Jenise Dixon fell behind on rent after losing her job in the film industry last year. Dixon, who lives in Los Angeles, applied for rent relief in April and has yet to receive any help from the billions in federal funds set aside for that purpose. Despite her pending aid application and local and federal protections against eviction, Dixon’s landlord has served her with an eviction notice, Sam Levin reported for The Guardian.

The situation has left Dixon anxious as she continues to live in the same place. “I’m just doing what I can to survive,” she told Levin. “We didn’t ask for this pandemic, we didn’t ask to lose our jobs. We didn’t ask for all this turmoil.”

The threat of eviction and the resulting turmoil, fear, and anxiety have serious health effects for people at risk of losing their homes. In California, most of those facing eviction are people of color. For renters with low incomes facing this pressure, help has been slow in coming, despite legislation intended to help them.

California has the longest-running eviction moratorium in the nation. It started on August 21, 2020, and will be in place until September 30, 2021. A recent extension of the ban, which was part of the state budget passed in June, came with a promise to pay any rent owed by tenants with low incomes. More than $5.2 billion is available to help Californians behind on their rent and can cover up to three months of future rent payments. Overdue utility bills are covered too, and the assistance can help people pay future bills for up to 12 months. The Biden administration also extended the federal eviction moratorium until October 3, 2021, and legal challenges so far have not succeeded. The federal ban on evictions is currently facing challenges in court, and on Friday, a federal judge denied a request from a landlord’s group to block the ban.

Lengthening the eviction moratorium was meant to give states more time to help renters with low incomes. “The program has been slow to roll out, with eligible tenants across the state having difficulties applying while others say they’ve had to wait months for funds,” Levin wrote.

Falling Behind on Rent Linked to Significant Health Problems

Missed rent payments have hurt the health of Californians, and evictions could cause even greater harm to the health of people who can’t pay their rent. A recent report coproduced by the Bay Area Regional Health Inequities Initiative, Housing Now! California, and PolicyLink suggests significant health effects from being behind on rent during the pandemic. For their report, Preventing an Eviction and Debt Epidemic, they surveyed 177 people who work in intake and outreach for state and local emergency rental assistance programs. Those workers reported that 83% of their clients mentioned mental health concerns and 56% were forced to go to work even when potentially ill, in order to pay their rent.

Researchers have established a clear link between housing instability and health. In a recent Health Affairs article, Gracie Himmelstein and Matthew Desmond wrote that “In the past several years, evidence of the detrimental effect of eviction on health has grown, with analyses demonstrating negative impacts on a variety of health metrics ranging from birth outcomes to mental health hospitalizations to all-cause mortality.”

“Adults who have been evicted have worse self-reported physical health than non-evicted people,” they wrote, “and quasi-experimental analyses indicate that eviction causes an increase in the frequency of emergency department visits.”

People who have been evicted also report “significantly worse mental health,” Himmelstein and Desmond reported. They are more likely to die by suicide and have higher rates of hospitalization for mental health issues compared to people who have not been evicted.

Eviction also hurts the health of infants and children. “Multiple studies have linked eviction to an increased incidence of adverse birth outcomes, including low birth weight, prematurity, and infant mortality,” Himmelstein and Desmond wrote. Children are affected by the impact eviction has on the emotional state of their caregivers. “Prior evictions are associated with worse caregiver-reported child health and an increase in childhood hospitalizations, as well as worse self-reported health and depressive symptoms among caregivers.”

Findings from Preventing an Eviction and Debt Epidemic are consistent with this body of research described by Himmelstein and Desmond, with 59% of survey respondents reporting their clients had physical health concerns related to housing instability in addition to the high rates of mental health concerns.

The Unequal Burden of Eviction

Dixon is one of more than 800,000 Californians who remain behind on their rent despite legislative efforts, according to the National Equity Atlas. Some regions of California have been especially hard hit, CalMatters found in an analysis of evictions statewide. Reporters Manuela Tobias, Nigel Duara, and John Osborn D’Agostino discovered that on average, 6 of every 10,000 households were evicted between July 2020 and March 2021. Eviction rates were far higher in the Central Valley: 14 per 10,000 households in Kern County, 11 in Kings County, 12 in Merced County, and 18 in Stanislaus County. Some Central Valley counties, such as Fresno, did not respond to CalMatters’ request for eviction data and so are not included in the analysis.

More than 75% of Californians behind on rent are people of color, a disparity mirrored in national data. According to a recent article in the Aspen Institute’s blog, “Studies from cities throughout the country have shown that people of color, particularly Black and Latinx people, constitute approximately 80% of people facing eviction.”

Unemployment related to COVID-19 affected people of color at much higher rates than their White counterparts, as cited in the blog. “Initial numbers from April highlight this disparity: 61% of Hispanic Americans and 44% of Black Americans said that they or someone in their household had experienced a job or wage loss due to the coronavirus outbreak, compared with 38% of White Americans.”

Disparities in eviction predate the pandemic, according to the atlas. In 2019, more than 40% of Californians of color were already economically insecure and rent-burdened, meaning they spent more than 30% of their income on rent.

In California, $1 Billion in Pending Requests for Relief

California and other states have become better at getting money to people facing eviction, Rachel Siegel reported in the Washington Post. The amount California spent on aid for back rent more than doubled in June to $74.4 million, up from $30.2 million in May. As of August 5, California paid $242 million to renters and landlords. An additional $1 billion in requests for assistance is pending, according to Melissa Colorado of NBC Bay Area.

California’s Business, Consumer Services and Housing Agency told Colorado they’re doubling case management staff to handle the influx of applications. In June, state legislators also made it possible for tenants to apply directly for aid so they could pay their landlords rather than waiting for their landlords to apply for aid.

Housing assistance still may not reach everyone before October 1, when the moratorium ends. Assembly Speaker Anthony Rendon told Manuela Tobias of CalMatters that lawmakers couldn’t guarantee they would get rental relief to everyone by September 30, “but we do want to do everything we possibly can.”

Advocates also worry about the people who don’t even apply for relief. “A big concern is the people I don’t see, that never make it to my office,” Tiffany Hickey, an attorney with the civil rights advocacy group Advancing Justice-Asian Law Caucus, told San Francisco Chronicle reporter Lauren Hepler. Hickey expressed concern for people who move when a landlord even threatens to evict them because they don’t know how to navigate the system to get help.

For renters in need who have received help, paying their back rent has been life changing. When Jackie Lowery of Antioch finally heard this summer that she’d been approved for rent relief, months of stress evaporated, she told Hepler.

People who need help paying rent and landlords seeking payment can apply through California’s housing assistance program, Housing Is Key.

To send questions or comments, tweet at me with #EssentialCoverage or email me.

Heather Tirado Gilligan

Heather Tirado Gilligan is a journalist who has written for publications including Slate, The Nation, CNN, and the Washington Post. Previously, she was executive editor of the California Health Report, a news nonprofit covering disparities in health and access to health care. Heather received a master’s degree in journalism from UC Berkeley and a PhD in English from Rutgers University, where she studied race in American culture.

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