Rates and Predictors of Returns to Homelessness Among Veterans, 2018–2022

Abstract

IntroductionThe progress made by the U.S. Department of Veterans Affairs (VA) towards ending veteran homelessness requires attention be paid to preventing returns to homelessness. MethodsUsing national VA data on 293,820 exits from a VA homeless program to a permanent housing destination between January 2018 thru December 2022, rates and predictors of returns to homelessness among veterans were examined. Analyses were conducted June-August 2023. A return to homelessness was operationally defined as a return encounter with a VA homeless program. Results5.8% of successful exits to permanent housing resulted in a return to homelessness within 6 months, 10.2% return within 12 months, and 16.7% return within 24 months. In the total sample, veterans who were male (hazard ratio [HR]= 1.47), widowed (HR= 1.29), had diagnoses of drug use disorder (HR= 1.40) or psychotic disorder (HR= 1.20), and had used more inpatient or urgent care services in the year prior (HR= 1.05-1.15) were at significantly greater risk of returning to homelessness. Many of these predictors remained significant in subgroup analyses of female veterans, veterans aged 65 or older, and veterans in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program. ConclusionsMost homeless veterans served by VA who exit to permanent housing do not return to homelessness within 2 years. The most critical period seems to be the first year, when 1 in 10 veterans return to homelessness. Knowledge of these risk factors may be important in planning secondary and tertiary prevention efforts for homelessness.