Housing Status Changes Are Associated With Cancer Outcomes Among US Veterans

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Cancer disproportionately affects older unhoused adults, a vulnerable population.
• Housing status is a critical social determinant of health, impacting cancer survivorship.
• Understanding the impact of housing instability on cancer outcomes is essential for targeted interventions.

Purpose of the Study:

• To investigate the association between housing status changes (homelessness, gaining/losing housing) and all-cause survival in veterans post-cancer diagnosis.
• To compare survival rates among continuously housed, continuously unhoused, and those experiencing housing transitions after cancer diagnosis.

Main Methods:

• Retrospective cohort study of over 100,000 US veterans diagnosed with lung, colorectal, or breast cancer between 2011-2020.
• Analysis of all-cause survival based on housing status at diagnosis and housing changes within one year post-diagnosis.
• Comparison of survival curves between different housing status groups.

Main Results:

• Five percent of veterans were unhoused at diagnosis; 21% gained housing, and 1% lost housing within a year.
• Continuously unhoused veterans and those who lost housing experienced poorer survival after lung and colorectal cancer diagnoses.
• No significant survival difference was observed for veterans who gained housing compared to continuously housed veterans.

Conclusions:

• Homelessness and housing loss post-cancer diagnosis are associated with reduced survival in veterans, particularly for lung and colorectal cancers.
• Policies aimed at preventing and resolving homelessness among cancer patients are crucial for improving health outcomes.
• Ensuring stable housing is a vital component of supportive cancer care and survivorship.