Am J Epidemiol. 2021 Dec 1;190(12):2503-2510. doi: 10.1093/aje/kwab196.
The coronavirus disease 2019 (COVID-19) pandemic and associated economic crisis have placed millions of US households at risk of eviction. Evictions may accelerate COVID-19 transmission by decreasing individuals' ability to socially distance. We leveraged variation in the expiration of eviction moratoriums in US states to test for associations between evictions and COVID-19 incidence and mortality. The study included 44 US states that instituted eviction moratoriums, followed from March 13 to September 3, 2020. We modeled associations using a difference-in-difference approach with an event-study specification. Negative binomial regression models of cases and deaths included fixed effects for state and week and controlled for time-varying indicators of testing, stay-at-home orders, school closures, and mask mandates. COVID-19 incidence and mortality increased steadily in states after eviction moratoriums expired, and expiration was associated with a doubling of COVID-19 incidence (incidence rate ratio = 2.1; 95% confidence interval (CI): 1.1, 3.9) and a 5-fold increase in COVID-19 mortality (mortality rate ratio = 5.4; CI: 3.1, 9.3) 16 weeks after moratoriums lapsed. These results imply an estimated 433,700 excess cases (CI: 365,200, 502,200) and 10,700 excess deaths (CI: 8,900, 12,500) nationally by September 3, 2020. The expiration of eviction moratoriums was associated with increased COVID-19 incidence and mortality, supporting the public-health rationale for eviction prevention to limit COVID-19 cases and deaths.
2019 年冠状病毒病(COVID-19)大流行和相关的经济危机使数以百万计的美国家庭面临被驱逐的风险。驱逐可能会通过降低个人保持社交距离的能力来加速 COVID-19 的传播。我们利用美国各州驱逐禁令的到期时间的变化来检验驱逐与 COVID-19 发病率和死亡率之间的关联。该研究包括实施了驱逐禁令的 44 个美国州,时间从 2020 年 3 月 13 日到 9 月 3 日。我们使用差分法和事件研究规范进行了关联建模。病例和死亡的负二项回归模型包括州和周的固定效应,并控制了测试、居家令、学校关闭和口罩强制令等随时间变化的指标。在驱逐禁令到期后,各州的 COVID-19 发病率和死亡率稳步上升,禁令的到期与 COVID-19 发病率增加一倍(发病率比=2.1;95%置信区间(CI):1.1,3.9)和 COVID-19 死亡率增加五倍(死亡率比=5.4;CI:3.1,9.3)有关,在禁令失效后 16 周。这些结果意味着到 2020 年 9 月 3 日,全国估计有 433700 例额外病例(CI:365200,502200)和 10700 例额外死亡(CI:8900,12500)。驱逐禁令的到期与 COVID-19 发病率和死亡率的增加有关,这支持了为限制 COVID-19 病例和死亡而采取的驱逐预防的公共卫生理由。