dc.contributor.author | Sandoval-Olascoaga, Sebastian | |
dc.contributor.author | Venkataramani, Atheendar S. | |
dc.contributor.author | Arcaya, Mariana Clair | |
dc.date.accessioned | 2021-09-03T15:15:15Z | |
dc.date.available | 2021-09-03T15:15:15Z | |
dc.date.issued | 2021-08 | |
dc.identifier.issn | 2574-3805 | |
dc.identifier.uri | https://hdl.handle.net/1721.1/131237 | |
dc.description.abstract | Importance: Housing insecurity induced by evictions may increase the risk of contracting COVID-19.
Objective: To estimate the association of lifting state-level eviction moratoria, which increased housing insecurity during the COVID-19 pandemic, with the risk of being diagnosed with COVID-19.
Design, Setting, and Participants:This retrospective cohort study included individuals with commercial insurance or Medicare Advantage who lived in a state that issued an eviction moratorium and were diagnosed with COVID-19 as well as a control group comprising an equal number of randomly selected individuals in these states who were not diagnosed with COVID-19. Data were collected from OptumLabs Data Warehouse, a database of deidentified administrative claims. The study used a difference-in-differences analysis among states that implemented an eviction moratorium between March 13, 2020, and September 4, 2020.
Exposures: Time since state-level eviction moratoria were lifted.
Main Outcomes and Measures: The primary outcome measure was a binary variable indicating whether an individual was diagnosed with COVID-19 for the first time in a given week with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code U07.1. The study analyzed changes in COVID-19 diagnosis before vs after a state lifted its moratorium compared with changes in states that did not lift it. For sensitivity analyses, models were reestimated on a 2% random sample of all individuals in the claims database during this period in these states.
Results: The cohort consisted of 509 694 individuals (254 847 [50.0%] diagnosed with COVID-19; mean [SD] age, 47.0 [23.6] years; 239 056 [53.3%] men). During the study period, 43 states and the District of Columbia implemented an eviction moratorium and 7 did not. Among the states that implemented a moratorium, 26 (59.1%) lifted their moratorium before the US Centers for Disease Control and Prevention issued their national moratorium, while 18 (40.1%) maintained theirs. In a Cox difference-in-differences regression model, individuals living in a state that lifted its eviction moratorium experienced higher hazards of a COVID-19 diagnosis beginning 5 weeks after the moratorium was lifted (hazard ratio [HR], 1.39; 95% CI, 1.11-1.76; P = .004), reaching an HR of 1.83 (95% CI, 1.36-2.46; P < .001) 12 weeks after. Hazards increased in magnitude among individuals with preexisting comorbidities and those living in nonaffluent and rent-burdened areas. Individuals with a Charlson Comorbidity Index score of 3 or greater had an HR of 2.37 (95% CI, 1.67-3.36; P < .001) at the end of the study period. Those living in nonaffluent areas had an HR of 2.14 (95% CI, 1.51-3.05; P < .001), while those living in areas with a high rent burden had an HR of 2.31 (95% CI, 1.64-3.26; P < .001).
Conclusions and Relevance:The findings of this difference-in-differences analysis suggest that eviction-led housing insecurity may have exacerbated the COVID-19 pandemic. | en_US |
dc.publisher | American Medical Association (AMA) | en_US |
dc.relation.isversionof | http://dx.doi.org/10.1001/jamanetworkopen.2021.29041 | en_US |
dc.rights | Creative Commons Attribution 4.0 International license | en_US |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_US |
dc.source | JAMA Network Open | en_US |
dc.title | Eviction Moratoria Expiration and COVID-19 Infection Risk Across Strata of Health and Socioeconomic Status in the United States | en_US |
dc.type | Article | en_US |
dc.identifier.citation | Sandoval-Olascoaga, Sebastian et al. "Eviction Moratoria Expiration and COVID-19 Infection Risk Across Strata of Health and Socioeconomic Status in the United States." JAMA Network Open 4, 8 (August 2021): e2129041. © 2021 Sandoval-Olascoaga S et al. | en_US |
dc.contributor.department | Massachusetts Institute of Technology. Department of Urban Studies and Planning | |
dc.relation.journal | JAMA Network Open | en_US |
dc.eprint.version | Final published version | en_US |
dc.type.uri | http://purl.org/eprint/type/JournalArticle | en_US |
eprint.status | http://purl.org/eprint/status/PeerReviewed | en_US |
dspace.date.submission | 2021-09-02T13:40:00Z | |
mit.journal.volume | 4 | en_US |
mit.journal.issue | 8 | en_US |
mit.license | PUBLISHER_CC | |
mit.metadata.status | Complete | en_US |