Eviction and Household Health and Hardships in Families With Very Young Children

• Published in: Pediatrics (Evanston) Vol. 150; no. 4; p. 1
• Main Authors: Cutts, Diana B., Ettinger de Cuba, Stephanie, Bovell-Ammon, Allison, Wellington, Chevaughn, Coleman, Sharon M., Frank, Deborah A., Black, Maureen M., Ochoa, Eduardo, Chilton, Mariana, Lê-Scherban, Félice, Heeren, Timothy, Rateau, Lindsey J., Sandel, Megan
• Format: Journal Article
• Language: English
• Published: Evanston American Academy of Pediatrics 01-10-2022
• Subjects: Caregivers; Children; Children & youth; Emergency medical care; Evictions; Health care; Housing; Medical screening; Pediatrics; Primary care; Sensitivity analysis
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2022-056692

BACKGROUND
Families with versus without children are at greater eviction risk. Eviction is a perinatal, pediatric, and adult health concern. Most studies evaluate only formal evictions.
METHODS
Using cross-sectional surveys of 26 441 caregiver or young child (<48 months) dyads from 2011 to 2019 in emergency departments (EDs) and primary care clinics, we investigated relationships of 5 year history of formal (court-involved) and informal (not court-involved) evictions with caregiver and child health, history of hospitalizations, hospital admission from the ED on the day of the interview, and housing-related and other material hardships.
RESULTS
3.9% of 26 441 caregivers reported 5 year eviction history (eviction), of which 57.0% were formal evictions. After controlling for covariates, we found associations were minimally different between formal versus informal evictions and were, therefore, combined. Compared to no evictions, evictions were associated with 1.43 (95% CI: 1.17–1.73), 1.55 (95% confidence interval [CI]: 1.32–1.82), and 1.24 (95% CI: 1.01–1.53) times greater odds of child fair or poor health, developmental risk, and hospital admission from the ED, respectively, as well as adverse caregiver and hardship outcomes. Adjusting separately for household income and for housing-related hardships in sensitivity analyses did not significantly alter results, although odds ratios were attenuated. Hospital admission from the ED was no longer significant.
CONCLUSIONS
Demonstrated associations between eviction and health and hardships support broad initiatives, such as housing-specific policies, income-focused benefits, and social determinants of health screening and community connections in health care settings. Such multifaceted efforts may decrease formal and informal eviction incidence and mitigate potential harmful associations for very young children and their families.