The Concentrated Geography of Eviction

Eviction as a community health exposure

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.

Housing instability and psychological distress in African American cancer survivors: findings from the Detroit Research on Cancer Survivors study

PURPOSE

As health care systems seek to screen for and address housing instability in patient populations, robust evidence linking unstable housing to patient-reported outcomes is needed. Housing instability may increase psychological distress in cancer survivors, potentially more so among African American cancer survivors who are also likely to experience disproportionate burden of housing instability. The purpose of this analysis was to estimate associations between housing instability and psychological distress in African Americans diagnosed with cancer.

METHODS

We included survey responses from 2875 African American cancer survivors in the Detroit Research on Cancer Survivors (ROCS) study. We examined how housing instability at enrollment, using an item adapted from the Health Leads Screening Toolkit, related to psychological distress at enrollment, using Patient Reported Outcomes Measurement System (PROMIS) 4-item anxiety and depression short forms. Linear regression models adjusted for sociodemographic factors were used to estimate associations overall and stratified by stage at diagnosis.

RESULTS

Approximately 12% of participants reported being unstably housed. Housing instability was associated with significant differences in PROMIS scores for both anxiety (difference: 6.79; 95% CI: 5.57-8.01) and depression (difference: 6.16; 95% CI: 4.99-7.34). We did not find meaningful differences stratifying by disease stage.

CONCLUSION

Housing instability was experienced by over a tenth of this cohort of African American cancer survivors and was related to statistically and clinically meaningful differences in psychological distress even following adjustment for sociodemographics.

IMPLICATIONS FOR CANCER SURVIVORS

These findings provide evidence supporting screening of housing instability in cancer survivors, especially those from medically underserved populations.

Landlords' rental businesses before and after the COVID-19 pandemic: Evidence from a National Cross-Site Survey

This paper uses a survey of over 2500 rental property owners in ten cities across the United States to determine the impact of the COVID-19 pandemic on landlords' rent collection and business behavior. Our findings show that yearly rent collection was down significantly in 2020 relative to 2019-both within and across rental markets-and that an increasing number of owners have a large share of their portfolio behind on rent. Small owners and owners of color faced the highest exposure to deep tenant arrears in 2020, challenges they were also more likely to face prior to pandemic. Our findings show that owner business practices changed dramatically in 2020, with a higher share of landlords granting tenants rent extensions or forgiving back rent during the pandemic relative to prior. However, many owners also disinvested in their rental properties through deferred maintenance, missed mortgage payments, and property sale listings. Landlords of color pursued disinvestment strategies during the pandemic at an elevated rate compared to white landlords. Owners of properties in neighborhoods with more non-white residents were both more likely to experience decreased rent collection and more likely to pursue evictions and rental late fees holding constant rental payment rates, implying the pandemic has disproportionately affected renters in communities of color. Overall, our findings highlight the strain the pandemic has placed on the housing stock, which has implications for the long-term viability and affordability of many of these units. More concerningly, our results show that households of color-which have been disproportionately affected by the pandemic in other domains-were more likely to face punitive measures from landlords in both 2019 and 2020, suggesting the pandemic has exacerbated existing racial inequality in housing markets.

Unequal effects of disruptive events

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.