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The impact of eviction on preventive and primary care: a large-scale administrative linkage study

Award Number: R01NR022053
ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2031

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The impact of eviction on preventive and primary care: a large-scale administrative linkage study - Improving preventive care is crucial for public health: today, only 8% of adults receive all recommended, high-priority preventive services. Disrupted primary care continuity compounds this challenge, lowering care quality and inhibiting preventive care uptake. The consequences are dire: poor primary and preventive care cost tens of thousands of lives and >$700 billion each year while burdening acute care systems with avoidable utilization. Still, key gaps remain in our understanding of how primary or preventive care might be improved. One poorly understood challenge is housing insecurity. US housing prices have risen faster than wages for decades, causing a nationwide crisis. More than half of renters are now “rent-burdened,” and 4 million Americans are evicted annually. Emerging evidence shows evictions cause numerous health problems and increase mortality risk by 40%. Our preliminary research suggests evictions also make it harder for tenants to retain Medicaid coverage, acquire ambulatory care, or fill prescriptions. Yet we know astonishingly little about evictions’ healthcare impacts, including on key preventive services; primary care continuity, especially for chronic diseases; or avoidable acute care utilization. A better grasp on how evictions shape these outcomes is important for informing healthcare and housing programs. Unfortunately, clarifying evictions’ healthcare impacts (and their implications for later chronic disease) has proven difficult, as almost no studies have linked eviction records with healthcare data at scale. To overcome that roadblock and advance towards our long-term goal of reducing preventable morbidity while lowering healthcare costs, we will merge 14 years of uniquely publicly-available eviction data in New York City to Medicaid claims—an approach we pioneered in preliminary studies. This will create the largest, and one of the only, databases in the US linking individual-level evictions to detailed healthcare information. Our data will allow us to answer critical questions about how evictions affect healthcare, especially in ways that could create long-term issues for population health and healthcare financing. We approach this question comprehensively, examining healthcare outcomes across the preventive care spectrum and applying state-of-the-science causal inference methods, including (A) coarsened exact matching and (B) a natural experiment / instrumental variables analysis. Aim 1 quantifies evictions’ impact on preventive care services whose interruption can worsen chronic disease prognoses. Aim 2 then examines evictions’ relationship to primary care continuity, focusing on patients with chronic conditions. Finally, Aim 3 assesses the relationship between eviction and potentially avoidable acute care and related healthcare costs. Results would offer fresh insights for clinicians and healthcare systems looking to protect evicted patients’ health, and allow healthcare payers to weigh the full healthcare externalities of investing in eviction prevention.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $789,428 )
2026	2026	DREXEL UNIVERSITY	3141 CHESTNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	1	9/1/2026	NEW	$789,428
														Subtotal = $789,428

Grand Total All Awards = $789,428

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The impact of eviction on preventive and primary care: a large-scale administrative linkage study

Award Number: R01NR022053

ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2031

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