Table 3.

Comparative Published Studies of Homeless Veterans and Other Homeless Adults, 1987–2013

First Author, Year (Reference No.)	Design	Data Source	Location	Total No.a	No. of Veterans	Sampling Frame	Study Period	Findings
Robertson. 1987 (1)b	Cross-sectional study	Surveys of shelter users	Los Angeles and Boston	635	246	Homeless male adults in Los Angeles and Boston	1983–1985	Veterans were older, better educated, more likely to be white, more likely to have married, and more likely to be receiving some type of government assistance than nonveterans. Veterans also had higher rates of psychiatric hospitalization and more physical health problems, and they were more likely to identify substance abuse as a reason for their homelessness, although they were less likely to be street drug users than nonveterans.
Roth, 1992 (58)	Cross-sectional study	State-wide survey of homeless adults	Ohio	790	305	Homeless male adults in Ohio	1984	Veterans were older, more likely to be white, better educated, more likely to have been married, to have been in jail, to have alcohol problems, and to use shelters than nonveterans.
Rosenheck, 1994 (52)	Population-based case-control and cross-sectional study	Urban Institute's 1987 national survey of homeless service users, 3 city surveys, and the 1987 Current Population Survey	City-wide surveys were in Los Angeles, Baltimore, and Chicago	2,223	916	Homeless male adults	1985–1987	Veterans were at higher risk than nonveterans, especially striking among white men aged 20–34 years, post-Vietnam era or later (OR = 4.76).
								Among white men and black men, homeless veterans were more educated and more likely to be married than their nonveteran counterparts. There was little difference in mental and substance use disorders, except in those aged 20–34 years in which white veterans had higher rates of mental and substance use disorders than nonveterans, and black veterans had higher rates of substance use disorders.
Rosenheck, 1993 (60)	Population-based cross-sectional study	Urban Institute's 1987 national survey of homeless service users and 2 city surveys in 1986	City-wide surveys were in Los Angeles and Chicago	1,991	793	Homeless male adults	1986–1987	Veterans were older, more educated, more likely to have married, and more likely to be white than nonveterans.
								No consistent difference in physical or mental health between veterans and nonveterans.
Rosenheck, 1997 (39)c	Population-based case-control study	Four community homeless surveys and nationally conducted between 1986 and 1988, as well as the 1987 Current Population Survey	Baltimore, Los Angeles, and Chicago	2,223	915	Homeless adults	1986–1987	Only veterans of the post-Vietnam generation (OR = 3.95) and in the generation between the Korea and Vietnam eras (OR = 1.75) had a greater risk than nonveterans in those age cohorts.
Winkleby, 1993 (59)	Cross-sectional study	Survey of 3 National Guard armories offering free shelter to adults without children	California	1,008	423	Single homeless shelter users in California	1989–1990	Veterans entered homelessness at later ages and were older, more highly educated, more likely to be separated/divorced, and less likely to be Hispanic than nonveterans. Veterans were also more likely to have physical and mental disorders and to report excessive alcohol use than nonveterans.
Tessler, 2002 (61)	Cross-sectional study	ACCESS program evaluation	9 states	4,488	1,252	Homeless male adults	1994–1998	Veterans were older (OR = 0.58), better educated (OR = 1.16), less likely to have married (OR = 0.49), more likely to be working for pay (OR = 1.02), more likely black (OR = 1.3), less likely to be Hispanic (OR = 0.53), and were homeless for longer (OR = 1.17) than nonveterans.
								Veterans also reported fewer symptoms of conduct disorder in childhood (OR = 0.91) but were more likely to report alcohol abuse/dependence in adulthood (OR = 1.56).
Gamache, 2003 (53)	Population-based case-control study and cross-sectional study	ACCESS program evaluation, NSHAPC, and the 1996 Current Population Survey	9 states	3,490	143	Homeless women with mental illness	1994–1998	Female veterans were more likely to be homeless than female adults in the general population (OR = 3.58) and the low-income population (OR = 4.39).
								Female veterans were less likely to report misconduct or family instability during childhood and were more educated, more likely to be married, and more likely recently employed than female nonveterans.
Gamache, 2001 (27)	Population-based case-control study	NSHAPC and the 1996 Current Population Survey	National	1,841	602	Homeless male adults	1996	White veterans and black veterans under the age of 55 years (post-Vietnam era or later) had a greater risk than nonveterans (OR = 1.01–3.95).
Tessler, 2003 (57)	Cross-sectional study	NSHAPC	National	1,691	570	Homeless male adults who used homeless services	1996	Veterans less than 45 years of age (early years of the all-volunteer force) were more likely to be homeless for longer than 6 months than other adults (OR = 2.48), but veterans 45 years or older were less likely and had fewer risk factors.
								Compared with other homeless adults less than 45 years of age, homeless veterans were less often white, less likely to have an employment history, more likely to be divorced/separated, more likely to have drug problems, and more likely to have used inpatient mental health services, but they had a higher level of education and were likely to have been in foster care.
O'Toole, 2003 (62)	Cross-sectional study	Survey in unsheltered enclaves, emergency shelters, and transitional housing or single-room occupancy dwellings	Pittsburgh and Philadelphia	425	127	Homeless male adults in Pittsburgh and Philadelphia	1997	Veterans were significantly older, better educated, and more likely to have health insurance (including VA coverage) than nonveterans.
								Veterans were more likely to report a chronic medical condition (66.1% vs. 55.4%), especially hepatitis or cirrhosis (18.9% vs. 7.0%) than nonveterans and to have more than 1 mental health condition (33.1% vs. 22.2%), especially post-traumatic stress disorder (18.1% vs. 8.1%).
Tsai, 2012 (56)	Observational longitudinal study	Collaborative Initiative to Help End Chronic Homelessness Program evaluation	9 states	550	162	Chronically homeless adults	2004–2009	Veterans were older, more likely to be in the Vietnam era age group, to be male, and to have a higher education than nonveterans.
								There were no differences between veterans and nonveterans on housing or clinical outcomes over 1 year.
Fargo, 2012 (55)	Case-control study	HMIS and the American Community Survey	National	130,554	10,726	Homeless adults in the community	2008	Veterans were at greater risk for homelessness compared with other homeless adults in the general population (RR = 1.3) and in the poverty population (RR = 2.1). For veterans and nonveterans, being black (OR = 2.18.45–5.49) and men aged between 45 and 54 years were at higher risk (OR = 1.85– 2.65).
HUD and VA, 2010 (54)	Case-control study	Point-in-Time data from HUD and HMIS	National	1,257,927	144,842	All sheltered homeless adults	2010	Veterans who were female, individuals (as opposed to families), from racial/ethnic minority groups, and aged 18– 30 years were at greater risk than nonveterans.
Montgomery, 2013 (65)	Cross-sectional study	Washington State Behavioral Risk Factor Surveillance System	Washington State	2,313,988	293,707	Veterans and other adults with any history of homelessness	2010	The association between adverse childhood experiences and adult homelessness was greater for nonveterans than veterans (OR = 1.67 vs. 1.42).

Abbreviations: ACCESS, Access to Community Care and Effective Services and Supports; HMIS, Homeless Management Information System; HUD, Department of Housing and Urban Development; NSHAPC, National Survey of Homeless Assistance Providers and Clients; OR, odds ratio; RR, risk ratio; VA, Department of Veterans Affairs.

^aTotal sample size of homeless adults (not including nonhomeless adults).

^bSurveys of Boston were conducted by Schutt in 1985 and 1986 (111, 112) but described by Robertson (1).

^cThis book chapter was also cited in Table 1.