Significance: A growing share of families rent their homes and, given rising housing costs and stagnant incomes, find themselves unable to pay rent and facing eviction. Evidence suggests that low-income urban families with children experience disproportionately high burdens of eviction. Residential mobility has been shown to cause poor health and cognitive development among children and evictions may be particularly damaging source of mobility, with respect to children's wellbeing. In one study, family eviction history was associated with a 10% increase in the probability of poor parent-reported child health. However, the extent and geographic scope of eviction among low-income U.S. families with children is not known, nor has eviction been causally linked to the development of specific diseases or deficiencies in childhood. Finally, research has not begun to explore mechanisms through which evictions might cause negative child health outcomes.
Specific Aims :
We aim to 1) determine the prevalence and spatial patterning of eviction among low-income families with children (<18 years of age) in the U.S. in 2013, 2) determine the association between family eviction in very early childhood (ages 0-4) and developmental and health outcomes (i.e. cognitive development, weight-for-height, and asthma control) in middle childhood and adolescence (ages 5-15) among low-income children born in large U.S. cities between 1998 and 2000 and 3) Determine the association of family eviction with 1) social safety net program participation and 2) access to resources in very early childhood (0-4 years) among children in Baltimore City between 2011 and 2016. The long-term objective of this project is to inform housing policies and identify targets for interventions to improve child health among low-income families. Approach:
Aim 1 will use descriptive epidemiology and spatial statistics to measure the prevalence and spatial patterning of eviction among families with children in the American Housing Survey.
Aim 2 will use data from the Fragile Families and Child Wellbeing Study, a birth cohort of low-income children in 20 large US cities, to determine, via longitudinal data analysis, whether children who experience eviction in very early childhood are at increased risk of poor child health outcomes in middle childhood and adolescence.
Aim 3 will focus on Baltimore, the U.S. city with the most court-ordered evictions per capita, and will leverage data from the Children's HealthWatch Survey to measure associations between eviction, participation in social safety net programs (SNAP, WIC, and Medicaid), food security, and healthcare continuity. Fellowship Information: Through a combination of coursework, professional skills development, and mentored research training, the proposed training program will equip Ms. Leifheit with the knowledge, skills, and experience to complete the aims of the proposed research and become a successful academic social epidemiologist, studying the intersection of housing policy and child health.

Public Health Relevance

A growing number of families in the United States are evicted from their homes. We hypothesize that the experience of eviction is harmful to the health of children. This study will 1) describe the rates and geographic distribution of eviction in the U.S., among low-income families with children, 2) determine whether eviction in very early childhood is associated with poor child health and cognitive development later in life and 3) determine whether these health and development problems might arise from limited family access to social safety net programs (food stamps, Medicaid) and resources (food, healthcare) around the time of eviction.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Predoctoral Individual National Research Service Award (F31)
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Special Emphasis Panel (ZRG1)
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Chinn, Juanita Jeanne
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Johns Hopkins University
Public Health & Prev Medicine
Schools of Public Health
United States
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