Leifheit Kathryn M, Schwartz Gabriel L, Pollack Craig E, Black Maureen M, Edin Kathryn J, Althoff Keri N, Jennings Jacky M
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Baltimore, MD, 21205, USA.
Center for Child and Community Health Research, Department of Pediatrics, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Baltimore, MD, 21224, USA.
SSM Popul Health. 2020 Apr 4;11:100575. doi: 10.1016/j.ssmph.2020.100575. eCollection 2020 Aug.
Eviction affects a substantial share of U.S. children, but its effects on child health are largely unknown. Our objectives were to examine how eviction relates to 1) children's health and sociodemographic characteristics at birth, 2) neighborhood poverty and food security at age 5, and 3) obesity in later childhood and adolescence. We analyzed data from the Fragile Families and Child Wellbeing Study, a longitudinal cohort of children born in 20 large U.S. cities. Children who lived in rental housing with known eviction histories and measured outcomes were included. We compared maternal and infant health and sociodemographic characteristics at the time of the child's birth. We then characterized the associations between eviction and neighborhood poverty and food security at age 5 and obesity at ages 5, 9, and 15 using log binomial regression with inverse probability of treatment and censoring weights. Of the 2556 children included in objective 1, 164 (6%) experienced eviction before age 5. Children who experienced eviction had lower household income and maternal education and were more likely to be born to mothers who were unmarried, smoked during pregnancy, and had mental health problems. Evicted and non-evicted children were equally likely to experience high neighborhood poverty at age 5 (prevalence ratio (PR) = 1.03, 95% CI 0.82, 1.29) but had an increased prevalence of low food security (PR = 2.16, 95% CI 1.46, 3.19). Obesity prevalence did not differ at age 5 (PR = 1.01; 95% CI 0.58, 1.75), 9 (PR = 1.08; 95% CI 0.715, 1.55); or 15 (PR = 1.05; 95% CI 0.51, 2.18). In conclusion, children who went on to experience eviction showed signs of poor health and socioeconomic disadvantage already at birth. Eviction in early childhood was not associated with children's likelihood of neighborhood poverty, suggesting that eviction may not qualitatively change children's neighborhood conditions in this disadvantaged sample. Though we saw evidence supporting an association with low child food security at age 5, we did not find eviction to be associated with obesity in later childhood and adolescence.
驱逐影响了相当一部分美国儿童,但驱逐对儿童健康的影响在很大程度上尚不清楚。我们的目标是研究驱逐如何与以下方面相关:1)儿童出生时的健康和社会人口特征;2)5岁时邻里的贫困状况和粮食安全;3)儿童后期和青少年期的肥胖情况。我们分析了脆弱家庭与儿童福祉研究的数据,该研究是对在美国20个大城市出生的儿童进行的纵向队列研究。纳入了居住在有已知驱逐历史的出租房且有测量结果的儿童。我们比较了孩子出生时母亲和婴儿的健康及社会人口特征。然后,我们使用带治疗和删失权重的逆概率的对数二项回归来描述驱逐与5岁时邻里贫困和粮食安全以及5岁、9岁和15岁时肥胖之间的关联。在目标1纳入的2556名儿童中,164名(6%)在5岁前经历了驱逐。经历驱逐的儿童家庭收入和母亲受教育程度较低,其母亲更有可能未婚、在孕期吸烟且有心理健康问题。经历驱逐和未经历驱逐的儿童在5岁时经历邻里高贫困的可能性相同(患病率比(PR)=1.03,95%置信区间0.82,1.29),但粮食安全水平低的患病率有所增加(PR = 2.16,95%置信区间1.46,3.19)。5岁(PR = 1.01;95%置信区间0.58,1.75)、9岁(PR = 1.08;95%置信区间0.715,1.55)和15岁(PR = 1.05;95%置信区间0.51,2.18)时肥胖患病率没有差异。总之,后来经历驱逐的儿童在出生时就已显示出健康状况不佳和社会经济劣势的迹象。幼儿期的驱逐与儿童邻里贫困的可能性无关,这表明在这个弱势样本中,驱逐可能不会从质上改变儿童所处的邻里环境。尽管我们看到有证据支持驱逐与5岁时儿童粮食安全水平低有关联,但我们并未发现驱逐与儿童后期和青少年期的肥胖有关。