Gender and the use of veterans health administration homeless services programs among Iraq/Afghanistan veterans

Oni J. Blackstock, Sally G. Haskell, Cynthia A. Brandt, Rani A. Desai

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Female Veterans comprise 12% of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, the largest proportion of women to serve of any prior cohort. We sought to determine the sex-specific risk of using a Veterans Health Administration (VHA) homeless program among OEF/OIF Veterans and to identify factors associated with increased risk of program use for women compared with men. Methods: We included OEF/OIF Veterans with at least 1 VHA clinical visit between October 1, 2001, and September 30, 2009. The study's outcome was the time to first use of a VHA homeless program. Cox proportional-hazards regression was used to estimate the relative risk of using a homeless program by sex, adjusting for relevant sociodemographic and clinical variables. Exploratory analyses examined interactions between sex and all covariates. Results: Of 445,319 Veterans, 7431 (1.7%) used a VHA homeless program, of which 961 were females (1.8%), and 6470 were males (1.7%) during a median follow-up period of 3.20 years. Women were as likely as men to use a homeless program (adjusted hazard ratio, 1.02; 95% confidence interval, 0.95-1.09); median time to first use was similar for female and male Veterans (1.88 vs. 1.88 y, respectively, P=0.53). In exploratory analyses, we found increased risk of program use for women compared with men for the following subgroups: ages 26-35 years, 100% service-connected disability rating, posttraumatic stress disorder diagnosis, and northeast location. Conclusions: Overall, there was no substantial difference in the sex-specific risk of using a VHA homeless program. In light of this finding, VHA homeless programs must be prepared to recognize and address the unique needs of female OEF/OIF Veterans.

Original languageEnglish (US)
Pages (from-to)347-352
Number of pages6
JournalMedical Care
Volume50
Issue number4
DOIs
StatePublished - Apr 2012
Externally publishedYes

Fingerprint

2003-2011 Iraq War
Veterans Health
Afghanistan
Iraq
United States Department of Veterans Affairs
Veterans
Afghan Campaign 2001-
Post-Traumatic Stress Disorders
Sex Characteristics
Outcome Assessment (Health Care)
Confidence Intervals

Keywords

  • health services
  • homelessness
  • utilization
  • Veterans
  • women

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Gender and the use of veterans health administration homeless services programs among Iraq/Afghanistan veterans. / Blackstock, Oni J.; Haskell, Sally G.; Brandt, Cynthia A.; Desai, Rani A.

In: Medical Care, Vol. 50, No. 4, 04.2012, p. 347-352.

Research output: Contribution to journalArticle

Blackstock, Oni J. ; Haskell, Sally G. ; Brandt, Cynthia A. ; Desai, Rani A. / Gender and the use of veterans health administration homeless services programs among Iraq/Afghanistan veterans. In: Medical Care. 2012 ; Vol. 50, No. 4. pp. 347-352.
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abstract = "Background: Female Veterans comprise 12{\%} of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, the largest proportion of women to serve of any prior cohort. We sought to determine the sex-specific risk of using a Veterans Health Administration (VHA) homeless program among OEF/OIF Veterans and to identify factors associated with increased risk of program use for women compared with men. Methods: We included OEF/OIF Veterans with at least 1 VHA clinical visit between October 1, 2001, and September 30, 2009. The study's outcome was the time to first use of a VHA homeless program. Cox proportional-hazards regression was used to estimate the relative risk of using a homeless program by sex, adjusting for relevant sociodemographic and clinical variables. Exploratory analyses examined interactions between sex and all covariates. Results: Of 445,319 Veterans, 7431 (1.7{\%}) used a VHA homeless program, of which 961 were females (1.8{\%}), and 6470 were males (1.7{\%}) during a median follow-up period of 3.20 years. Women were as likely as men to use a homeless program (adjusted hazard ratio, 1.02; 95{\%} confidence interval, 0.95-1.09); median time to first use was similar for female and male Veterans (1.88 vs. 1.88 y, respectively, P=0.53). In exploratory analyses, we found increased risk of program use for women compared with men for the following subgroups: ages 26-35 years, 100{\%} service-connected disability rating, posttraumatic stress disorder diagnosis, and northeast location. Conclusions: Overall, there was no substantial difference in the sex-specific risk of using a VHA homeless program. In light of this finding, VHA homeless programs must be prepared to recognize and address the unique needs of female OEF/OIF Veterans.",
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