Excerpt

In 2009, President Obama and Secretary Shinseki committed to ending homelessness among Veterans. In support of that effort, the Federal Strategic Plan to Prevent and End Homelessness 2010 developed by the United States Interagency Council on Homelessness (USICH) established as one of its goals to prevent and end homelessness among Veterans in five years. An understanding of the epidemiology of homelessness among Veterans and the methodological strengths and weaknesses of this evidence base may inform program-planning efforts and future research needs. Understanding the risk factors for homelessness among Veterans and how these risk factors compare to the general population is important in developing identification and prevention programs for Veterans at risk for homelessness. This report was requested by VA Central Office and The National Center for Homelessness Among Veterans as part of that effort to identify what is known and what is not known about the prevalence of homelessness among Veterans, and about the risk factors for homelessness among Veterans, including risk factors related to military service and incarceration.

Contents

• PREFACE
• EXECUTIVE SUMMARY
  • BACKGROUND
  • METHODS
  • DATA SYNTHESIS
  • PEER REVIEW
  • RESULTS
  • LIMITATIONS OF THE EVIDENCE
  • ABBREVIATIONS TABLE
• INTRODUCTION
  • BACKGROUND
• METHODS
  • TOPIC DEVELOPMENT
  • SEARCH STRATEGY
  • STUDY SELECTION
  • DATA SYNTHESIS
  • CONCEPTUAL MODEL
  • PEER REVIEW
• RESULTS
  • DEFINITIONS OF HOMELESSNESS
  • ASSESSING THE LIMITATIONS OF THE CURRENT RESEARCH
  • DATA SOURCES
  • METHODOLOGICAL CONSIDERATIONS
  • KEY QUESTION #1A What is the prevalence and incidence of homelessness among Veterans?
  • KEY QUESTION #1B How has the prevalence and incidence of homelessness among Veterans changed over time?
  • KEY QUESTION #1C How prevalent are psychiatric illness, substance abuse, and chronic medical illness among homeless Veterans?
  • KEY QUESTION #2A Which risk factors are associated with new homelessness or a return to homelessness among Veterans? How do these risk factors differ from non-Veteran populations?
  • KEY QUESTION #2B Have risk factors for homelessness among Veterans changed over time?
  • KEY QUESTION #3 Are there factors specific to military service that increase the risk of homelessness, or is the increased risk a marker for pre-military comorbidities and social support deficiencies?
  • KEY QUESTION #4 What is the relationship between incarceration and homelessness among Veterans?
• SUMMARY AND DISCUSSION
  • RECOMMENDATIONS FOR FUTURE RESEARCH
• REFERENCES
• APPENDIX A PEER REVIEW COMMENTS/AUTHOR RESPONSES
• APPENDIX B TECHNICAL EXPERTS CONSULTED AND REVIEWERS

All authors contributed equally to this report.

Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center, Portland, OR, Devan Kansagara, MD, MCR, Director.

Suggested citation:

Balshem H, Christensen V, Tuepker A, Kansagara D. A Critical Review of the Literature Regarding Homelessness among Veterans. VA-ESP Project #05-225: 2011

This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Portland VA Medical Center, Portland, OR funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the United States government. Therefore, no statement in this article should be construed as an official position of the Department of Veterans Affairs. No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in the report.