Eviction increases the risk of mental health harm among people experiencing homelessness in king county, WA
Date:
Presenting Author: Ihsan Kahveci, PhD Student, University of Washington
Abstract Background: Eviction represents a major threat to housing stability and increases the likelihood of homelessness, both of which are fundamental determinants of health. The paucity of reliable individual-level data has limited research on eviction and health relationships, particularly through the pathway of homelessness. This is a particularly salient topic as post-pandemic rents, evictions, and homelessness are exceeding pre-pandemic averages, increasing housing precarity and health challenges among the most vulnerable. This study uses a new survey that measures the relationship of eviction, homelessness, and mental health. Methods: We employ a 2023 representative survey of King County, Washington’s unhoused population collected by a team at the University of Washington. The survey comprised 1,106 respondents, including demographics, the size and characteristics of their social networks, and self-reported health assessments.
We used propensity scores to estimate the average marginal effect of being evicted on self-reported health, substance use, and mental health, accounting for confounding demographic characteristics (age, gender, race/ethnicity), duration of homelessness, and sheltered or unsheltered status. Full matching on the propensity score was estimated using a probit regression of eviction on the covariates, yielding better balance than a logistic regression.
To estimate the treatment effect and its standard error, we fit a sample weighted logistic regression model with self-reported (overall) health (low/high), mental health problem (yes/no), and substance use (yes/no) as the outcome variable, and eviction (yes/no) as the exposure, covariate, and their interaction as predictors. We included propensity weights in the estimation. A cluster-robust variance was used to estimate standard error with matching stratum membership as the clustering variable.
Results: About 22% of our unhoused population sample reported (ever) being evicted, compared to 1.1% of the county’s renter population. Thus, eviction is a major issue in the Seattle-area homeless community.
We estimate the treatment effect (in log odds) as 0.109 (SE = 0.044, p = 0.013), indicating that getting evicted increases the odds of a mental health problem by 11%. We found no effect between eviction and self-reported physical (overall) health or substance use.
Discussion: We contribute additional evidence to a growing body of research demonstrating the health harms of eviction.