The Pending Eviction Crisis Is Going to Make Covid-19 Even Worse
Research shows eviction and homelessness lead to ‘deaths of despair’
Covid-19 has contributed to increased business closings, leaving high numbers of Americans unemployed. As a result, eviction is becoming more commonplace. That can mean a family, often with children, is physically removed from their home and left — suddenly — without shelter.
The CARES Act’s federal ban on eviction expired on July 24, 2020. It had protected tenants from eviction since March 27, 2020. Tenants are now reliant on state protections only, which leaves them increasingly vulnerable. The research on homelessness and health points to likely grave consequences here: The physical and mental health of many may be in jeopardy as 2020 marches on.
Brendan O’Flaherty, professor of economics at Columbia University, estimates homelessness in the U.S. could exceed 40% this year due to the anticipated increase in evictions from Covid-19 economic distress.
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Covid-19: implications on evictions and homelessness
Professor Emily Benfer is a leading expert on evictions. She serves as chair of the American Bar Association’s Task Force Committee on Eviction. Benfer is also co-creator of the Covid-19 Housing Policy Scorecard with Princeton University’s Eviction Lab.
She has investigated state actions on evictions and shares them in a public database. The database also contains summary information regarding Covid-19 legislation throughout the U.S. that impacts evictions and foreclosures. Benfer believes evictions and homelessness could further contribute to the spread of Covid-19, worsening the epidemiological impact on the U.S.
In a CNBC interview in July, Benfer asserted that, as support measures expire in the coming weeks and months, the U.S. is due to face unprecedented eviction rates. “We’re looking at 20 million to 28 million people at this moment, between now and September, facing eviction.”
Deaths of despair
We know that people who cannot shelter properly face an array of health assaults. The husband-wife team of Angus Deaton (Nobel laureate in economics) and Anne Case have examined these issues closely. In their book, Deaths of Despair and the Future of Capitalism, they note a recent decline in life expectancy for Americans aged 45–54, a pattern seen in very few other places on Earth.
Significant empirical evidence associates eviction and bad health outcomes, both mental and physical. The existential threat from Covid-19 is potentiating these outcomes.
They attest that much of the longevity decline stems from higher rates of “deaths of despair.” These deaths involve suicide, opioid overdoses, and alcohol-related illnesses — all of which occur at higher rates in evicted populations. Case and Deaton also note that this reversal in longevity exists almost entirely among white Americans who lack four-year college degrees, a demographic that accounts for 38% of the working-age population in the U.S.
Increased suicide rates
In 2014, Katherine Fowler, PhD, and her team from the Centers for Disease Control and Prevention (CDC) published one of the earliest studies associating suicide with home eviction and foreclosure. They concluded that housing loss is a crisis that can precipitate suicide. Their study tracked and analyzed violent deaths from 2005–2010 from 16 states that maintained such statistics.
Additionally, the report suggested various suicide prevention strategies for recent or imminent evictees. These strategies include training financial professionals to detect warning signs, providing support for those projected to lose their home, intervention before move-out date, and bolstering populationwide suicide prevention measures during economic crises.
Certain communities, such as Washington County, Oregon, appear to have successfully implemented some of these strategies. After putting training and prevention efforts in place, Washington County’s suicide rate fell by 40% between 2015 and 2019.
Kimberly Repp is Washington County’s public health program supervisor and epidemiologist. From 2014–2016, she visited over 200 death scenes and created a list of 46 risk factors she believed contributed to death by suicide. This list led to an expansion of Washington County’s list of partner organizations targeted for training, prevention, and intervention efforts.
Washington County uses the “QPR” approach: question, persuade, refer. QPR is a series of techniques and interventions accredited as an evidence-based practice by the Substance Abuse and Mental Health Services Administration (SAMHSA), a division of the U.S. Department of Health and Human Services. Washington County provides QPR training to people who may interact with someone in danger of eviction. Trained personnel bluntly ask the potential evictee if they’re considering harming themself. Then they persuade the person to remember those people in their life who can help and to think of things for which they are grateful. Finally, the person intervening provides a referral to various community resources for additional help.
Compromised health parameters and inequities
In March 2016, Hugo Vásquez-Vera and his team of researchers from the Department of Experimental and Health Sciences in Barcelona conducted a literature review related to eviction. They assessed the threat of home eviction and potential health impacts through the equity lens. Their study was published in the February 2017 issue of the journal Social Science & Medicine. The 47 articles reviewed were primarily from the U.S. and other Anglo-Saxon countries (86%), and most were dated from 2009–2016 (75%).
The review found that individuals under threat of eviction showed statistically significant adverse health outcomes — both mental and physical. These outcomes included depression, anxiety, psychological distress, suicide, poor self-reported health, high blood pressure, and child maltreatment.
The severity of these adverse health outcomes varied according to gender, age, ethnicity, and geographic location. For example, three of the studies reviewed by Vasquez, et al. found that eviction threat had a stronger effect on the mental and physical health of women than men. Another study from their literature review found that problems in paying rent or mortgage had a significantly increased association with alcohol dependence and drinking consequences for men, but not women.
Rising deaths related to adverse economic outcomes
Additionally worrisome findings were published in the December 2019 issue of the journal Health Services Research. This study explored the impact of evictions on accidental drug and alcohol mortality. W. David Bradford, PhD, of the Department of Public Administration and Policy at the University of Georgia, and Ashley C. Bradford, of the Paul H. O’Neill School of Public and Environmental Affairs at Indiana University, analyzed data from 2003–2016. Bradford and Bradford investigated the nascent eviction crisis (later described by Case and Deaton in Deaths of Despair). They concluded that evictions are associated with several adverse economic conditions, and that deaths of despair related to these conditions have been rising. More specifically, Bradford and Bradford found that deaths of despair occur in response to traumatic life events such as eviction. Additionally, higher eviction rates are associated with higher rates of substance abuse related to accidental deaths.
Impact of homelessness on children
Eviction leading to homelessness is especially tragic for children. A 2016 study found a correlation between homelessness and compromised health in children. Sandra Ahumada, PhD, at the University of Minnesota Institute of Child Development, and her team published their results in the Journal of Children and Poverty in 2017. They found that children who experience homelessness have an increased risk of elevated stress levels, health problems, and the need for pediatric care.
A previous study, also from the University of Minnesota Institute of Child Development, in the April 1993 Journal of Consulting and Clinical Psychology found similar issues. Ann S. Masten, PhD, and her team showed that children in homeless families faced increased risk to both mental health and development. Overall, these children had greater stress exposure. Additionally, they suffered from disrupted schooling and friendships. They also had behavior problems above normative levels, especially antisocial behavior.
One tragedy begets another
Significant empirical evidence associates eviction and bad health outcomes, both mental and physical. The existential threat from Covid-19 is potentiating these outcomes. To make matters worse, eviction often cascades into homelessness. This can trigger even more dangerous situations such as suicide and long-lasting developmental problems for children.
In addition to the erosion of mental and physical health by eviction, there has been a more subtle, but equally important effect on the faith of citizens in their government. This faith is predicated on the existence of a social contract between the United States and its citizens. By and large, Americans support a government we believe will protect certain “inalienable rights.” This is the fabric of our social contract — and it’s starting to tear.
If you (or someone you know) are in crisis and in need of urgent help, please contact the National Suicide Prevention Lifeline at (800) 273–8255.