Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois, USA.
J Epidemiol Community Health. 2022 Apr;76(4):398-403. doi: 10.1136/jech-2020-215377. Epub 2021 Oct 4.
Housing instability is associated with adverse pregnancy outcomes. Recent studies indicate that eviction, which may affect a larger segment of the population than other forms of housing instability, is also associated with adverse pregnancy outcomes. However, these studies evaluate eviction across large areas, such as counties, so it remains unclear whether these patterns extend to individual-level pregnancy outcomes.
We used data on a cohort of all singleton live births at a single Chicago hospital between March 2008 and March 2018 to investigate the associations between block-group eviction rates and individual adverse pregnancy outcomes. Eviction data were obtained from the Eviction Lab at Princeton University. Generalised estimating equations were used to estimate associations and account for correlations among individuals living in the same block groups.
Individuals living in block groups in the highest quartile for eviction filing rate were 1.17 times as likely to deliver preterm (95% CI: 1.08 to 1.27) and 1.13 times as likely to deliver a small for gestational age infant (95% CI: 1.03 to 1.25) as compared with individuals living in block groups in the lowest quartile. Further, tests for linear trend indicated that for each quartile increase in eviction filing rate, there was a corresponding increase in odds of adverse outcomes (p<0.05). Results were strongest in magnitude for those with low neighbourhood and individual socioeconomic status, who are most likely to be renters and affected by local eviction policies.
Our results suggest that individuals living in block groups with higher eviction rates are more likely to deliver preterm. Future research should explore associations of individual experience with eviction on adverse pregnancy outcomes and examine whether policies to improve tenant protections also impact pregnancy outcomes.
住房不稳定与不良妊娠结局有关。最近的研究表明,驱逐(可能比其他形式的住房不稳定影响更大的人群)也与不良妊娠结局有关。然而,这些研究评估了整个县等大区域的驱逐情况,因此尚不清楚这些模式是否会扩展到个体层面的妊娠结局。
我们使用了 2008 年 3 月至 2018 年 3 月期间芝加哥一家医院所有单胎活产的队列数据,调查了街区组驱逐率与个体不良妊娠结局之间的关联。驱逐数据来自普林斯顿大学的驱逐实验室。广义估计方程用于估计关联,并考虑了居住在同一街区组的个体之间的相关性。
与居住在驱逐申请率最低四分位数的街区组的个体相比,居住在驱逐申请率最高四分位数的街区组的个体早产的可能性高 1.17 倍(95%CI:1.08 至 1.27),胎儿生长受限的可能性高 1.13 倍(95%CI:1.03 至 1.25)。此外,线性趋势检验表明,驱逐申请率每增加一个四分位,不良结局的几率就会相应增加(p<0.05)。对于那些社区和个体社会经济地位较低的人,结果的幅度最大,他们最有可能是租客,受到当地驱逐政策的影响。
我们的结果表明,居住在驱逐率较高的街区组的个体更有可能早产。未来的研究应该探讨个人经历与驱逐对不良妊娠结局的关联,并研究改善租户保护的政策是否也会影响妊娠结局。