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arxiv: 2604.15504 · v1 · submitted 2026-04-16 · 💻 cs.SI · stat.AP

Recognition: unknown

A Quasi-Experiment comparing the health of unhoused people who have and have not experienced an eviction in King County, WA

Ihsan Kahveci , Timothy A. Thomas , Nathalie E. Williams , Janelle Rothfolk , Cathea Carey , Paul Hebert , Amy Hagopian , Zack W. Almquist
Authors on Pith no claims yet

Pith reviewed 2026-05-10 09:05 UTC · model grok-4.3

classification 💻 cs.SI stat.AP
keywords evictionhomelessnesshealth outcomessubstance usequasi-experimental designhousing instabilityKing County
0
0 comments X

The pith

Eviction is linked to an 8.3 percentage point rise in poor general health reports and a 9.5 point rise in substance use disorder among unhoused people.

A machine-rendered reading of the paper's core claim, the machinery that carries it, and where it could break.

The paper uses a quasi-experimental comparison to test whether eviction worsens health even among people who are already unhoused in King County. It finds that those who experienced eviction report worse general health and more substance use problems than those who did not, with no clear difference in mental health. A sympathetic reader would care because it suggests that preventing evictions could improve specific health outcomes for this group beyond simply providing shelter. The study draws on survey responses from 1,106 individuals to isolate this association.

Core claim

In a sample of 1,106 unhoused people, those who had experienced an eviction showed an 8.3 percentage point higher likelihood of reporting poor general health and a 9.5 percentage point higher rate of substance use disorder compared to those who had not, with no significant difference in mental health outcomes.

What carries the argument

A quasi-experimental design that compares health and substance use outcomes between unhoused individuals who have and have not experienced eviction to estimate the associated differences.

If this is right

  • Eviction prevention programs could reduce reported poor health and substance use in unhoused populations.
  • The absence of a mental health link suggests eviction's effects on health are specific rather than broad.
  • Integrated services addressing both housing loss and substance issues may be more effective than separate approaches.
  • Local policy changes that lower eviction rates might produce measurable health improvements in similar settings.

Where Pith is reading between the lines

These are editorial extensions of the paper, not claims the author makes directly.

  • The results imply eviction creates additional health burdens that continue even after people lose stable housing.
  • Repeating the comparison in other cities or with larger samples could test whether the pattern holds more widely.
  • Policymakers might view eviction prevention as one tool within broader public health strategies for vulnerable groups.

Load-bearing premise

The quasi-experimental design and any adjustments isolate the effect of eviction experience from other unmeasured differences between the two groups.

What would settle it

A follow-up study that tracks individuals before and after eviction with stronger controls for prior conditions and finds no health differences would challenge the claimed associations.

Figures

Figures reproduced from arXiv: 2604.15504 by Amy Hagopian, Cathea Carey, Ihsan Kahveci, Janelle Rothfolk, Nathalie E. Williams, Paul Hebert, Timothy A. Thomas, Zack W. Almquist.

Figure 1
Figure 1. Figure 1: Directed Acyclic Graph (DAG) depicting relationships among variables. [PITH_FULL_IMAGE:figures/full_fig_p008_1.png] view at source ↗
Figure 2
Figure 2. Figure 2: Histogram of time since eviction (in years) among the evicted respondents ( [PITH_FULL_IMAGE:figures/full_fig_p025_2.png] view at source ↗
Figure 3
Figure 3. Figure 3: Distributions of estimated propensity scores by eviction status. [PITH_FULL_IMAGE:figures/full_fig_p027_3.png] view at source ↗
Figure 4
Figure 4. Figure 4: Distribution of network size by eviction status before and after weighting. [PITH_FULL_IMAGE:figures/full_fig_p028_4.png] view at source ↗
Figure 5
Figure 5. Figure 5: Covariate balance before and after propensity adjustment across two metrics. [PITH_FULL_IMAGE:figures/full_fig_p029_5.png] view at source ↗
read the original abstract

Home eviction poses a significant threat to housing stability, a critical determinant of health. This study examines the relationship between eviction and health and substance use within the unhoused population of King County, Washington. Using a sample of 1,106 individuals experiencing homelessness, we employed a quasi-experimental design to compare the health outcomes of those who have experienced eviction with those who have not. Our findings reveal eviction is associated with an 8.3% point increase (SE = 0.039) in the likelihood of reporting poor general health and an 9.5% increase (SE = 0.032) in substance use disorder. No significant effect was found for mental health outcomes. While these results highlight the severe health risks linked to eviction, further research with more precise estimates is necessary to better understand long-term effects. These findings contribute to the growing evidence of how home eviction undermines the well-being of vulnerable populations.

Editorial analysis

A structured set of objections, weighed in public.

Desk editor's note, referee report, simulated authors' rebuttal, and a circularity audit. Tearing a paper down is the easy half of reading it; the pith above is the substance, this is the friction.

Referee Report

2 major / 1 minor

Summary. The manuscript reports results from a quasi-experimental comparison of 1,106 unhoused individuals in King County, WA, finding that those who have experienced eviction show an 8.3 percentage point higher rate of reporting poor general health (SE = 0.039) and a 9.5 percentage point higher rate of substance use disorder (SE = 0.032) relative to those who have not, with no significant difference in mental health outcomes.

Significance. If the quasi-experimental design successfully isolates the effect of eviction from confounding factors in this unhoused sample, the findings would add targeted evidence on how eviction exacerbates health risks within an already vulnerable population. The study benefits from its focus on a direct within-group comparison rather than broader population contrasts.

major comments (2)
  1. [Abstract] Abstract: The reported associations (8.3 pp increase in poor general health, SE = 0.039; 9.5 pp increase in substance use disorder, SE = 0.032) are presented as the central results, yet the abstract supplies no information on the quasi-experimental design implementation, covariates, matching procedure, missing-data handling, or robustness checks. This is load-bearing for the claim that the differences can be attributed to eviction experience.
  2. [Methods] Methods section: No description is provided of how the two groups (evicted vs. non-evicted within the unhoused sample) were rendered comparable, such as through matching on observables, regression controls for length of homelessness or prior health, fixed effects, or falsification tests. Without this, the design cannot rule out selection on unmeasured factors like substance-use trajectories or family support.
minor comments (1)
  1. [Abstract] Abstract: The phrasing 'an 9.5% increase' is grammatically incorrect and should read 'a 9.5% increase'.

Simulated Author's Rebuttal

2 responses · 0 unresolved

We thank the referee for their constructive comments, which highlight opportunities to strengthen the transparency of our quasi-experimental design. We will revise the manuscript to address these points by expanding relevant sections with additional details on the methods used.

read point-by-point responses

  1. Referee: [Abstract] Abstract: The reported associations (8.3 pp increase in poor general health, SE = 0.039; 9.5 pp increase in substance use disorder, SE = 0.032) are presented as the central results, yet the abstract supplies no information on the quasi-experimental design implementation, covariates, matching procedure, missing-data handling, or robustness checks. This is load-bearing for the claim that the differences can be attributed to eviction experience.

    Authors: We agree that the abstract would benefit from greater detail on the design to contextualize the reported associations. In the revision, we will expand the abstract (within length constraints) to briefly describe the quasi-experimental comparison within the unhoused sample, key covariates, and robustness considerations. revision: yes

  2. Referee: [Methods] Methods section: No description is provided of how the two groups (evicted vs. non-evicted within the unhoused sample) were rendered comparable, such as through matching on observables, regression controls for length of homelessness or prior health, fixed effects, or falsification tests. Without this, the design cannot rule out selection on unmeasured factors like substance-use trajectories or family support.

    Authors: The methods section describes the overall quasi-experimental design but provides limited detail on how comparability between evicted and non-evicted groups was achieved. We will revise the methods to explicitly detail the regression controls (including length of homelessness and prior health), any matching procedures, missing-data handling, and additional robustness checks or falsification tests performed. revision: yes

Circularity Check

0 steps flagged

No circularity: direct empirical group comparison

full rationale

The paper reports raw statistical associations from a sample of 1,106 unhoused individuals, comparing self-reported health outcomes between those with and without eviction history via a quasi-experimental design. No equations, fitted parameters, predictions, or derivations are described that reduce the reported 8.3 pp or 9.5 pp estimates to inputs by construction. No self-citations or uniqueness theorems are invoked as load-bearing premises. The central results are straightforward mean differences or regressions on the observed data, making the analysis self-contained against external benchmarks.

Axiom & Free-Parameter Ledger

0 free parameters · 1 axioms · 0 invented entities

The claim rests on the assumption that the quasi-experimental split and any implicit adjustments remove confounding between eviction history and health reports in this population.

axioms (1)
  • domain assumption Quasi-experimental comparison of self-reported eviction history isolates its association with health outcomes after basic adjustments
    Invoked by the choice of design and the reporting of adjusted percentage-point differences.

pith-pipeline@v0.9.0 · 5494 in / 1289 out tokens · 48053 ms · 2026-05-10T09:05:01.335045+00:00 · methodology

discussion (0)

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Reference graph

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