“Homelessness and Trauma Go Hand-in-Hand”: Pathways to Homelessness among Women Veterans

Hamilton, Alison B.; Poza, Ines; Washington, Donna L.

doi:10.1016/j.whi.2011.04.005

Cited by 156 publications

(131 citation statements)

References 32 publications

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“…Past-year IPV was associated with indicators of economic hardship, including lower levels of employment, receipt of public assistance, low income and past-year homelessness. Although we are not able to discern the temporal nature of these relationships, there is a substantial literature that suggests unemployment, 35 reliance on public assistance, 36 and homelessness [37][38][39] to be consequences of IPV. This set of findings suggests that policies to promote economic empowerment among women who experience IPV are relevant to meeting the needs of women Veterans.…”

Section: Discussionmentioning

confidence: 83%

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

et al. 2016

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OBJECTIVES:The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics. DESIGN: This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey. PARTICIPANTS: A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study. MAIN MEASURES: Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via selfreport and VHA administrative data. KEY RESULTS: The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% -25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/ guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers. CONCLUSIONS: The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social services and MST-related care.

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Section: Discussionmentioning

confidence: 83%

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

et al. 2016

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“…Finally, these data do not provide information regarding adverse premilitary circumstances or other traumatic stressors, which may be an important factor given the increased likelihood for interpersonal violence among those with prior trauma. 6,9,29 Although this study is limited to veterans of the US military, sexual abuse and harassment of military personnel is not unique to the United States; international research literature indicates that sexual harassment and assault are prevalent. [30][31][32][33] Sexual abuse and harassment are also prevalent in civilian populations, and similar difficulties may exist among survivors in these populations.…”

Section: Discussionmentioning

confidence: 99%

Differential Risk for Homelessness Among US Male and Female Veterans With a Positive Screen for Military Sexual Trauma

et al. 2016

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IMPORTANCE Military sexual trauma (MST) is associated with adverse physical and mental health outcomes following military separation. Recent research suggests that MST may be a determinant in several factors associated with postdeployment homelessness. OBJECTIVE To evaluate MST as an independent risk factor for homelessness and to determine whether risk varies by sex. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study of US veterans who used Veterans Health Administration (VHA) services between fiscal years 2004 and 2013 was conducted using administrative data from the Department of Defense and VHA. Included in the study were 601 892 US veterans deployed in Iraq or Afghanistan who separated from the military between fiscal years 2001 and 2011 and subsequently used VHA services. EXPOSURE Positive response to screen for MST administered in VHA facilities. MAIN OUTCOMES AND MEASURESAdministrative evidence of homelessness within 30 days, 1 year, and 5 years following the first VHA encounter after last deployment. RESULTSThe mean (SD) age of the 601 892 participants was 38.9 (9.4) years, 527 874 (87.7%) were male, 310 854 (51.6%) were white, and 382 361 (63.5%) were enlisted in the Army. Among veterans with a positive screen for MST, rates of homelessness were 1.6% within 30 days, 4.4% within 1 year, and 9.6% within 5 years, more than double the rates of veterans with a negative MST screen (0.7%, 1.8%, and 4.3%, respectively). A positive screen for MST was significantly and independently associated with postdeployment homelessness. In regression models adjusted for demographic and military service characteristics, odds of experiencing homelessness were higher among those who screened positive for MST compared with those who screened negative (30-day: adjusted odds ratio [AOR], 1.89; 95% CI, 1.58-2.24; 1-year: AOR, 2.27; 95% CI, 2.04-2.53; and 5-year: AOR, 2.63; 95% CI, 2.36-2.93). Military sexual trauma screen status remained independently associated with homelessness after adjusting for co-occurring mental health and substance abuse diagnoses in follow-up regression models (30-day:

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“…They report having poor health overall (Pierce, LewandowskiRoomps, & Silverschanz, 2011), higher LDL cholesterol levels (Vimalananda, Miller, Palnati, Christiansen, & Fincke, 2011), smoke tobacco at higher rates than men (Farmer, Rose, Riopelle, Lanto, & Yano, 2011), and avoid cancer screening (Yee et al, 2011). These women are also more frequently victims of intimate partner violence (Dichter, Cerulli, & Bossarte, 2011), and some are caught in a web of vulnerability leading to homelessness (Hamilton, Poza, & Washington, 2011). Female veterans suffer from more health-related disorders and engage in risky health behaviors more than civilian females.…”

Section: Discussionmentioning

confidence: 99%

Being a Female Veteran: A Grounded Theory of Coping With Transitions

Burkhart

Hogan

2014

Social Work in Mental Health

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“Homelessness and Trauma Go Hand-in-Hand”: Pathways to Homelessness among Women Veterans

Cited by 156 publications

References 32 publications

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care

Differential Risk for Homelessness Among US Male and Female Veterans With a Positive Screen for Military Sexual Trauma

Being a Female Veteran: A Grounded Theory of Coping With Transitions

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