Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island

Objective Policy ramifications of the COVID-19 pandemic shape the concurrent housing and overdose crises in the USA. Housing insecurity is a known risk factor for overdose, yet how residential eviction may influence fatal overdose risk is understudied. We sought to evaluate the spatiotemporal relati...

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Main Authors: Jennifer Ahern, Magdalena Cerdá, William C Goedel, Elizabeth A Samuels, Yu Li, Alexandria Macmadu, Benjamin D Hallowell, Kathryn M Leifheit, Alexandra Skinner, Victoria Jent, Bennett Allen, Abigail R Cartus, Claire Pratty, Brandon DL Marshall
Format: Article
Language:English
Published: BMJ Publishing Group 2024-04-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/2/1/e000756.full
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author Jennifer Ahern
Magdalena Cerdá
William C Goedel
Elizabeth A Samuels
Yu Li
Alexandria Macmadu
Benjamin D Hallowell
Kathryn M Leifheit
Alexandra Skinner
Victoria Jent
Bennett Allen
Abigail R Cartus
Claire Pratty
Brandon DL Marshall
author_facet Jennifer Ahern
Magdalena Cerdá
William C Goedel
Elizabeth A Samuels
Yu Li
Alexandria Macmadu
Benjamin D Hallowell
Kathryn M Leifheit
Alexandra Skinner
Victoria Jent
Bennett Allen
Abigail R Cartus
Claire Pratty
Brandon DL Marshall
author_sort Jennifer Ahern
collection DOAJ
description Objective Policy ramifications of the COVID-19 pandemic shape the concurrent housing and overdose crises in the USA. Housing insecurity is a known risk factor for overdose, yet how residential eviction may influence fatal overdose risk is understudied. We sought to evaluate the spatiotemporal relationship between neighbourhood-level residential eviction rates and overdose mortality in Rhode Island (RI) before and during a statewide eviction moratorium in response to COVID-19.Methods We conducted an ecological study at the census tract level in RI (N=240) by modelling the association between quintiles of eviction rates and fatal overdose rates from 2016 to 2021. We applied a Bayesian spatiotemporal approach using an integrated nested Laplace approximation and adjusted for an a priori determined set of time-varying demographic and policy covariates.Results Descriptively, we observed a direct, dose–response relationship between quintiles of eviction incidence rates over the full study period and fatal overdose. Prior to the implementation of a statewide eviction moratorium, census tracts in the highest eviction quintile had increased rates of overdose mortality, relative to those in the lowest quintile (posterior mean relative rate = 1.49, 95% credible interval: 1.05 to 2.13). Associations during the periods of eviction moratorium were non-significant.Conclusion This work highlights the neighbourhood-level relationship between residential eviction and fatal overdose risk in the absence of an eviction moratorium. Enhanced investment in eviction prevention policies, such as rent relief and limitations to the circumstances under which landlords can file for eviction, may complement harm reduction efforts to reduce neighbourhood-level overdose inequalities.
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spelling doaj-art-e96395dccda14805a39844c4f3d8184a2025-01-29T02:30:10ZengBMJ Publishing GroupBMJ Public Health2753-42942024-04-012110.1136/bmjph-2023-000756Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode IslandJennifer Ahern0Magdalena Cerdá1William C Goedel2Elizabeth A Samuels3Yu Li4Alexandria Macmadu5Benjamin D Hallowell6Kathryn M Leifheit7Alexandra Skinner8Victoria Jent9Bennett Allen10Abigail R Cartus11Claire Pratty12Brandon DL Marshall13Department of Epidemiology, University of California Berkeley School of Public Health, Berkeley, California, USAprofessor and directorDepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USADepartment of Emergency Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USADepartment of Anesthesiology, Wenzhou Central Hospital, Wenzhou, Zhejiang, ChinaDepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USAState of Rhode Island Department of Health, Providence, Rhode Island, USADepartment of Pediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USADepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USADepartment of Population Health, New York University Grossman School of Medicine, New York, New York, USADepartment of Population Health, New York University Grossman School of Medicine, New York, New York, USADepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USADepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USADepartment of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USAObjective Policy ramifications of the COVID-19 pandemic shape the concurrent housing and overdose crises in the USA. Housing insecurity is a known risk factor for overdose, yet how residential eviction may influence fatal overdose risk is understudied. We sought to evaluate the spatiotemporal relationship between neighbourhood-level residential eviction rates and overdose mortality in Rhode Island (RI) before and during a statewide eviction moratorium in response to COVID-19.Methods We conducted an ecological study at the census tract level in RI (N=240) by modelling the association between quintiles of eviction rates and fatal overdose rates from 2016 to 2021. We applied a Bayesian spatiotemporal approach using an integrated nested Laplace approximation and adjusted for an a priori determined set of time-varying demographic and policy covariates.Results Descriptively, we observed a direct, dose–response relationship between quintiles of eviction incidence rates over the full study period and fatal overdose. Prior to the implementation of a statewide eviction moratorium, census tracts in the highest eviction quintile had increased rates of overdose mortality, relative to those in the lowest quintile (posterior mean relative rate = 1.49, 95% credible interval: 1.05 to 2.13). Associations during the periods of eviction moratorium were non-significant.Conclusion This work highlights the neighbourhood-level relationship between residential eviction and fatal overdose risk in the absence of an eviction moratorium. Enhanced investment in eviction prevention policies, such as rent relief and limitations to the circumstances under which landlords can file for eviction, may complement harm reduction efforts to reduce neighbourhood-level overdose inequalities.https://bmjpublichealth.bmj.com/content/2/1/e000756.full
spellingShingle Jennifer Ahern
Magdalena Cerdá
William C Goedel
Elizabeth A Samuels
Yu Li
Alexandria Macmadu
Benjamin D Hallowell
Kathryn M Leifheit
Alexandra Skinner
Victoria Jent
Bennett Allen
Abigail R Cartus
Claire Pratty
Brandon DL Marshall
Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island
BMJ Public Health
title Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island
title_full Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island
title_fullStr Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island
title_full_unstemmed Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island
title_short Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island
title_sort spatiotemporal analysis of the association between residential eviction and fatal overdose in rhode island
url https://bmjpublichealth.bmj.com/content/2/1/e000756.full
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