Homelessness following disability-related discharges from active duty military service in Afghanistan and Iraq
| Autor: | Miland N. Palmer, Rachel Peterson, Matthew H. Samore, Adi V. Gundlapalli, Jamison D. Fargo, Andrew Redd, Tyson S. Barrett, Emily Brignone, Marjorie E. Carter, Stephen Metraux |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Military service Logistic regression 01 natural sciences 03 medical and health sciences 0302 clinical medicine Risk Factors Disability benefits Health care medicine Humans Disabled Persons 030212 general & internal medicine 0101 mathematics Risk factor Psychiatry Iraq War 2003-2011 Veterans Disability Claims health care economics and organizations Retrospective Studies Veterans Receipt Afghan Campaign 2001 business.industry Mental Disorders 010102 general mathematics Afghanistan Public Health Environmental and Occupational Health Retrospective cohort study General Medicine Middle Aged Mental health United States humanities United States Department of Veterans Affairs Logistic Models Military Personnel Ill-Housed Persons Iraq Female business |
| Zdroj: | Disability and Health Journal. 10:592-599 |
| ISSN: | 1936-6574 |
| DOI: | 10.1016/j.dhjo.2017.03.003 |
| Popis: | Background Many dynamics in the relationship among military service-related disabilities, health care benefits, mental health disorders, and post-deployment homelessness among US Veterans are not well understood. Objectives Determine whether Veterans with a disability-related discharge from military service are at higher risk for homelessness, whether Veterans Health Administration (VHA) service-connected disability benefits mitigates that risk, and whether risks associated with discharge type, service-connected disability, or the interaction between them vary as a function of mental health disorders. Methods Retrospective cohort study of 364,997 Veterans with a disability-related or routine discharge and initial VHA encounter between 2005 and 2013. Logistic regression and survival analyses were used to estimate homelessness risk as a function of discharge status, mental health disorders, and receipt of VHA disability benefits. Results Disability-discharged Veterans had higher rates of homelessness compared to routine discharges (15.1 verses 9.1 per 1000 person-years at risk). At the time of the first VHA encounter, mental health disorders were associated with differentially greater risk for homelessness among Veterans with a disability discharge relative to those with a routine discharge. During the first year of VHA service usage, higher levels of disability benefits were protective against homelessness among routinely-discharged Veterans, but not among disability-discharged Veterans. By 5-years, disability discharge was a risk factor for homelessness (AOR = 1.30). Conclusions In the long-term, disability discharge is an independent risk factor for homelessness. While VHA disability benefits help mitigate homelessness risk among routinely-discharged Veterans during the early reintegration period, they may not offer sufficient protection for disability-discharged Veterans. |
| Databáze: | OpenAIRE |
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