be able to offset the challenges arising from children's, but not adults', use of acute care. In the face of economic precarity, informal safety nets may be insufficient to reduce the impact of acute care utilization on housing hardships.
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Affiliation(s)
- Sarah Gold
- Bendheim-Thoman Center for Research on Child Wellbeing, School of Public and International Affairs, Princeton University, Princeton, NJ 08544
| | - Brandon Wagner
- Department of Sociology, Anthropology, and Social Work, Texas Tech University, 63 Holden Hall, Lubbock, TX 79409
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Ramiller A. Displacement through development? Property turnover and eviction risk in Seattle. URBAN STUDIES (EDINBURGH, SCOTLAND) 2022; 59:1148-1166. [PMID: 35602657 PMCID: PMC9122234 DOI: 10.1177/00420980211004214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Eviction is a powerful form of displacement that perpetuates and amplifies socioeconomic and racial inequalities through the rental housing market. Examining the relationship between evictions and property turnover through Neil Smith's theories of gentrification and uneven geographical development, this article considers the argument that eviction provides a mechanism for property owners to facilitate displacement prior to property redevelopment and neighborhood change. Models of property-level turnover in the city of Seattle reveal that evictions are more likely to occur at properties that are sold in the same year, properties where planned demolition or remodeling activity is imminent, and buildings that were recently constructed. Increased likelihood of eviction is also associated with a greater volume of remodeling and demolition permit applications filed in the surrounding neighborhood, suggesting that evictions may be more likely to occur at the early stages of development-driven neighborhood change. These findings highlight the multifaceted relationship between evictions and property turnover and illustrate the value of administrative microdata for displacement research.
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Affiliation(s)
- Alex Ramiller
- Department of City and Regional Planning, University of California - Berkeley, 230 Wurster Hall #1820, Berkeley, CA, USA 94720
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Scott-Storey K, O'Donnell S, Busolo D, DiTommaso E, Malcolm J, Taylor P, Vincent CD, Wuest J. Cumulative lifetime violence severity, social determinants and anxiety in a national sample of Canadian men. BMC Psychiatry 2022; 22:265. [PMID: 35421946 PMCID: PMC9008675 DOI: 10.1186/s12888-022-03865-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/14/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite anxiety disorders being the ninth leading cause of disability and associated with social inequities, little attention has been given to how intersections among social determinants of health and chronic stressors such as cumulative lifetime violence affect the likelihood of experiencing anxiety disorders. Our purpose was to explore the relationships among cumulative lifetime violence severity as target and perpetrator, social determinants of health and generalized anxiety disorder in Canadian men. METHODS Using a community sample of 592 Canadian men who self-identified as having experienced violence, we developed and tested an evidence-based model of generalized anxiety disorder including indicators of cumulative lifetime violence, gender, social location, socio-economic disparity, personal resources and other chronic stressors using logistic regression. RESULTS Most men (76.4%, n = 452) reported experiences as both target and perpetrator. The model accounted for 50.8% of the variance in anxiety severity χ2 (8) = 264.43, p = .000). The prevalence of probable generalized anxiety disorder was 30.9%, a rate higher than that found among Canadian men in general in the same period. Remarkably, the likelihood of generalized anxiety disorder increased by a factor of 5.30 for each increase of 1 in cumulative lifetime violence severity, and six-fold for feeling overwhelmed by demands of everyday life (aOR = 6.26). Masculine discrepancy stress, having been born in Canada, unemployment, and food insecurity also contributed significantly to increasing the likelihood of generalized anxiety disorder. Both social support and mastery had significant aORs < 1, suggesting possible protective effects. Together these findings delineate characteristics and social determinants that may heighten vulnerability to generalized anxiety disorder and influence its progression among men who have experienced lifetime violence. CONCLUSIONS These findings are the first evidence that Canadian men with lifetime violence histories are a sub-group disproportionately affected by chronic stressors and socio-economic disparities and that together the presence and/or severity of these factors increases their vulnerability to generalized anxiety disorder. Our results highlight the importance of strengths-based trauma- and violence-informed approaches to care, including practical resources to reduce the stress of everyday life, improve social support, and reinforce personal control and choice.
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Affiliation(s)
- Kelly Scott-Storey
- Faculty of Nursing, University of New Brunswick, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - Sue O'Donnell
- Faculty of Nursing, University of New Brunswick, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - David Busolo
- Faculty of Nursing, University of New Brunswick, Moncton, Canada
| | - Enrico DiTommaso
- Department of Psychology, University of New Brunswick, Saint John, Canada
| | - Jeannie Malcolm
- Faculty of Nursing, University of New Brunswick, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - Petrea Taylor
- Faculty of Nursing, University of New Brunswick, Moncton, Canada
| | - Charlene D Vincent
- Faculty of Nursing, University of New Brunswick, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada
| | - Judith Wuest
- Faculty of Nursing, University of New Brunswick, P.O. Box 4400, Fredericton, NB, E3B 5A3, Canada.
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Race, mental health, and evictions filings in Memphis, TN, USA. Prev Med Rep 2022; 26:101736. [PMID: 35242502 PMCID: PMC8866154 DOI: 10.1016/j.pmedr.2022.101736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/06/2022] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Eviction filing rates are associated with mental distress in Black neighborhoods. Eviction prevention should consider housing market dynamics and racial segregation. Public policy interventions are needed to address the adverse effects of evictions.
Although evictions are a major disruptor of residential stability, their contribution to health disparities is understudied. Both experiencing eviction and the threat of being evicted are associated with adverse physical and mental health outcomes. Communities with higher proportions of Black people have higher rates of eviction filings. Market characteristics alone are insufficient for explaining the clustering of eviction in neighborhoods of color. Memphis is the fastest-growing rental market in the United States, facing an eviction crisis and is rife with persistent racial health disparities. This study explored the relationship between eviction filings, mental health, and neighborhood racial composition in Memphis to inform local policy approaches. We combined health from the City Health Dashboard, 2019 American Community Survey 5-year estimates, and eviction filings from the Shelby County, TN General Sessions Civil Court. Multivariate regression models were used to examine the relationship between health outcomes and eviction filing rates while controlling other relevant neighborhood characteristics. Separate models were run based on neighborhood racial composition. Poor mental health was significantly associated with higher eviction filling rates in majority Black neighborhoods but not in majority white and racially mixed neighborhoods. These findings point to evictions as an important contributor to racial health inequities in Memphis and the importance of race-conscious policy interventions that address the dual crisis of evictions and racial health disparities.
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Housing Insecurity and Mental Health: the Effect of Housing Tenure and the Coexistence of Life Insecurities. J Urban Health 2022; 99:268-276. [PMID: 35303243 PMCID: PMC9033895 DOI: 10.1007/s11524-022-00619-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 10/18/2022]
Abstract
While the adverse effects of housing insecurity on mental health are known, much less is known about the modifiers underlying these effects. The aim of this study was to analyze the mental health of people with housing insecurity by housing tenure and considering the coexistence of other life insecurities (energy poverty and food insecurity). We conducted a cross-sectional study through a survey performed in all people attending the Platform for People Affected by Mortgages or the Alliance against Energy Poverty of Barcelona for the first time between June 2017 and December 2019 and who reported housing insecurity. The dependent variables were the risk of poor mental health, self-reported anxiety and/or depression, and the use of psychotropic drugs. We fitted age-adjusted robust Poisson regression models for each dependent variable and estimated adjusted prevalence ratios (aPR). The study included 256 women and 104 men. The prevalence of poor mental health was 89% in women and 85.3% in men, which was much higher than that in the general population of Barcelona (19.5% and 14.5%, respectively). Among women, mental health was worse in those living in a squat (aPR 1.16; 95% CI: 1.02-1.31) and in those with food insecurity (aPR 1.11; 95% CI: 1.01-1.21). The number of coexisting insecurities showed a gradient effect (3 insecurities: aPR 1.21; 95% CI: 1.01-1.45). Among men, the results showed no clear pattern. Poor mental health was highly prevalent in people with housing insecurity and was exacerbated by the coexistence of life insecurities. Public policymakers should consider the complexity of persons with housing insecurity.
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Aquino T, Brand JE, Torche F. Unequal effects of disruptive events. SOCIOLOGY COMPASS 2022; 16:e12972. [PMID: 38895138 PMCID: PMC11185416 DOI: 10.1111/soc4.12972] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/07/2022] [Indexed: 06/21/2024]
Abstract
Disruptive events have significant consequences for the individuals and families who experience them, but these effects do not occur equally across the population. While some groups are strongly affected, others experience few consequences. We review recent findings on inequality in the effects of disruptive events. We consider heterogeneity based on socioeconomic resources, race/ethnicity, the likelihood of experiencing disruption, and contextual factors such as the normativity of the event in particular social settings. We focus on micro-level events affecting specific individuals and families, including divorce, job loss, home loss and eviction, health shocks and deaths, and violence and incarceration, but also refer to macro-level events such as recession and natural disasters. We describe patterns of variation that suggest a process of resource disparities and cumulative disadvantage versus those that reflect the impact of non-normative and unexpected shocks. Finally, we review methodological considerations when examining variation in the effect of disruptive events.
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Affiliation(s)
- Taylor Aquino
- University of California, Los Angeles, California, USA
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46
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Vásquez-Vera C, Fernández A, Borrell C. Gender-based inequalities in the effects of housing on health: A critical review. SSM Popul Health 2022; 17:101068. [PMID: 35360438 PMCID: PMC8961216 DOI: 10.1016/j.ssmph.2022.101068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/09/2022] Open
Abstract
Gender and its power relations are produced and reproduced in the housing sphere, leading to inequalities in living conditions and, therefore, in gender inequalities in health outcomes. The aim of the study is to review the published literature on gender, housing and health, to critically evaluate the incorporation of the gender perspective, and to incorporate this perspective into the conceptual framework of housing and health. Using the critical review method, we conducted a literature review in MEDLINE, Scopus, WOS and Redalyc, without restriction of publication date, including studies published up to October 2020. We analyzed the gender perspective in health research using the Gender Perspective in Health Research Questionnaire and described the results according to main housing dimensions. Of the 20,988 articles identified, we selected 90 for full-text analysis, of which 18 were included in the feminist research category, 27 in gender-sensitive, 31 in sex difference and 14 did not include any gender perspective. Regarding the association between housing and health, most studies analyzed affordability (36%) and physical conditions (32%), and trends in health outcomes by gender varied according to each exposure analyzed, although overall the effects were worse for women and non-binary or trans people. To date, very few studies consider the gender perspective. It is urgent to address gender relations in housing and health studies, and to open an interdisciplinary and intersectoral agenda to address this complex relationship.
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Ettman CK, Adam GP, Clark MA, Wilson IB, Vivier PM, Galea S. Wealth and depression: A scoping review. Brain Behav 2022; 12:e2486. [PMID: 35134277 PMCID: PMC8933775 DOI: 10.1002/brb3.2486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/16/2021] [Accepted: 12/08/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The inverse relation between income and depression is well established. Less is understood about the relation between wealth and depression. We therefore conducted a scoping review to answer the question: What is known from the existing literature about the relation between wealth and depression? METHODS We searched for studies and articles in Medline (via PubMed), Embase, PsycINFO, PsycArticles, EconLit, and SocINDEX from inception through July 19, 2020. Ninety-six articles were included in our review. Key article characteristics were year of publication, sample size, country, study design, definition of depression, definition of wealth, and association between wealth and depression. Thirty-two longitudinal articles were included in a detailed charted review. RESULTS Depression was defined in a relatively standard manner across articles. In contrast, definitions and measurements of wealth varied greatly. The majority of studies in the full review (n = 56, 58%) and half of the studies in the longitudinal charted review (n = 16, 50%) reported an inverse relation between wealth and depression. The longitudinal charted review showed that (1) macro-economic events influenced depression, (2) wealth status influenced depression across the lifecourse, (3) wealth protected against depression in the face of stressors such as job loss, (4) subjective or psychosocial factors such as perception of wealth, relative comparison, and social status modified the relation between wealth and depression, and (5) savings interventions were successful in reducing depression and varied by context. CONCLUSION These findings suggest that wealth should be included in our consideration of the forces that shape mental health.
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Affiliation(s)
- Catherine K Ettman
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, USA.,Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Gaelen P Adam
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Melissa A Clark
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Ira B Wilson
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Patrick M Vivier
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Providence, Rhode Island, USA
| | - Sandro Galea
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, USA
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Biederman DJ, Callejo-Black P, Douglas C, O’Donohue HA, Daeges M, Sofela O, Brown A. Changes in health and health care utilization following eviction from public housing. Public Health Nurs 2022; 39:363-371. [PMID: 34492122 PMCID: PMC9279006 DOI: 10.1111/phn.12964] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study sought to (1) determine the number of persons evicted from the Durham Housing Authority (DHA) over a 5-year period, (2) explore changes in the number of persons with various medical diagnoses and health care utilization patterns before and after eviction, and (3) examine how many persons evicted from DHA became literally homeless. DESIGN This was a pre/post cross-sectional quantitative study. SAMPLE Heads of households evicted from DHA properties from January 1, 2013 through December 31, 2017 were included in the study. MEASUREMENTS We matched people evicted by the DHA in a university health system electronic health record system to determine changes in diagnoses and health care utilization before and after eviction. We also matched the cohort in the homeless management information system to determine how many persons evicted became literally homeless. RESULTS Findings indicate statistically significant increases in persons with medical diagnoses in five of ten categories, total hospital admissions, and emergency department visits after eviction. Of the 152 people included in the study, 34 (22%) became literally homeless. CONCLUSIONS Health and health care utilization patterns were different before and after eviction. Implications for clinicians are explored.
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Affiliation(s)
| | | | | | | | - Monica Daeges
- Alumna of Duke University School of Nursing, Durham, NC
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Characterization of Healthy Housing in Africa: Method, Profiles, and Determinants. J Urban Health 2022; 99:146-163. [PMID: 35079945 PMCID: PMC8788402 DOI: 10.1007/s11524-021-00603-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/02/2022]
Abstract
Housing is a key social determinant of health with implications for both physical and mental health. The measurement of healthy housing and studies characterizing the same in sub-Saharan Africa (SSA) are uncommon. This study described a methodological approach employed in the assessment and characterization of healthy housing in SSA using the Demographic and Health Survey (DHS) data for 15 countries and explored healthy housing determinants using a multiple survey-weighted logistic regression analysis. For all countries, we demonstrated that the healthy housing index developed using factor analysis reasonably satisfies both reliability and validity tests and can therefore be used to describe the distribution of healthy housing across different groups and in understanding the linkage with individual health outcomes. We infer from the results that unhealthy housing remains quite high in most SSA countries. Having a male head of the household was associated with decreased odds of healthy housing in Burkina Faso (OR = 0.80, CI = 0.68-0.95), Cameroon (OR = 0.65, CI = 0.57, 0.76), Malawi (OR = 0.70, CI = 0.64-0.78), and Senegal (OR = 0.62, CI = 0.51-0.74). Further, increasing household size was associated with reducing odds of healthy housing in Kenya (OR = 0.53, CI = 0.44-0.65), Namibia (OR = 0.34, CI = 0.24-0.48), Nigeria (OR = 0.57, CI = 0.46-0.71), and Uganda (OR = 0.79, CI = 0.67-0.94). Across all countries, household wealth was a strong determinant of healthy housing, with middle and rich households having higher odds of residing in healthy homes compared to poor households. Odds ratios ranged from 3.63 (CI = 2.96-4.44) for households in the middle wealth group in the DRC to 2812.2 (CI = 1634.8-4837.7) in Namibia's wealthiest households. For other factors, the analysis also showed variation across countries. Our findings provide timely insights for the implementation of housing policies across SSA countries, drawing attention to aspects of housing that would promote occupant health and wellbeing. Beyond the contribution to the measurement of healthy housing in SSA, our paper highlights key policy and program issues that need further interrogation in the search for pathways to addressing the healthy housing deficit across most SSA countries. This has become critical amid the COVID-19 pandemic, where access to healthy housing is pivotal in its control.
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50
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Bushman G, Mehdipanah R. Housing and health inequities during COVID-19: findings from the national Household Pulse Survey. J Epidemiol Community Health 2022; 76:121-127. [PMID: 34226259 PMCID: PMC8260303 DOI: 10.1136/jech-2021-216764] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/26/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND COVID-19 has exploited the inequities within the US housing system. Examining the association between housing and health during the pandemic is imperative to reducing health inequities and improving population health. METHODS We analysed 957 714 responses from the Household Pulse Survey Study, collected between April and July 2020. Using survey-weighted multivariable regression analyses, we assessed the relationships between housing tenure and health, both on average and over time, as well as how these relationships were moderated by COVID-19-related hardships including job loss, food insecurity and inability to afford housing-related costs. We controlled for a variety of potential socioeconomic and demographic confounding factors. RESULTS We found that housing tenure was significantly associated with both self-rated health and mental distress. Compared with homeowners without mortgage debt, homeowners with mortgage debt reported worse self-rated health (β=-0.13; 95% CI -0.15 to -0.12, p<0.001) and greater mental distress (β=0.50; 95% CI 0.44 to 0.55, p<0.001). Renters also reported worse self-rated health (β=-0.18; 95% CI -0.20 to -0.16, p<0.001) and greater mental distress (β=0.76; 95% CI 0.69 to 0.83, p<0.001) than homeowners without mortgage debt. Across all tenure groups, self-rated health decreased (β=-0.007; 95% CI -0.011 to -0.004, p<0.001) and mental distress increased (β=0.05; 95% CI 0.05 to 0.06, p<0.001) over this period. Additionally, time and COVID-19-related hardships compounded differences in health status between homeowners and renters. CONCLUSIONS These results add to a limited body of evidence suggesting that, during this period, housing instability and COVID-19-related hardships have contributed to an increase in health inequities in the USA.
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Affiliation(s)
- Gregory Bushman
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Roshanak Mehdipanah
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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