Correlates of Transitions Into Housing Instability Among Veterans Accessing Veterans Health Administration Health Care

Bibliographic Data

ID9101643
AuthorsAnn Elizabeth Montgomery (0000-0002-4420-3526, United States Department of Veterans Affairs, corresponding author), Fazlur Rahman (0000-0003-4520-5520, University of Alabama at Birmingham), Fazlur A K M Rahman (University of Alabama at Birmingham), Meagan Cusack (0000-0003-2622-4566, VA Center for Health Equity Research and Promotion), Allyson L Varley (0000-0002-1851-6502, Birmingham VA Medical Center), Allyson Varley (Birmingham VA Medical Center, Birmingham, AL), Thomas Byrne (0000-0002-8809-3664, Boston University School of Social Work)
Year2020
Volume58
Issue12
Pages1105-1110
Publication date2020-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001416
PMID32925462
OpenAlexW3084568883
LanguageEN
Citations received2
References cited26

BACKGROUND: Prior research has explored the patterns and dynamics of homelessness; such an understanding is necessary to improve policy and programmatic responses and prevent new episodes of housing instability. OBJECTIVES: The objectives of this study are to identify correlates of veterans' transitions into housing instability and inform initiatives aimed to address their needs, with a focus on how to prevent new episodes of housing instability. METHODS: The cohort for this study includes 4,633,069 veterans who responded to the Veterans Health Administration's universal screen for housing instability at least twice between October 1, 2012, and September 30, 2016; 1.2% reported recent housing instability and 98.8% reported ongoing housing stability. The χ or Fisher exact tests, as appropriate, compared veterans' characteristics by housing status. A multivariate logistic regression identified independent risk factors associated with recent housing instability, controlling for sociodemographic, military service, diagnostic, and health services use variables. RESULTS: Sociodemographic and health services use variables increased veterans' odds of transitioning into housing instability. The diagnoses with the greatest effect sizes were drug use disorder (adjusted odds ratio=1.50, 95% confidence interval: 1.45-1.55) and opioid use disorder, which was associated with a >2-fold increase in the odds of experiencing recent housing instability (adjusted odds ratio=2.22, 95% confidence interval: 2.04-2.41). CONCLUSIONS: The present study provides evidence to inform existing and future interventions to prevent new episodes of housing instability. Veterans with opioid use disorder were at greatest risk of becoming unstably housed; increasing access to medication-assisted treatment in homeless-focused services is needed

Confidence interval · Environmental health · Health care · Housing First · Logistic regression · Mental health · Mental illness · Odds · Odds ratio · Psychiatry · Psychological intervention · Food Security and Health in Diverse Populations · Geriatric Care and Nursing Homes · Homelessness and Social Issues · Internal Medicine · Medicine · Gerontology