Skip to main content
. Author manuscript; available in PMC: 2015 Jul 31.
Published in final edited form as: Epidemiol Rev. 2015 Jan 16;37:177–195. doi: 10.1093/epirev/mxu004

Table 2.

Less Rigorous Published Studies on Risk Factors for Veteran Homelessness, 1997–2014

First Author, Year (Reference No.) Design Data Source Total No. No. of Homeless Sampling Frame Study Period Identified Risk Factors
Rosenheck, 1997 (39) Case-control study VA's Homeless Chronically Mentally Ill veterans program, 1987 Third Survey of Veterans, a 1990 national survey of VA outpatient mental health clinic users, and the NVVRS 98,371 34,711 Homeless veterans engaged in VA services 1986–1992 Military combat exposure was associated with lower likelihood for homelessness (OR = 0.48–0.85). PTSD was not associated with greater likelihood for homelessness among veterans with other mental health diagnoses (OR = 0.41–0.96).
Wenzel, 1993 (46) Cross-sectional study on duration of lifetime homelessness Domiciliary care for homeless veterans in Los Angeles 343 343 Homeless veterans enrolled in a VA domiciliary care program 1988–1992 Being white and having a longer period of recent homelessness, a greater number of homeless episodes, a poorer employment history, greater mental and substance use problems, and weaker social support were associated with longer term homelessness.
Douyon, 1998 (48) Cross-sectional study Assessment battery on homeless VA inpatient service users 53 33 Homeless veterans enrolled in acute inpatient care Unknown Neurological deficits (frontoparietal, cerebellar, and frontal lobe functions).
Gamache, 2000 (29) Case-control study ACCESS evaluation and the NVVRS 1,676 from NVVRS; 616 from ACCESS 616 Homeless male veterans with mental illness 1995–1998 for ACCESS 6.8% of homeless veterans with mental illness had either a bad conduct or dishonorable discharge.
1986–1988 for NVVRS The relative risk for homelessness among veterans who served in the Vietnam era and had a bad conduct or dishonorable discharge is 9.9 times as great as among veterans without such discharges.
Tsai, 2013 (49) Cross-sectional study on severity of homelessness National data from the HUD–VASH Program 1,161 1,161 Homeless veterans enrolled in VA-supported housing 1992–2003 Conduct disorder behaviors (Cohen's d = 0.16–1.13), family instability during childhood (d = 0.47–1.43), and childhood abuse (d = 0.05–0.40) were each weakly associated with lifetime homeless episodes.
Mares, 2004 (47) Cross-sectional study on perceived military risk for homelessness Therapeutic Employment Place and Support Program evaluation 631 631 Homeless veterans enrolled in VA vocational rehabilitation 2001–2003 31% of sample reported that military service increased their risk for becoming homeless.
Perceived risk factors included substance abuse and health problems in the military, inadequate preparation for civilian employment, loss of structured lifestyle after military, weakened social connections, and interrupted education.
Younger age at military discharge, greater childhood problems, and less social support were associated with more rapid homelessness after military discharge.
van den Berk-Clark, 2013 (51) Cross-sectional study VA-funded specialized transitional living programs 59 33 chronically and 26 acutely homeless Homeless elderly veterans in Los Angeles 2003–2005 Chronically homeless veterans were less educated and had a smaller social network, particularly for “instrumental support” than acutely homeless veterans.
Kasprow, 2011 (50) Population-based cross-sectional study VA administrative data and “VetPop 2007” 18,997,936 73,740 OEF/OIF veterans who had contact with the VA homeless services 2001–2007 OEF/OIF veterans were seen in VA homeless programs at a lower rate in all age categories than other veterans (OR = 0.09–0.69), except for veterans less than 25 years of age (OR = 2.22).
Tsai, 2014 (21) Cross-sectional study Administrative data from the VA's HCRV Program 30,348 9,201 Incarcerated veterans in state or federal prisons 2007–2011 Rate of lifetime homelessness among incarcerated veterans is 5 times the rate in the general population (30% vs. 6%).
Incarcerated veterans with homeless histories reported more mental health and substance abuse problems, especially drug abuse/dependence (OR = 1.55–1.984), more times arrested in their lifetime (OR = 1.01–1.02), and were more likely to be incarcerated for a nonviolent offense than other incarcerated veterans (OR = 1.44–1.60).

Abbreviations: ACCESS, Access to Community Care and Effective Services and Supports; HCRV, Health Care for Reentry Veterans Program; HUD–VASH, Housing and Urban Development–Veterans Affairs Supportive Housing Program; NVVRS, National Vietnam Veterans Readjustment Study; OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom; OR, odds ratio; PTSD, post-traumatic stress disorder; VA, Department of Veterans Affairs.