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Younger, Hispanic, Educated US Veterans Face Higher Unsheltered Homelessness

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A recent study has revealed concerning trends in the demographics and healthcare engagement of unsheltered homeless veterans in the US. While the overall number of homeless veterans has declined, the proportion of those who are unsheltered has seen a notable increase. This shift highlights the urgent need for targeted interventions to address the specific needs of this vulnerable population. 

The study, published in the journal Public Health Reports, utilised data from the Veterans Affairs (VA) Homeless Operations Management Evaluation System (HOMES) and the Corporate Data Warehouse, covering 191,204 veterans from January 2018 to December 2021. The findings underscore significant changes in the demographic profile of unsheltered homeless veterans compared to their sheltered counterparts.

Historically, unsheltered homeless veterans were predominantly older, white males living in extreme poverty and often without access to VA benefits. However, the contemporary unsheltered homeless veteran population is younger, more diverse, and better educated. The study found that younger veterans (under 50 years old), Hispanic veterans, and those with some college education or a bachelor’s degree are more likely to experience unsheltered homelessness.

The research also revealed disparities in health conditions and service utilisation between unsheltered and sheltered homeless veterans. Unsheltered veterans were more likely to have a VA service-connected disability, experience military sexual trauma, and have a history of combat exposure. Despite these serious conditions, they demonstrated lower engagement with VA outpatient mental health and rehabilitation services.

Unsheltered veterans showed a higher propensity for using emergency departments and urgent care services, reflecting a reliance on immediate, crisis-driven healthcare rather than preventive or continuous care. This pattern of healthcare usage exacerbates their health conditions and underscores the need for more effective outreach and engagement strategies.

The study highlighted that despite some veterans having access to VA disability benefits, many remain unsheltered due to complex socioeconomic factors. These include stagnant wages, lack of affordable housing, and social isolation, which increase the risk of homelessness as veterans transition from military to civilian life. The findings suggest that more comprehensive support systems are required to prevent veterans from becoming unsheltered.

In response to these findings, the study’s authors advocate for innovative public health approaches and policy efforts to address the unique challenges faced by unsheltered homeless veterans. They recommend increasing culturally sensitive outreach efforts, particularly for Hispanic veterans who may face cultural barriers in accessing VA services. Additionally, there is a call for the evaluation of existing VA programmes such as the Grants Per Diem Low Demand model and the Health Care for Homeless Veterans Safe Haven model, which aim to engage unsheltered homeless veterans in housing and clinical services.

The federal strategic plan, ALL INside, emphasises the need to reduce programmatic and regulatory barriers that delay access to housing. This initiative aligns with the study’s recommendations, aiming to provide more immediate and flexible support to unsheltered homeless veterans.

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