Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT
We sought to examine whether and how landlord-related forced moves (inclusive of, but not limited to, legal eviction) were associated with emergency department (ED) use over time.We used survey data collected between 2017 and 2019 among 283 low-income participants in New Haven, CT to examine whether...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Preventive Medicine Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335522002637 |
| _version_ | 1828105294864973824 |
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| author | Patrick D. Smith Allison K. Groves Brent A. Langellier Danya E. Keene Alana Rosenberg Kim M. Blankenship |
| author_facet | Patrick D. Smith Allison K. Groves Brent A. Langellier Danya E. Keene Alana Rosenberg Kim M. Blankenship |
| author_sort | Patrick D. Smith |
| collection | DOAJ |
| description | We sought to examine whether and how landlord-related forced moves (inclusive of, but not limited to, legal eviction) were associated with emergency department (ED) use over time.We used survey data collected between 2017 and 2019 among 283 low-income participants in New Haven, CT to examine whether experiencing a legal eviction or other landlord-related forced move (T0) was associated with increased odds of ED use 6 months (T1) and 12 months (T2) later. We conducted bootstrapped mediation analyses to examine indirect effects of post-traumatic stress symptoms.One-fifth of participants (n = 61) reported a recent forced move at baseline (T0); half of these were legally evicted. Landlord-related forced moves were associated with ED use at T1 (AOR = 2.06, 95 % CI: 1.04–4.06) and T2 (AOR = 3.05, 95 % CI: 1.59–5.88). After adjustment for sociodemographic factors and other health-related confounders, legal eviction was not significantly associated with ED use at T1 (AOR = 1.61, 95 % CI: 0.68–3.81), but was significantly associated with ED use at T2 (AOR = 3.58, 95 % CI: 1.58–8.10). Post-traumatic stress symptoms accounted for 15.1% of forced moves’ association with ED use (p <.05).Landlord-related forced moves are positively associated with subsequent ED use, and post-traumatic stress symptoms are one factor that may help explain this association. Structural interventions that promote housing stability are needed to advance health equity, and they may also help to reduce preventable ED use. Such interventions are imperative in the context of the COVID-19 pandemic, which has strained health system capacity and exacerbated housing instability for many low-income renters. Results underscore the relevance of trauma-informed care and integrated care management to clinical practice in emergency settings. |
| first_indexed | 2024-04-11T10:01:03Z |
| format | Article |
| id | doaj.art-d0cbbd5091e84c0a8136aae7547d7d82 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-04-11T10:01:03Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-d0cbbd5091e84c0a8136aae7547d7d822022-12-22T04:30:25ZengElsevierPreventive Medicine Reports2211-33552022-10-0129101956Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CTPatrick D. Smith0Allison K. Groves1Brent A. Langellier2Danya E. Keene3Alana Rosenberg4Kim M. Blankenship5Drexel University Dornsife School of Public Health, Department of Community Health and Prevention, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA; Corresponding author at: Drexel University Dornsife School of Public Health, 3215 Market St, Office 718, Philadelphia, PA 19104, USA.Drexel University Dornsife School of Public Health, Department of Community Health and Prevention, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USADrexel University Dornsife School of Public Health, Department of Health Management and Policy, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USAYale University School of Public Health, Department of Social and Behavioral Sciences, 60 College Street, New Haven, CT 06510, USAYale University School of Public Health, Department of Social and Behavioral Sciences, 60 College Street, New Haven, CT 06510, USAAmerican University, Department of Sociology, 4400 Massachusetts Avenue, Washington, DC 20016, USAWe sought to examine whether and how landlord-related forced moves (inclusive of, but not limited to, legal eviction) were associated with emergency department (ED) use over time.We used survey data collected between 2017 and 2019 among 283 low-income participants in New Haven, CT to examine whether experiencing a legal eviction or other landlord-related forced move (T0) was associated with increased odds of ED use 6 months (T1) and 12 months (T2) later. We conducted bootstrapped mediation analyses to examine indirect effects of post-traumatic stress symptoms.One-fifth of participants (n = 61) reported a recent forced move at baseline (T0); half of these were legally evicted. Landlord-related forced moves were associated with ED use at T1 (AOR = 2.06, 95 % CI: 1.04–4.06) and T2 (AOR = 3.05, 95 % CI: 1.59–5.88). After adjustment for sociodemographic factors and other health-related confounders, legal eviction was not significantly associated with ED use at T1 (AOR = 1.61, 95 % CI: 0.68–3.81), but was significantly associated with ED use at T2 (AOR = 3.58, 95 % CI: 1.58–8.10). Post-traumatic stress symptoms accounted for 15.1% of forced moves’ association with ED use (p <.05).Landlord-related forced moves are positively associated with subsequent ED use, and post-traumatic stress symptoms are one factor that may help explain this association. Structural interventions that promote housing stability are needed to advance health equity, and they may also help to reduce preventable ED use. Such interventions are imperative in the context of the COVID-19 pandemic, which has strained health system capacity and exacerbated housing instability for many low-income renters. Results underscore the relevance of trauma-informed care and integrated care management to clinical practice in emergency settings.http://www.sciencedirect.com/science/article/pii/S2211335522002637 |
| spellingShingle | Patrick D. Smith Allison K. Groves Brent A. Langellier Danya E. Keene Alana Rosenberg Kim M. Blankenship Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT Preventive Medicine Reports |
| title | Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT |
| title_full | Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT |
| title_fullStr | Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT |
| title_full_unstemmed | Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT |
| title_short | Eviction, post-traumatic stress, and emergency department use among low-income individuals in New Haven, CT |
| title_sort | eviction post traumatic stress and emergency department use among low income individuals in new haven ct |
| url | http://www.sciencedirect.com/science/article/pii/S2211335522002637 |
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