A spatial analysis of the associations between housing eviction and alcohol-related hospitalizations in Pennsylvania

Alcohol consumption has substantial negative health consequences and those who experience homelessness bear a disproportionate burden of these consequences. Housing eviction is a widespread, modifiable cause of homelessness and housing insecurity more broadly. Understanding the associations between eviction and alcohol-related harms could reveal important prevention opportunities.

We examined spatial patterns of inpatient hospitalizations for alcohol use disorder (AUD) and harms that are partially attributable to alcohol assumption, including assault, intimate partner violence (IPV), and self-harm at the ZIP code level in Pennsylvania. Using Bayesian hierarchical space-time misalignment models, we examined the associations between ZIP code-level eviction filing rates and hospitalizations for these conditions, reporting relative rates (RR) and 95% credible intervals (CIs). We stratified our analyses across two time periods, 2018-2019 (n = 2901 ZIP code-years) and 2020-2022 (n = 4356 ZIP code-years).

Eviction filings were associated with increased hospitalizations for AUD; a one percentage point increase in the eviction filing rate was associated with a 1.4% (95% CI: 1.011 - 1.018) and 1.1% (95% CI:1.007-1.014) increase in AUD hospitalizations in 2018-2019 and 2020-2022, respectively. The associations between eviction filings and hospitalizations for IPV (RR: 1.018, 95% CI: 1.005-1.031) and hospitalizations for assault (RR: 1.033, 95% CI: 1.002, 1.065) were only well-supported during 2020-2022.

This study highlights the potential for leveraging housing eviction interventions for the prevention of alcohol-related harms, especially AUD. Future research should examine the mechanisms linking eviction, alcohol consumption, and related harms, and measure the alcohol-related impacts of eviction prevention interventions.