#### By American Heart Association News HealthDay Reporter
(American Heart Association News) — The solution to homelessness may lie not just in providing housing but also in preventing people from losing it.
That’s according to new research that found evictions – particularly during childhood – can have long-term health consequences, such as high blood pressure, coronary heart disease and diabetes.
“There is a really strong relationship between evictions and poor health,” said Dr. Margot Kushel, director of the Benioff Homelessness and Housing Initiative at the University of California, San Francisco.
The findings “highlight the importance of policies to keep people stably housed,” said Kushel, who was not involved in the study.
It’s estimated that more than half a million people in the United States are homeless on any given night. Decades of research have found that these individuals experience various health problems at much higher rates than people with stable housing. For instance, homeless adults are 10 times more likely to die early than housed adults, and homeless children are more prone to chronic health conditions, infectious diseases and developmental disabilities.
But this new study, published Monday in JAMA Network Open, suggests evictions may be an especially powerful factor.
The study found that childhood evictions were associated with a two- to threefold increased risk of coronary heart disease in adulthood, and a 60% increased risk of diabetes. Eviction as an adult was associated with a twofold increased risk of high blood pressure.
“This study adds to the existing literature on the health effects of housing instability, and highlights the critical role of stable housing during childhood,” said Dr. Margot Bass, assistant professor of medicine at Boston Medical Center and Harvard Medical School.
Bass, who was not involved in the research, said the results underscore the need to prevent homelessness. “We need to prioritize policies that keep families housed in stable homes, such as strengthening rental assistance programs and expanding access to affordable housing,” she said.
Past studies have shown an increased risk of developing obesity, heart failure and severe psychological distress following evictions. Some of the health risks likely stem from the stress associated with eviction and residential instability, while others come from substandard and unsafe housing conditions often associated with unaffordable housing.
A 2020 study in JAMA Internal Medicine found that receiving government housing vouchers resulted in significant improvements in hyperglycemia and blood pressure control among people with prediabetes or diabetes.
“Housing is so fundamental to health,” Kushel said. “Just having safe, stable housing can improve health in profound ways.”
The new research analyzed data on over 12,000 adults who were participants of a long-running health and aging study in Northern California. The participants completed a series of health assessments over the years and reported whether they had ever experienced an eviction.
A little over 20% of the participants reported experiencing an eviction during childhood and about 13% reported an eviction during adulthood.
After accounting for a variety of factors, such as age, sex, race, income, education and neighborhood safety, the researchers found that childhood and adult evictions were significantly associated with prevalent high blood pressure, coronary heart disease and type 2 diabetes in midlife.
To improve population health, Kushel sees housing as fundamental as medical care. It also needs to be addressed more holistically, from building affordable housing and providing rental assistance, to addressing homelessness once it occurs, she said.
“Just as you wouldn’t let your blood pressure go uncontrolled, we shouldn’t stand by and watch this epidemic of homelessness unfold,” she said. “We spend so much money on providing health care to people who are homeless. If we just housed them, we could reduce those health care costs dramatically.”
