Changes in Homelessness Among US Veterans After Implementation of the Ending Veteran Homelessness Initiative

Area of Science:

• Public Health
• Health Services Research
• Social Determinants of Health

Background:

• Homelessness is a significant and escalating public health issue.
• The precise role of health systems in addressing homelessness and integrating strategies is not well-defined.

Purpose of the Study:

• To compare rates of homelessness among veterans to the general population.
• To evaluate the impact of the Ending Veteran Homelessness Initiative (EVHI) over a 16-year period.

Main Methods:

• A national retrospective cohort study utilized mixed methods, analyzing administrative and population data from 2007-2022.
• Examined Point-in-Time (PIT) counts, housing voucher data, community grants, and veteran housing numbers.
• Included semistructured interviews with Veterans Health Administration (VHA) leadership.

Main Results:

• Veteran homelessness decreased by 55.3% following EVHI implementation, compared to an 8.6% decrease in the general population.
• The proportion of veterans experiencing homelessness dropped from 11.6% to 5.3%.
• Key factors included a "housing first" policy, increased housing vouchers, community grants, and expanded VHA services.

Conclusions:

• The EVHI demonstrated a substantially greater reduction in veteran homelessness compared to the general population.
• Findings underscore the vital role of health systems in tackling complex social determinants of health.
• Lessons from the VHA initiative are transferable to other health systems addressing homelessness.