The impacts of rent burden and eviction on mortality in the United States, 2000-2019.

Investments in stable, affordable housing may be an important tool for improving population health, especially in the context of rising costs and evictions for American renters. Still, a lack of longitudinal data linking these exposures to health outcomes has limited prior research. In this study, we use linked administrative data to estimate the associations of rent burden and eviction with all-cause mortality. We constructed a novel dataset linking renters in the long-form 2000 Census (N = 6,587,000) to mortality follow-up through 2019 from the Census Numident file. To measure exposure to eviction, we further linked this dataset to 38 million eviction records between 2000 and 2016 using names and addresses. For a subsample of renters, we also measured within-individual changes in rent burden between 2000 and 2008-2012 by linking to the American Community Survey. We estimated the associations of rent burden and eviction with mortality using Cox proportional-hazards models and discrete-time hazard models adjusted for individual, household, neighborhood, and state characteristics, examining varying associations by cohort, race, gender, and eviction risk. Higher baseline rent burden, increases in rent burden during midlife, and evictions were all associated with increased mortality. Compared to a baseline rent burden of 30%, a burden of 70% was associated with 12% (95% confidence interval = 11-13%) higher mortality. A 20-point increase in rent burden between 2000 and 2008-2012 was associated with 16% (12-19%) higher mortality through 2019. An eviction filing without judgment was associated with a 19% (15-23%) increase in mortality and an eviction judgment was associated with a 40% (36-43%) increase. Associations were larger for those at lower predicted risk of eviction. These findings reveal how rising costs and evictions are shaping mortality for American renters. Policies designed to increase the supply of affordable housing and prevent eviction may lead to widespread improvements in population health.