{"doi":"10.1001/jamapediatrics.2024.4699","title":"Tenant Right-to-Counsel and Adverse Birth Outcomes in New York, New York","abstract":"Importance: In 2017, New York, New York, launched the United States' first right-to-counsel program, guaranteeing lawyers to low-income tenants in select zip codes, which was associated with reducing eviction risk by half. Given documented associations between evictions during pregnancy and adverse birth outcomes, the right-to-counsel program may be associated with improved birth outcomes. Objective: To measure associations between zip code-level right-to-counsel access and risk of adverse birth outcomes, including preterm birth and low birth weight, among infants born to Medicaid-insured birthing parents. Design, Setting, and Participants: This retrospective cohort study leveraged the staggered rollout of New York's right-to-counsel program from January 2016 to February 2020 as a natural experiment using a population-based sample of live births to Medicaid-insured birthing parents residing in New York, New York. Data were analyzed from February 2022 to September 2024. Exposure: Zip code right-to-counsel status 9 months prior to birth. Main Outcomes and Measures: Adverse birth outcomes were measured using individual birth records from the New York Bureau of Vital Statistics. Outcomes included dichotomous indicators of low birth weight (<2500 g), preterm birth (<37 weeks' gestation), and a composite of both. Difference-in-differences linear probability models controlled for year, month, and zip code and included clustered standard errors. Results: Among 260 493 live births (mean [SD] birthing parent age, 29 [6] years) from January 2016 to February 2020, 43 081 births (17%) were to birthing parents residing in zip codes where right-to-counsel was available during pregnancy. Exposure to right-to-counsel during pregnancy was associated with statistically significant reductions in infants' probability of adverse birth outcomes, with reductions of 0.73 (95% CI, 0.06-1.41) percentage points in low birth weight, 0.91 (95% CI, 0.10-1.71) percentage points in preterm birth, and 0.96 (95% CI, 0.09-1.84) percentage points in the composite outcome in treated vs untreated zip codes. Conclusions and Relevance: This cohort study found that right-to-counsel was associated with reduced risk of adverse birth outcomes among Medicaid-insured birthing parents. These findings suggest that eviction prevention via right-to-counsel may have benefits that extend beyond the courtroom and across the life-course.","journal":"JAMA Pediatrics","year":2024,"id":441373,"datarank":0.4130992122198242,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.06771144827071729,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.06771144827071729,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":8,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9544,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":523702,"name":"Katherine L. Chen","orcid":"0000-0002-4122-2916","position":1,"is_corresponding":false},{"id":699339,"name":"Nathaniel Anderson","orcid":"0000-0002-4305-2447","position":2,"is_corresponding":false},{"id":1071946,"name":"Cecile Yama","orcid":"0000-0002-7434-9497","position":3,"is_corresponding":false},{"id":1254423,"name":"Achyuth Sriram","orcid":null,"position":4,"is_corresponding":false},{"id":533232,"name":"Craig Evan Pollack","orcid":"0000-0003-2464-6415","position":5,"is_corresponding":false},{"id":272428,"name":"Alison Gemmill","orcid":"0000-0001-5879-9730","position":6,"is_corresponding":false},{"id":642450,"name":"Frederick J. Zimmerman","orcid":"0000-0002-4163-9893","position":7,"is_corresponding":false},{"id":426619,"name":"Kathryn M. Leifheit","orcid":"0000-0003-3980-9715","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:01:06.281460Z","pmid":"39466257","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}