Introduction
Addressing veteran homelessness is a major federal priority, but there has been little
research on the period between military discharge and homelessness. There are public
concerns about new waves of homelessness among recent veterans and questions about
a possible sleeper effect, that is, a delayed risk that becomes stronger with time.
Methods
Data from 2 national samples were analyzed: Department of Veterans Affairs administrative
records of a population-based sample of 275,775 homeless Department of Veterans Affairs
service users in 2000–2019 and a nationally representative community survey of 115
veterans with a history of homelessness conducted in 2018.
Results
In the Department of Veterans Affairs sample, the average time between discharge and
homelessness was 5.5 (SD=4.2) years. In the community veteran sample, the average
time between discharge and homelessness was 9.9 (SD=10.5) years. Service in Iraq and
Afghanistan was significantly associated with shorter duration between discharge and
homelessness. Service in Vietnam, younger age at military discharge, more chronic
medical conditions, depression, and alcohol use problems were associated with longer
interval between discharge and homelessness. Among homeless service users who were
discharged from 2000 to 2003, the rate of homelessness doubled between 10 and 15 years
after discharge. Similarly, among those discharged from 2009 to 2013, the rate of
homelessness more than doubled between 2 and 5 years after discharge.
Conclusions
There appears to be a sleeper effect in veteran homelessness after military discharge.
The primary and secondary preventions focused on chronic health conditions, and social
adjustment may be needed to address homelessness among recent veterans.
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Article Info
Publication History
Published online: May 05, 2020
Identification
Copyright
Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
