Association between receipt of a continuum of supportive housing services and mortality among Veterans with experience of housing instability.

Autor: Montgomery AE; Birmingham AL Veterans Affairs Health Care System (BVAHCS), Birmingham, AL, USA; Department of Health Behavior, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, USA. Electronic address: ann.montgomery2@va.gov., Jones KC; Birmingham AL Veterans Affairs Health Care System (BVAHCS), Birmingham, AL, USA; Department of Health Behavior, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, USA., True G; South Central Mental Illness, Research, Education and Clinical Center, Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA; Section of Community and Population Medicine, Department of Medicine, Louisiana State University (LSU) School of Medicine, LSU Health Science Center, New Orleans, LA, USA., deRussy A; Birmingham AL Veterans Affairs Health Care System (BVAHCS), Birmingham, AL, USA., Richman JS; Birmingham AL Veterans Affairs Health Care System (BVAHCS), Birmingham, AL, USA; Department of Surgery, Heersink School of Medicine, UAB, Birmingham, AL, USA., Dichter ME; VA Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA; Temple University School of Social Work, Philadelphia, PA., Blosnich JR; Suzanne Dwoark-Peck School of Social Work, University of Southern California, Los Angeles, CA.
Jazyk: angličtina
Zdroj: American journal of preventive medicine [Am J Prev Med] 2024 Nov 29. Date of Electronic Publication: 2024 Nov 29.
DOI: 10.1016/j.amepre.2024.11.011
Abstrakt: Introduction: Veterans face elevated risk of suicide and homelessness, with housing instability being a significant, independent risk factor among this population. Addressing housing instability through primary, secondary, and tertiary prevention services is crucial for improving health and mortality outcomes, though research remains limited. The objective of this study is to assess the association between receipt of primary, secondary, and tertiary homelessness prevention services and risk of suicide and all-cause mortality among Veterans within 24 months of experiencing housing instability.
Methods: Data were extracted from national U.S. Department of Veterans Affairs (VA) electronic health records (EHR), 2014-2019, and mortality data from National Death Index. Logistic regressions conducted in 2024 modeled suicide and all-cause mortality using a time-discreet survival framework with person-month as the unit of analysis. Cohort included 662,682 Veterans with indicators of housing instability in EHR.
Results: Veterans who received homeless services across the three levels of public health prevention had reduced odds of suicide compared to non-participants while Veterans exiting these programs had higher odds of suicide (p-value ranges <.001 - 0.05). Consistent results were found for all-cause mortality.
Conclusions: Continued receipt of services to address housing instability is associated with reduced mortality risk. Exiting programs to address housing instability may be a vulnerable period for Veterans, and investment in homelessness prevention is crucial to reduce mortality and improve outcomes among Veterans. Ongoing support is essential to mitigate risks associated with program exit.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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