26 Aug Misconduct During Military Service Is Strongest Predictor of Homelessness After Discharge
MedicalResearch.com Interview with:
Adi V. Gundlapalli, MD, PhD
Associate Professor of Internal Medicine
University of Utah School of Medicine and University of Utah Hospitals and ClinicsInformatics, Decision Enhancement, and Analytic Sciences Center
VA Salt Lake City Health Care System,
Salt Lake City, Utah
Medical Research: What is the background for this study? What are the main findings?
Dr. Gundlapalli: We wanted to explore the hypothesis that those separated for misconduct-related reasons would have more difficulty reintegrating into their communities post-deployment, with homelessness as an extreme example of such difficulties. Misconduct-related separations from the military are associated with subsequent adverse civilian outcomes that are of substantial public health concern. This study analyzed the association between misconduct-related separations and homelessness among recently returned active-duty military service members. Using US Department of Veterans Affairs (VA) data, investigators identified 448,290 Veterans who were separated from the military (end date of last deployment) between October 1, 2001 and December 31, 2011; had been deployed to Iraq and/or Afghanistan; and had subsequently used VA healthcare. Homelessness was determined by an assignment of “lack of housing” during a VA healthcare visit, by participation in a VA homelessness program, or both. Veterans’ housing status was followed through April 30, 2012. We assessed risk for homelessness as a function of separation category (e.g., normal, misconduct, early release), controlling for patient demographics and military service covariates, including service-related disability, branch, rank, and combat exposure. In our opinion, the most significant finding was that 26% of Veterans who were separated for misconduct related reasons were homeless at their first VA encounter; and this number climbed to 28% within one year after their first VA encounter. Additionally, the likelihood of being homeless at the first VA encounter was nearly 5 times greater for those separated for misconduct-related reasons as compared to normal separations; this climbed to nearly 7 times greater at one year after the first VA encounter. Collectively, these results represent the strongest risk factor for homelessness among US Veterans observed to date, and helps to explain the higher risk of homelessness observed among Veterans, despite access to VA benefits and services.
Medical Research: What should clinicians and patients take away from your report?
Dr. Gundlapalli: Our goal is to raise awareness among all stakeholders (Veterans, clinicians, Departments of Defense and Veterans Affairs administration/leadership) that there seems to be a sub-population of vulnerable Veterans who are at higher risk for homelessness as compared to other Veterans.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: These findings support reports of recently returned Veterans with records of misconduct having difficulties re-entering civilian life. This association takes on added significance because the incidence of misconduct-related separations is increasing at a time when ending homelessness among Veterans is a federal government priority.
This may represent an opportunity for investigating early identification and active case management as strategies to prevent homelessness in this and other vulnerable populations at the time of separation from the military. This would ideally be a joint effort between the Department of Defense and the VA.
As a follow-up to this study, we are exploring the resource utilization patterns and associated costs of care received by this sub-population of Veterans in VA medical facilities.
Citation:
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Adi V. Gundlapalli, MD, PhD (2015). Misconduct During Military Service Is Strongest Predictor of Homelessness After Discharge
Last Updated on August 26, 2015 by Marie Benz MD FAAD