John Pollock (JD) and Kathryn Leifheit (PhD, MSPH) contributed to this article.
Public health and preventive medicine work to lessen the severity of health problems by preventing them from occurring in the first place (primary prevention) or by reducing their consequences in the short and long term (i.e., secondary and tertiary prevention, respectively).
By focusing on prevention, both populations and individuals can reduce their risk of serious health problems or even death
. Investing in basic care and the socioeconomic determinants of health can reduce the need for more expensive services like hospitalizations and treatments for chronic diseases.
In a system where 81% of landlords and only 3% of renters have access to representation, Legal Support for Renters is preventative legal medicine for the eviction crisis.
It is possible to mitigate the poor health outcomes and other impacts of evictions on displaced families and society as a whole by intervening early and guaranteeing renters facing eviction access to legal representation.
Given the disproportionate rate at which tenants of colour, and notably Black women, are evicted, Legal Support for Renters can also be seen as a remedy for systemic inequalities in the rental housing market.
There is mounting evidence that evictions contribute to poor health outcomes for renters and their communities, and that they are both a symptom and a cause of poverty.
Renters’ mental health is negatively impacted by evictions because of the loss of stability in their living situations, the increased risk of exposure to infectious diseases, and the decreased availability of health-promoting resources like food and medical care.
Throughout the lifespan, evictions have been related to negative health effects through various mechanisms.
There is an increased risk of premature delivery and poor birth weight in pregnant women who are evicted. At age 5, children who experienced homelessness as children had a reduced likelihood of having access to adequate nutrition, and at age 9, they had lower cognitive scores.
Moving out might trigger depression in young adults and teenagers. Studies of far larger populations have found a correlation between being evicted and a higher probability of suicide or death.
Research suggests that evictions promote the spread of the COVID-19 pandemic, resulting in more cases and deaths. Disruptions in healthcare access due to evictions have been linked to increased healthcare costs and emergency room visits.
The damages to families and the costs to city governments caused by evictions extend far beyond the expense of providing medical care.
Many studies have shown that losing one’s home can lead to a cascade of negative outcomes, including homelessness, foster care for children, school disruptions (including lack of school transportation for homeless children), and eventually, lost jobs.
Furthermore, public benefits for evicted renters facing unemployment and law enforcement/incarceration costs associated with the criminalization of homelessness are not included because they have not yet been estimated due to data gaps.
Landlord-Tenant Legal Aid
Additionally, research shows that having legal counsel for tenants facing eviction is an effective first and last line of defence against eviction.
From a primary prevention perspective, research out of Hennepin County, Minnesota indicated that tenants who were represented by an attorney were twice as likely to remain in their rental units.
Similarly, in Oklahoma, having legal representation tripled the chances of tenants keeping their apartments.
According to research conducted in Massachusetts, tenants who had their best interests properly represented were twice as likely to continue living in their rental units as those who had received less comprehensive legal aid.
These are only a few of the many similar studies that have been conducted.
Having a legal advocate on your side might lessen the blow of being uprooted by helping you avoid being evicted in the future.
A study conducted in Hennepin County found that tenants with legal representation were given twice as much time as unrepresented tenants to vacate their units after an eviction.
Tenants who were represented in eviction proceedings were 13 times more likely to emerge from the case with an unblemished eviction history than those who were unrepresented, greatly improving their future opportunities to find safe, low-cost accommodation.
In California, after an eviction hearing, 71% of renters who were represented by an attorney were able to secure a new rental property, whereas only 43% of tenants who were not represented were successful in doing so.
Tenants in Chicago who have legal assistance were three times less likely to get an eviction notice. More than 90% of tenants are able to avoid disruptive eviction when they have the right to counsel, according to findings by Stout LLC, a financial analysis firm that has published detailed right to counsel reports for several cities.
According to Stout’s research, the expenses of a right to counsel are much lower than the costs to the government from unnecessary evictions and the disruptions they cause.
At least 16 jurisdictions (13 cities and 3 states) have passed Legal Support for Renters policies since 2017.
In particular, the year 2021 was a watershed moment, with eleven states introducing Legal Support for Renters legislation, twelve cities taking steps in the same direction, and nine jurisdictions (three states and six cities) establishing a policy.
These initiatives’ success in primary and secondary prevention has more than paid for themselves.
Eighty-four per cent of renters represented in New York City are still in their apartments, ninety-three per cent of tenants represented in Cleveland are still in their houses, and over sixty per cent of tenants represented in San Francisco are still in their apartments.
Prior to enactment, a study estimated New York City would save $320 million by enacting such a policy, and a pre-enactment study of a pilot programme in San Francisco estimated that the City saved over $1 million from avoided shelter costs, so it likely that these cities are seeing financial savings as a result of these policies.
City governments may save a lot of money and assist families to avoid the health risks and other negative consequences of evictions by enacting measures that provide renters with legal protections from eviction.
Preventative legal medicine, in the form of Legal Support for Renters, is as essential to the development of fair and thriving communities as preventative medicine is to the health of a population.
Attorney John Pollock coordinates the National Coalition for a Civil Right to Counsel, which fights for the right to legal representation in all civil disputes involving necessities like food and shelter.
Postdoctoral fellow and epidemiology at the UCLA Fielding School of Public Health, Kathryn Leifheit holds a PhD and MSPH. The effects of evictions on children’s and communities’ health have been established in several studies.
