The effects of homelessness on Veterans' health care service use: an evaluation of independence from comorbidities

Increased Mortality Among Older Veterans Admitted to VA Homelessness Programs

“…Notably, the cumulative survival rate for older ($60) veterans in the homeless sample was 58%. The RRs for all-cause mortality among homeless veterans were comparable to those previously reported for a sample of veterans who were homeless 6,9). These results lend further support to the hypothesis of excess mortality among veterans who are homeless and provide estimates of mortality risk for older veterans who are homeless.…”

“…Thus we could not provide a detailed description of sample characteristics or conduct analyses that could be adjusted for general medical and psychiatric comorbidities, substance abuse, use of VA and communitybased health care services, and other factors. Although a previous study found a substantial increase in all-cause mortality among veterans who were homeless, even after the analyses controlled for the factors mentioned above, similar adjustments will be necessary to obtain more accurate estimates of mortality among older veterans who are homeless (9). Future studies would be most valuable if they employed longitudinal approaches to explore risk factors for homelessness among veterans and the impact of long-term housing interventions and health care access on longevity among veterans who are homeless.…”

“…Analyses of age of death among veterans who died from suicide have shown that veterans who were homeless were significantly younger when they died compared with veterans without a history of homelessness (8). In a one-year follow-up of veterans receiving care from a regional U.S. Department of Veterans Affairs (VA) health care system in 2010, veterans who were homeless were found to have a 32.3% increase in all-cause mortality compared with veterans who were not homeless (9). Higher all-cause mortality was found even after the analyses controlled for age, race, gender, serious mental illness, substance use disorders, and comorbidity of general medical diseases.…”

Missing the obvious: psychosocial obstacles in Veterans with hepatocellular carcinoma

“…The present findings demonstrate many psychosocial and socioeconomic factors in Veterans treated for HCC. These factors have all been identified to be barriers to successful medical care delivery and, therefore, need to be identified and addressed . Although patients in the general population with HCC face similar barriers, these obstacles are much more prevalent in the Veteran population.…”

“…Factors such as homelessness, low income, substance abuse, psychiatric disorders and low socioeconomic status are all highly prevalent in this population and have been shown to affect negatively cancer care. 2,[13][14][15][16][17][18][19][20][21][22][23][24] These barriers seem to be out of proportion and not well acknowledged in the Veteran population. 7,8,25 As cancer treatment continues to evolve, clinicians taking care of Veterans not only need to consider the disease process but should also be aware of the psychological and socioeconomic issues these patients face.…”