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- Title
Variation in State-Level Eviction Moratorium Protections and Mental Health Among US Adults During the COVID-19 Pandemic.
- Authors
Leifheit, Kathryn M.; Pollack, Craig E.; Raifman, Julia; Schwartz, Gabriel L.; Koehler, Robert D.; Rodriguez Bronico, Jackie V.; Benfer, Emily A.; Zimmerman, Frederick J.; Linton, Sabriya L.
- Abstract
Key Points: Question: Which eviction protections were associated with reduced mental distress among renters during the COVID-19 pandemic? Findings: In this cohort study assessing data from 2317 adult respondents of the Understanding Coronavirus in America Survey, moratoriums that blocked landlords from giving notice or filing for evictions were associated with a relative reduction in mental distress of approximately 13%, whereas protections that blocked only court hearings, judgments, and enforcement did not reduce distress significantly. Meaning: Findings indicate that only moratoriums that blocked eviction notice and filing were associated with reduced renter distress, suggesting that to protect renters' mental health, interventions should aim to prevent evictions before filing. Importance: Although evictions have been associated with adverse mental health outcomes, it remains unclear which stages of the eviction process are associated with mental distress among renters. Variation in COVID-19 pandemic eviction protections across US states enables identification of intervention targets within the eviction process to improve renters' mental health. Objective: To measure the association between the strength of eviction protections (ie, stages blocked by eviction moratoriums) and mental distress among renters during the COVID-19 pandemic. Design, Setting, and Participants: This cohort study used individual-level, nationally representative data from the Understanding Coronavirus in America Survey to measure associations between state eviction moratorium protections and mental distress. The sample of 2317 respondents included renters with annual household incomes less than $75 000 who reported a state of residence and completed surveys between March 10 and September 3, 2020, prior to the federal eviction moratorium order by the Centers for Disease Control and Prevention. Exposures: Time-varying strength of state moratorium protections as a categorical variable: none, weak (blocking court hearings, judgments, or enforcement without blocking notice or filing), or strong (blocking all stages of the eviction process beginning with notice and filing). Main Outcomes and Measures: Moderate to severe mental distress was measured using the 4-item Patient Health Questionnaire. Linear regression models were adjusted for time-varying state COVID-19 incidence and mortality, public health restrictions, and unemployment rates. Models included individual and time fixed effects as well as clustered standard errors. Results: The sample consisted of 2317 individuals (20 853 total observations) composed largely (1788 [78%] weighted) of middle-aged adults (25-64 years of age) and women (1538 [60%]); 640 respondents (23%) self-reported as Hispanic or Latinx, 314 respondents (20%) as non-Hispanic Black, and 1071 respondents (48%) as non-Hispanic White race and ethnicity. Relative to no state-level eviction moratorium protections, strong protections were associated with a 12.6% relative reduction (risk ratio, 0.87; 95% CI, 0.76-0.99) in the probability of mental distress, whereas weak protections were not associated with a statistically significant reduction (risk ratio, 0.96; 95% CI, 0.86-1.06). Conclusions and Relevance: This analysis of the Understanding Coronavirus in America Survey data found that strong eviction moratoriums were associated with protection against mental distress, suggesting that distress begins early in the eviction process with notice and filing. This finding is consistent with the idea that to reduce mental distress among renters, policy makers should focus on primary prevention of evictions. This cohort study uses individual-level data from respondents of the Understanding Coronavirus in America Survey to assess associations between various levels of eviction protections and mental distress among renters during the COVID-19 pandemic.
- Subjects
UNITED States; HOUSING laws; CONFIDENCE intervals; HISPANIC Americans; MENTAL health; REGRESSION analysis; QUESTIONNAIRES; DESCRIPTIVE statistics; WHITE people; ODDS ratio; DATA analysis software; PSYCHOLOGICAL distress; COVID-19 pandemic; LONGITUDINAL method; PROBABILITY theory
- Publication
JAMA Network Open, 2021, Vol 4, Issue 12, pe2139585
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2021.39585