Forced to move: Eviction, household health and hardships in families with very young children

Infant and toddler health and development is affected by housing instability – specifically when families experience eviction. In a new study that focused on a large, geographically, and racially/ethnically diverse sample of families with young children, researchers examined how history of formal and informal evictions affect child and parent health and family economic hardship. The “Eviction and Household Health and Hardships in Families with Very Young Children,” study is available in the October 2022 Pediatrics.

“Most data on evictions relies on court filings to know how many families have been evicted,” explains Dr. Diana Cutts, Chair of Pediatrics at Hennepin Healthcare in Minneapolis and the lead author of the study. “However, evictions don’t always go through the courts and we wanted to capture both formal and informal evictions to understand how that affected child and adult health. We interviewed families in emergency departments and primary care clinics.”

Nearly 2 million US households are evicted or involuntarily displaced annually, and those with children are at an increased risk for eviction – a risk that increases with each additional child.

“You can just imagine how disrupting these evictions can be for families – especially abrupt, informal evictions when there’s a sudden displacement that is catastrophic for families, leading them to accept whatever housing is available at the time, regardless of location or quality,” said Dr. Cutts.

The families in this study are not nationally representative but rather a sentinel sample, primarily composed of families with low incomes accessing urban hospitals with a high proportion of both caregivers of color and immigrant caregivers, compared to national statistics.

Using cross-sectional surveys of 26,441 caregivers with a young child less than 48-month-old from 2011-2019 in emergency departments (ED) and primary care clinics, Dr. Cutts and her team investigated relationships between 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.

Compared to no evictions, evictions were associated with 1.43 greater odds of the child to have fair to poor health, 1.55 greater odds of the child to have developmental risk, and 1.24-times greater odds for the child to have hospital admission from the ED, as well as adverse caregiver and hardship outcomes.

While eviction’s causes and consequences may be complex and varied, the study’s findings suggest reducing evictions, both formal and informal, may address health disparities and help young families meet their basic needs. Policymakers, community organizations, and health professionals have important roles in designing evidence-based policy solutions to reduce evictions and improve opportunities for families to meet their basic needs. This study’s findings provide evidence to support investment in rental assistance and affordable housing production, eviction prevention 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.

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Minnesota health care systems declare gun violence a public health crisis

Health systems commit to collectively address growing crisis.

Health care leaders across Minnesota are joining together to express their shared view that gun violence is a public health crisis. Health care systems share a unique perspective on this growing crisis and the impact the lives lost and those forever changed by gun violence has on the health and well-being of our communities.

To address the epidemic of gun violence both locally and nationally, Minnesota’s health care systems have pledged to collaborate and take action on the development of solutions to prevent gun violence and advance important conversations on reforms to protect patients, employees and communities.

The CEOs from Allina Health, CentraCare, Children’s Minnesota, Essentia Health, Fairview Health Services, Gillette Children’s, HealthPartners, Hennepin Healthcare, North Memorial Health and Sanford Health have released the statement below:

As leaders of some of our state’s health care systems, we believe it is time to declare gun violence as a public health crisis and to work to prevent the deaths of innocent people of all ages and backgrounds. We must look no further than the recent shootings on a hospital campus in Tulsa, Oklahoma, at a school in Uvalde, Texas, a grocery store in Buffalo, New York, and countless others just this past year to see its devastating impacts. According to the Centers for Disease Control and Prevention, in 2020 more than 19,000 American lives were lost due to homicide involving a gun. That same year, guns became the leading cause of death for children and teenagers. These statistics are appalling and outrage us as health care providers and should outrage us all. Everyone deserves a world where they can feel safe and live their lives without fear of gun violence.

Gun violence and its horrific impacts are preventable. It has reached epidemic levels and represents a significant threat to public health. 

As health care providers, we see the impacts of gun violence firsthand every day. We uniquely understand the devastation of this violence in our hospitals and clinics, and the toll it takes on individuals, families, communities and the care providers who treat the victims. We have an important role to play in creating a safer future for all. 

We will continue to be fierce advocates for the safety of our employees, patients and the communities we serve, inside and outside our hospital and clinic walls.  By formally declaring gun violence as the public health crisis that it is, we will collectively seek the solutions required to save lives and stem the tide of violence.

Lisa Shannon                                                                Kenneth Holmen, MD
President and CEO                                                       President and CEO
Allina Health                                                                 CentraCare

Marc Gorelick, MD                                                       David Herman, MD
President and CEO                                                       CEO
Children’s Minnesota                                                   Essentia Health

James Hereford                                                            Barbara Joers
President and CEO                                                       President and CEO
Fairview Health Services                                             Gillette Children’s

Jennifer DeCubellis                                                      Andrea Walsh
CEO                                                                                  President and CEO
Hennepin Healthcare                                                   HealthPartners

J. Kevin Croston, MD
President and CEO
North Memorial Health

Bill Gassen, CEO, Sanford Health

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