Evictions Threaten Our Health
By Allison Groves, Patrick Smith, Luwam Gebrekristos, and Kim Blankenship
September 20, 2023
In August 2021 the temporary national moratorium on evictions policy passed by the Centers for Disease Control and Prevention ended. Issued at the onset of the COVID-19 pandemic, the eviction moratorium sought to mitigate the substantial public health risks associated with housing instability. Evictions continue to pose significant threats to individual and community health, including increases in intimate partner violence (IPV) and sexual health risks.
Even more renters experience other forms of landlord-related forced moves, such as eviction threats or steep rent increases. Moreover, there are race and gender disparities in eviction rates, such that Black renters, and especially Black women, face a disproportionate risk of eviction. Given that non-payment of rent is the leading cause of eviction, rising rents and the expiration of the policy protections against eviction pose a significant threat to housing stability across the country.
Housing Instability Impacts Health
The physical displacement, material hardship, and stress resulting from eviction have significant negative effects across the life course. Eviction has been associated with increased risk of adverse birth outcomes, depressive symptoms, and disruptions in healthcare access.
Disruptions related to eviction may also affect sexual partnership dynamics commonly associated with HIV acquisition, including intimate partner violence (IPV).
Eviction can result in greater likelihood that one will perpetrate or be vulnerable to IPV. Being forced to leave one’s home may overwhelm an individual’s ability to cope with stress. It may also create a sense of powerlessness that may, in turn, increase the likelihood that a person will act aggressively – and perpetrate violence – against their partner. Likewise, the loss of one’s home may increase one’s susceptibility to violence, by increasing dependence on a partner and/or constraining the ability to flee violent situations.
Eviction + Intimate Partner Violence + HIV Risk
In a new study, we expand understanding of the negative health effects of an eviction by examining the intersection between eviction, IPV, and HIV risk. We used data from a longitudinal study of 282 low-income, predominantly male adults in New Haven, Connecticut to examine whether reporting a landlord-related forced move (including, but not limited to, legal eviction) at the beginning of the study was associated with IPV and HIV risk reported six months later. HIV-related risk factors were based on participants’ reports of whether, in the past six months, they had had unprotected sex; they or their partners had multiple concurrent partners; or they had exchanged sex for money, drugs, or a place to live.
Landlord-related forced moves, defined as experiencing a legal eviction or being forced to move due to a rent hike, non-payment of rent, landlord foreclosure, or an accusation of overcrowding or illegal activity, were commonplace. More than 20 percent of participants reported experiencing at least one of these events two years leading up to study participation.
In the current study, we found that individuals who reported landlord-related forced moves were 1.2 times more likely to report IPV six months later.
It’s not just that housing instability leads to IPV; IPV also can cause housing instability. Individuals who experience IPV may leave a house for their own safety, or in some cases, may be evicted by a landlord for being labeled a “common nuisance” because of too many calls to 911.
We also found that IPV within a relationship may also directly and/or indirectly impact an individual’s risk of HIV infection. Specifically, individuals who are in violent relationships may not be able to refuse sex, resulting in rape. Individuals in violent relationships may also face challenges negotiating the conditions of sex, which might lower their likelihood of using condoms. Participants reported high levels of both IPV and HIV-related risk six months later. Specifically, one in seven participants reported experiencing IPV victimization in the past six months, while one in ten reported perpetrating IPV in the past six months. Moreover, nearly 2/3 of all participants reported at least one HIV-related risk in the past six months: over half reported having unprotected sex, and approximately one-fifth reported concurrency within their sexual partnership.
These findings – that landlord-related forced moves affected HIV risk by contributing to heightened IPV – add to a growing body of evidence that the disruptions caused by landlord-related forced moves negatively impact health. Understanding the pathways through which eviction impacts health is critical to effectively responding to and supporting individuals undergoing eviction and other forms of involuntary displacement.
Renters Rights = Renters Health
These findings have several clinical and policy implications. First, healthcare providers can play a role in IPV prevention and care through the provision of violence screening and referrals. Referrals for those exposed to IPV can include linkage to trauma-informed care as well as other resources that may promote their housing stability or their safety within the context of their sexual relationship. Efforts to improve screening are particularly necessary in the context of the COVID-19 pandemic, during which researchers have observed high rates of economic strain and an increase, relative to pre-pandemic levels, in IPV-related calls to police departments.
Second, these findings also shine a light on the importance of policy-level solutions to prevent eviction and increase housing affordability to address the rising burden – and inequitable distribution – of evictions among low-income renters. Policies which support tenants’ rights during eviction proceedings (for instance, through access to legal representation in court via Right-to-Council) reduce tenants’ risk of eviction. In cases where eviction is unavoidable, policies which mitigate its negative effects (by sealing rental history records) reduce future homelessness. Finally, policies which make housing more affordable (such as housing voucher programs, inclusionary zoning policies, and expansion of alternative land ownership models, such as community land trusts) are urgently needed.
The findings of our study, alongside growing evidence of poor health outcomes following eviction, serve as a reminder that housing is a key social determinant of health.
Given that eviction filings in Connecticut are higher than pre-pandemic levels (see figure below), it may be more important than ever to document the significant negative impacts of eviction. Such understanding can inform our response to eviction and future policies and programs to reduce eviction in the future.
Legal eviction filings in CT, relative to historical average
(Eviction Tracking System, 2023)
Peter Hepburn, Renee Louis, and Matthew Desmond. Eviction Tracking System: Version 1.0. Princeton: Princeton University, 2020. www.evictionlab.org.
Allison Groves is Associate Professor in the Dornsife University School of Public Health at Drexel University
Patrick Smith is PhD candidate in the Dornsife University School of Public Health at Drexel University
Luwam Gebrekristos is a PhD candidate in the Dornsife University School of Public Health at Drexel University
Kim Blankenship is Distinguished Professor in the Sociology Department at American University.
Photo credit: Istock.com/bodnarchuk