veteran homelessness essay

Why Veterans Remain at Greater Risk of Homelessness

One way to stand up for former service personnel is to advocate for more affordable housing, says BU researcher

Thomas Byrne, a BU School of Social Work associate professor, calls homelessness a “really temporary phenomenon”—and says giving assistance to solve a short-term housing crisis usually leads to long-term stability. Photo by debbiehelbing/iStock

Andrew Thurston

The signs dot highway bridges and town halls, celebrating the return of armed services personnel from dangerous overseas missions. “Welcome Home,” they proudly, joyously, declare. But for many veterans—carrying the visible and invisible scars of battle, more vulnerable to suicide , physical and mental illness , and substance use disorders —the message rings hollow: they might not even have a stable home to return to. Ex-service members have long been at greater risk of homelessness than the general population.

Thomas Byrne , a Boston University School of Social Work associate professor, is an expert on homelessness, and among the researchers studying why veterans are more likely to land in shelters—and how to better help them. He says that a lack of affordable housing can make it especially tough for former service members to find a stable home, and that those who want to help them should advocate for more economical options.

Byrne has studied housing insecurity in rural areas , the effectiveness of Department of Veterans Affairs (VA) housing programs , and the community and structural drivers of homelessness , such as income inequality and housing affordability . His latest project is a major assessment of Supportive Services for Veteran Families , a program that provides grants to community organizations helping those at high risk of homelessness. One focus of the research is an initiative giving veterans flexible temporary financial assistance that they can use on anything from security deposits to utility bills.

“We’ve found it’s associated with better housing and health outcomes,” says Byrne, who is also an investigator at the VA’s National Center on Homelessness among Veterans and with the Center for Healthcare Organization & Implementation Research at the VA Bedford Healthcare System . “We’re also nearly there on a study that’s comparing participation in this program to a group of veterans who don’t get it, so we can as rigorously as possible estimate its impact.”

Byrne first became involved with the VA as a graduate researcher—but the work has taken on additional meaning in recent years.

“I have members of my immediate family who are on active duty,” says Byrne, “including one of my sisters and brother-in-law. I serendipitously became involved with the VA, but it also has a personal salience for me.”

The Brink spoke with Byrne about why veterans might be at greater risk of homelessness, the stigma faced by those dealing with housing insecurity, and what we can all do to help.

with Thomas Byrne

The brink: how big of an issue is homelessness among veterans i’ve read that while veterans have historically been at greater risk of homelessness, the situation is improving..

Byrne: The research , including some studies that I’ve been a part of , does show that veterans do face an elevated risk of homelessness relative to the general population. Folks may think that veterans face an elevated risk due to stressors they might experience while they’re on active duty, combat experiences. When you look specifically within members of the military, combat exposure and PTSD are associated with higher risk of homelessness. And when we are talking about the most recent generations who served in Iraq and Afghanistan, there is some evidence that the dynamics of their homelessness is different, in that they appear to become homeless more quickly after exiting the military as compared to older veterans. But, broadly speaking, it’s not entirely clear why veterans, as a group, have a higher risk than the civilian population. One possibility is that it has to do with the fact that military veterans are not necessarily representative of the general US population. There’s some evidence that you see the elevated risk of homelessness for veterans first show up when the military switched to an all-volunteer force. What you get is not necessarily a broad-based sample of the population entering the military. You have folks who have socioeconomic characteristics, and maybe life experiences, that may have put them at an elevated risk of homelessness even prior to their military service. And so they remain at an elevated risk once they discharge. I think that’s certainly a plausible theory.

The Brink: Veterans experiencing homelessness are mostly male, but are there other things, apart from service, that they have in common?

Byrne: Military veterans are a heterogeneous group with respect to premilitary, military, and post-military risk factors. There’s been some research that’s tried to look explicitly at those three things. A lot of the risk factors for homelessness in the general population—adverse life experiences, lack of economic resources— also apply to members of the military . For premilitary risk factors, adverse childhood experiences can contribute; during military service, traumatic experiences—whether it’s combat exposure, military sexual trauma; and then post-military factors—job loss, financial difficulties, dissolution of relationships. One of my colleagues did a study looking at risk factors among military veterans who served in the post-9/11 era, and one of the strongest was military pay grade, which is a proxy for socioeconomic status.

The Brink: How do you define homelessness, because different groups categorize it in different ways?

Byrne: When we’re talking about homelessness in the United States, there is a definition that is shared by the Department of Veterans Affairs and by the Department of Housing and Urban Development. And it is basically people who are living in emergency shelters or transitional housing, residential programs specifically meant for people experiencing homelessness, or people who are unsheltered—literally living on the streets or in places not meant for human habitation. When we’re talking about the number of veterans experiencing homelessness, it doesn’t count people who might be doubled up, or couch surfing, who might be in housing arrangements that are less than ideal or unstable in some way. For some context, on a given night, there are around 37,000 veterans experiencing homelessness across the United States, and that’s a number that’s decreased by about 50 percent since 2009. Homelessness is a dynamic phenomenon: most folks who are homeless only experience homelessness for a fairly short period of time, and so there’s a lot of turnover in the population. The big reductions in homelessness among veterans over the past 10 to 12 years has a lot to do with the investments that the Department of Veterans Affairs has made in housing programs.

The Brink: There’s still a lot of stigma around homelessness. Can you humanize it for us?

Byrne: In some ways, the stigma of homelessness is an extension of the stigma that surrounds poverty in this country more broadly. Some of that is just deeply rooted in what we—broadly speaking, as an American society—value in individualism and self-reliance. We see poverty and homelessness as moral failings of individuals, when in reality there’s a lot of evidence, including work that I’ve done , that links homelessness in the aggregate most strongly to housing market conditions, the lack of affordable housing. It’s often the product of structural factors that mean we’re going to have some amount of homelessness, and then individual vulnerabilities that place people at a higher risk. There’s a lot of stigma, but there ought not be. For most veterans and people who are experiencing homelessness, it’s a really temporary phenomenon. It’s not something that people fall into and never escape from—it’s a housing crisis that people experience. More often than not, if people get some assistance to resolve that housing crisis, they’re likely to remain stably housed thereafter. I think there’s less stigma when we’re talking about military veterans specifically, because of the social status that they hold in society. They’re a group of folks whom we as a society and our political leaders have decided merits special attention, and that’s come in the form of big investments in housing programs specifically for veterans experiencing homelessness. There’s been a lot of success from those efforts. I think that goes to show what can happen when you destigmatize the issue of homelessness and focus on solutions that work to address the problem.

The Brink: According to Pine Street Inn , “56 percent of all homeless veterans are African American or Hispanic.” It also seems the improvements you’ve talked about haven’t necessarily reached them evenly. What is causing those huge disparities?

Byrne: It’s part and parcel of the same structural forces that underpin lots of inequities in our society. When we’re talking specifically about housing, you can bring into the conversation things like redlining and discrimination in rental markets that may have historically made it more difficult for people of color to access housing and to build wealth, which might buffer them in the instance of an economic shock. What holds true in the broader population likely holds true for military veterans, as well.

The Brink: What’s one thing everyone reading this can do to help veterans and others experiencing homelessness?

Byrne: Ultimately, what’s at the root of homelessness, both among veterans and more broadly, are the issues of affordable housing and housing affordability. Wherever it’s within your power, advocate for the expansion of housing for folks who are experiencing homelessness or just everyone in general. Part of what motivates me to do this work is that I think having a safe, decent place to live is a really fundamental right, and prerequisite to having any kind of decent life. Everyone would want that for themselves and for their family members, so just think about it in those terms. If people want to get involved more specifically, there are certainly organizations that are working directly with veterans experiencing homelessness. There’s a number of them here, locally, in Boston and in Massachusetts that are doing really great work. There is also sometimes a gap where some funding sources can’t be used to pay for certain things that people might need to set up their apartment, for example, so there’s a real need for philanthropy to fill in and provide funds.

The Brink: Lastly, what message or advice would you have for veterans—or families of veterans—reading this who are concerned about their housing status?

Byrne: It’s not unusual for me to get emails directly from veterans who are experiencing homelessness. And there are two resources that I direct folks to. The first is the National Call Center for Homeless Veterans , a 24/7 hotline where trained staff work to connect veterans and others with VA and non-VA services. The phone number is 1-877-4AID-VET (1-877-424-3838). The second is Supportive Services for Veteran Families , a homelessness prevention and rapid rehousing program funded by the VA, but operated by community-based agencies. The VA’s website has a comprehensive list of providers throughout the country and their contact information.

This interview was edited for brevity and clarity.

Byrne’s veteran-specific work is supported by the Department of Veterans Affairs’ Health Services Research and Development Service, Quality Enhancement Research Initiative, and National Center on Homelessness among Veterans.

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There are 3 comments on Why Veterans Remain at Greater Risk of Homelessness

I don’t believe any of our veterans should be homeless. It’s time our VA did the right thing for them.

I 100% agree! They need to make sure the people who sacrificed their bodies for x amount of time are taken care of.

I have the utmost respect for human life. Our veterans are believers in your safety. ITS A JOB not for many but resilience and determination they do it. I am currently waiting for a homeless service man now. I live in a travel trailer small but to help and feed one who protects my family and myself , it’s a honor to give back what they do for me. Thanks ps love is free….

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Addressing Veteran Homelessness

• First Online: 24 March 2023

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• Benjamin F. Henwood 3 &
• Sonya Gabrielian 3  

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During the past decade, homelessness among U.S. veterans has been reduced by nearly half. Most of this decline has been attributed to the success of the U.S. Department of Housing and Urban Development-U.S. Department of Veterans Affairs (VA) Supported Housing program (HUD-VASH, the VA’s permanent supportive housing program) and its adoption of a Housing First approach. Housing First is guided by several key principles that include: (1) immediate access to permanent housing; (2) no treatment or sobriety requirements (either before or after being housed); (3) availability of a flexible array of health and social services; and (4) choice in the type and frequency of housing and supportive services. For most homeless veterans—regardless of mental illness, substance use disorders, or co-occurring disorders—HUD-VASH has been associated with improved housing and clinical outcomes. Still, HUD-VASH is not appropriate for all homeless veterans, and it may work better for some than others. There can be significant challenges to engaging and enrolling some veterans in HUD-VASH. The VA and its community partners use several other services to address veteran homelessness, including transitional housing, residential rehabilitation, assertive community treatment, homeless outreach, and patient-centered medical homes tailored for homeless veterans (also known as homeless patient-aligned care teams). This chapter discusses contextual factors relevant to working with homeless veterans who have mental illness, substance use disorders, or co-occurring disorders and share best practices that meet the needs of homeless veterans using case examples to help bridge the gap between the research literature and frontline practice.

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Henwood, B.F., Gabrielian, S. (2023). Addressing Veteran Homelessness. In: Warner, C.H., Castro, C.A. (eds) Veteran and Military Mental Health. Springer, Cham. https://doi.org/10.1007/978-3-031-18009-5_19

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Risk Factors for Homelessness Among US Veterans

Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans.

INTRODUCTION

Homelessness among veterans has been of major public concern for over 3 decades. Homelessness among substantial numbers of veterans was first documented after the Civil War ( 1 ), but it was not until the early 1980s, a period characterized by high inflation and 2 economic recessions, that veteran homelessness began to be recognized as an important public health problem ( 2 – 4 ). Most recent estimates report that veterans are slightly overrepresented in the US homeless population with veterans constituting 12.3% of all homeless adults in the United States ( 5 ) but only 9.7% of the total US population ( 6 ).

Homelessness has been defined as not having a “fixed, regular, and adequate nighttime residence” (7, p. 1), and it includes moving frequently between different types of accommodations and staying in homeless shelters and places not meant for human habitation (e.g., vehicles, abandoned buildings). Among the general population, homelessness has been a social, economic, and public health concern in the United States and internationally since the early 1980s ( 8 – 10 ). Some consider homelessness a violation of a basic human right—the right to have access to safe and secure housing ( 11 , 12 ). Homelessness is also a concern because it is associated with a host of other negative outcomes, including a wide range of serious medical problems ( 13 , 14 ), mental health and substance abuse problems ( 10 , 15 ), premature mortality ( 16 , 17 ), frequent hospitalizations, greater than average costs per hospital stay ( 18 , 19 ), and incarceration ( 20 , 21 ).

Veterans constitute a unique segment of the US population because of their service to the nation and, as reflected in their increased access in the years since World War II ( 22 ), to special benefits such as VA health care, disability and education benefits, and home-loan guarantees. Veterans may also be more vulnerable to certain health and psychosocial problems than other adults because of their higher exposure to combat-related trauma and geographic dislocation for military deployment ( 23 ). The presence of veterans within the general US homeless population is regarded as a point of public shame by many, and public concern for their health and well-being is strong ( 24 , 25 ). In 2009, Secretary Eric Shinseki of the Department of Veterans Affairs (VA) pledged to end homelessness among veterans in the next 5 years, and since then millions of dollars have been used to fund the creation and expansion of VA services for homeless veterans ( 26 ). A growing component of those efforts is a focus on the prevention of homelessness, which involves addressing key risk factors before they result in an episode of homelessness.

Veterans have been overrepresented in the homeless population since at least the late 1980s. Although this disparity has attenuated over time ( 5 ), it remains puzzling because homeless veterans are consistently found to be older, better educated, more likely to have married, and more likely to have health coverage than other homeless adults ( 22 ). By virtue of their military service, all homeless veterans also have had some employment and a work history. These advantages should put veterans at lower risk for homelessness than other homeless adults, although they appear to be at higher risk among some veteran cohorts, especially those who were recruited after the advent of the all-volunteer force in 1975 ( 22 , 27 ). No comprehensive models of veteran homelessness have been formulated, but it has been recognized that premilitary, military, and postmilitary factors need to be considered in identifying risk factors for veteran homelessness ( 28 – 30 ).

Several reviews of studies on risk factors for homelessness in the general population have been conducted ( 31 – 33 ), and a broad literature review on homelessness among veterans was recently conducted by the VA's Evidence-Based Synthesis Program ( 34 ). However, to our knowledge, there has been no systematic review of risk factors for homelessness specifically among veterans in the published literature. Such a review is important as efforts to address veteran homelessness continue, government funds are directed at prevention efforts, more veterans return from recent conflicts in Iraq and Afghanistan, and the scientific community seeks to understand the body of knowledge amassed from research on the causes of homelessness among veterans.

In this systematic review, we provide a comprehensive examination of the published literature on risk factors of homelessness among US veterans. First, we compiled and categorized existing studies into 3 categories on the basis of the nature and rigor of their research designs: 1) large cohort, case-control, or other more rigorous studies based on recognized designs; 2) less rigorous, cross-sectional, descriptive, specific focus, or other uncontrolled studies; and 3) studies comparing homeless veterans with homeless nonveterans. Second, we summarized the findings of studies in each category and provide a synthesis of distinctively consistent findings across studies. Third, we describe current gaps in knowledge and recommend future areas for research. Fourth, we conclude with a discussion of the implications of these findings for policy and practice.

A systematic and exhaustive computerized literature search of PubMed, PsycINFO, Google Scholar, Academic Search Premier, and Web of Science databases was performed by both authors of studies published in English from 1900 to July 2014. Different combinations and iterations of the following key words and medical subject headings were used to search titles and abstracts in each database: homelessness, homeless, veterans, military, risk, risk factors, characteristics, and causes. Boolean operators (e.g., AND, OR) and wildcard symbols (e.g., *) were used (e.g., search string: “homeless veteran*” AND “risk factor*” OR “homeless veteran*” AND “characteristic*”).

Only studies that met the following criteria were included in the review: 1) sampled US veterans; 2) assessed homelessness in the United States; 3) included homelessness as an outcome or dependent variable; and 4) examined variables in relation to homelessness as a main study aim with the intent to identify risk factors orcharacteristics associated with homelessness. A broad definition of homelessness was used to be inclusive of studies, which included the US Housing and Urban Development's (HUD's) definition ( 35 ), use of any specialized VA homeless services, or a documented V60.0 clinical code suggesting homelessness according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Veteran status was defined as having ever served in the US military regardless of discharge status.

Studies were excluded if they reported only the effects of a specific intervention (e.g., supported housing) or if they reported only qualitative data. Case reports, published commentaries, and letters to the editor that did not report any quantitative data were also excluded. References from all relevant literature were hand searched and used to identify additional relevant studies. Several experts in the field were contacted to inquire about additional studies or reports that may not have been found in the literature search.

As Figure 1 shows, our search initially yielded a total of 153 individual records, which were screened generally for topic relevance and reporting of quantitative data, resulting in the exclusion of 30 of those records. The remaining 123 records were carefully examined, of which 81 were excluded because they failed to meet inclusion/exclusion criteria, resulting in a total of 32 studies that met criteria. All 32 studies included were peer-reviewed journal articles, except for 4 book chapters and 2 published governmental reports. One report ( 36 ) and one study ( 37 ) used the same data and reported similar results so they were considered one study, resulting in a total of 31 separate studies included in this review.

Different phases of the search for risk factors for homelessness among US veterans in studies published from 1900 to 2014.

Our systematic review followed the guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement ( 38 ). We did not conduct a meta-analysis because a varying array of measures, variables, research designs, and statistical tests were used in these studies that precluded an accurate, balanced, quantitative synthesis of this literature. However, we reported odds ratios or adjusted odds ratios (both denoted as “ORs” for simplicity) and other effect size statistics (e.g., hazard ratios, risk ratios, percentages) when available to provide readers with a sense of the magnitude of the risk factors identified. However, we do caution that these statistics must be understood in the context of each individual study and may not be directly comparable as different research designs, covariates, and measures were used in each study.

For our review, we categorized studies on the basis of the rigor of their research design and provided a narrative synthesis of their findings. We divided the 31 included studies into 3 categories: more rigorously designed studies, less rigorously designed studies, and comparative studies of homeless veterans and homeless nonveterans. One book chapter ( 39 ) contained 2 separate analyses so it was divided into 2 categories.

More rigorous studies consisted of studies that used a cohort, case-control, or clearly formulated research design that provided support for causal factors for homelessness (e.g., structural equation modeling estimates of causal relations) ( 40 ); used relatively large samples; and evaluated a broad range of sociodemographic, psychosocial, and health measures. These studies were judged to have lower risk for bias because methodologies were clearly described, more representative samples were used, and confounding variables were taken into account.

Less rigorously designed studies consisted of studies that were cross-sectional (i.e., descriptive) or had weaker research designs (e.g., case-control design with no historical controls); had relatively small sample sizes or focused descriptively on particular subgroups of homeless veterans; and utilized a limited number of psychosocial and health measures or focused on a particular domain (e.g., neurological deficits).

Comparative studies consisted entirely of studies that compared veterans with nonveterans on risk factors and characteristics associated with homelessness. These studies mostly used a cross-sectional research design, with a few exceptions (e.g., one longitudinal and one case-control design study).

More rigorous studies

A total of 7 studies were identified that were based on data collected between 1986 and 2011 (arranged by date of data in Table 1 ). Of these 7 studies, 3 were case-control studies, 3 were cohort studies, and 1 was a study that used a structural equation modeling analysis of cross-sectional data. These studies differed in their sample frames, partly based on when the studies were conducted. For example, one study sampled Vietnameraveterans( 28 ),while 3 studies exclusively sampled Iraq and Afghanistan era veterans ( 36 , 41 , 42 ). It is notable that all of the studies exclusively or predominantly sampled male veterans given the predominance of males in the veteran population, except for one study that exclusively sampled female veterans ( 43 ). All of the studies used large population-based samples, except the study focused on female veterans and another study that examined subsequent homelessness among veterans who had obtained supported housing ( 44 ).

More Rigorous Published Studies on Risk Factors for Veteran Homelessness, 1994–2013

Abbreviations: DoD, Department of Defense; HR, hazard ratio; HUD–VASH, Housing and Urban Development–Veterans Affairs Supportive Housing Program; OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom; OR, odds ratio; PTSD, post-traumatic stress disorder; RR, risk ratio; VA, Department of Veterans Affairs.

Of the 7 studies, the most consistent risk factors for homelessness identified by all studies were substance abuse and mental health problems. This was found in all 3 cohort studies ( 36 , 41 , 44 ), which provide support that these problems preceded homelessness. Substance abuse problems appeared to be the risk factor with the greatest magnitude of effect. Three of the 4 studies that included assessment of psychotic disorders (i.e., schizophrenia) also particularly identified psychotic disorders as a major risk factor ( 36 , 42 , 45 ). Post-traumatic stress disorder (PTSD) was a risk factor, but it was found to be of the same magnitude as other mental health disorders. One study did find that PTSD specifically increased a veteran's risk for returning to homelessness, but only after supported housing had led to an initial exit from being homeless ( 44 ).

Another consistent finding was that 6 of the 7 studies identified low income/poverty and income-related variables, such as military pay grade and unemployment, as risk factors for homelessness. Presumably all of the homeless veterans in these studies were poor and lacked financial resources for housing. One of these studies found that VA service connection, which is a VA source of disability compensation income, was protective against homelessness ( 45 ). Another of these studies further found that money mismanagement was a larger risk factor than income and mental health problems ( 7 ).

Three studies also suggested that lack of social support was a risk factor for homelessness. One study found that post-military social isolation after returning from the Vietnam theater had direct effects on homelessness ( 28 ), and 2 other studies identified unmarried status as a risk factor ( 42 , 43 ).

There were mixed findings regarding whether service in Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) increased risk for homelessness, which most likely reflected differences in the choice of comparison groups. Although one study found that OEF/OIF service was protective against homelessness when examined among a comprehensive sample of VA service users, even after adjustment for age ( 6 ), another study found that OEF/OIF war-zone service moderately increased the risk for homelessness when examined among only Iraq and Afghanistan era veterans ( 37 ). Therefore, it seems that, among veterans of all service eras, OEF/OIF war-zone service does not stand as a risk factor, but it does among veterans who have served since September 11, 2001.

Several potentially important risk factors that were identified and measured in only single studies were adverse childhood events (e.g., childhood abuse, foster care) ( 28 ) and criminal history ( 41 ).

Less rigorous studies

A total of 9 less rigorous studies were identified on the basis of data collected from 1993 to 2013 (arranged by date of data in Table 2 ). Seven of the studies were cross-sectional studies, and the remaining 2 were small case-control studies. These studies, although not having as rigorous research designs, as comprehensive measures, or ability to infer directionality of associations, largely supported the findings of the “more rigorous” studies. All 3 of the studies that examined substance abuse and mental health problems found that they increased the risk for homelessness ( 21 , 46 , 47 ), supporting findings from the more rigorously designed studies. Although no studies examined psychotic disorders specifically, one separate study examined PTSD specifically and found that veterans with PTSD were not at greater risk for homelessness than veterans with other mental health diagnoses ( 39 ), consistent with findings from the more rigorous studies. Moreover, veterans with combat exposure appeared to be at lower risk for homelessness than those without combat exposure ( 39 ). It is noteworthy that only a small number of studies actually examined mental disorders as a risk factor, because many studies sampled homeless veterans with mental illness exclusively ( 29 , 39 , 47 , 48 ). Moreover, income level/poverty was not examined specifically as a risk factor in these studies because, almost by definition, homeless veterans in these studies were poor and impoverished. A few other less rigorous studies provide further evidence for findings of the more rigorous studies. Childhood problems were found to be weakly associated with more extensive periods of homelessness ( 49 ), providing evidence that premilitary factors increase the risk for homelessness found in a more rigorous study ( 28 ). OEF/OIF veterans were generally not found to be at higher risk for homelessness compared with veterans of other eras ( 50 ), similar to findings reported in one more rigorous study ( 45 ). The presence of neurological deficits was also found to be a potential risk factor ( 48 ), which accords with a more rigorous study that found that traumatic brain injury increases the risk for homelessness among recent non-OEF/OIF male veterans ( 37 ). Specific to the veteran population, problematic military discharges were found to be a risk factor for homelessness ( 29 ) as found in a more rigorous study ( 37 ).

Less Rigorous Published Studies on Risk Factors for Veteran Homelessness, 1997–2014

Abbreviations: ACCESS, Access to Community Care and Effective Services and Supports; HCRV, Health Care for Reentry Veterans Program; HUD–VASH, Housing and Urban Development–Veterans Affairs Supportive Housing Program; NVVRS, National Vietnam Veterans Readjustment Study; OEF, Operation Enduring Freedom; OIF, Operation Iraqi Freedom; OR, odds ratio; PTSD, post-traumatic stress disorder; VA, Department of Veterans Affairs.

Consistent with 3 more rigorous studies suggesting that the effects of social isolation increased the risk for homelessness ( 28 , 42 , 43 ), 2 less rigorous studies also reported that weaker social support was associated with a longer duration of lifetime homelessness ( 46 ) and more chronic homelessness ( 51 ). A third less rigorous study reported that veterans themselves attributed weakened social connections to their increased risk for homelessness ( 47 ).

A strong association was found between incarceration and homelessness in veterans in one less rigorous study ( 21 ). Although the directionality of this relation is unclear, it is generally supportive of criminal history's being a risk factor for homelessness as reported in a more rigorous study ( 41 ).

Comparative studies of homeless veterans and homeless nonveterans

A total of 15 studies were identified that compared risk factors and characteristics of homeless veterans and homeless nonveterans. Collectively, these studies were based on data collected from 1983 to 2010, which include some of the earliest studies in this review (arranged by date of data in Table 3 ). Most of the studies were cross-sectional, except for 6 studies that had case-control design components ( 27 , 39 , 52 – 55 ) and 1 study that used observational longitudinal data ( 56 ).

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

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.

All of the case-control studies found a greater risk for homelessness among veterans compared with nonveterans, including other adults in the general population and specifically in low-income populations, although there were substantial differences between age strata representing different eras of military service ( 27 , 52 ). These studies further found particular subgroups of veterans who were at particularly greater risk than nonveterans. Male post-Vietnam era veterans, that is, those who served in the early years of the all-volunteer force, appeared to be at particularly greater risk for homelessness than other male adults in the same age cohort, while veterans who served during World War II or the Korean War era were at lower risk for homelessness than nonveterans. As one study suggested ( 57 ), this may be due to a “social selection” effect. Many of the men who volunteered to serve in the military during this time may have been escaping poor economic conditions and lacked family support. Two other case-control studies, conducted on data collected over a decade apart, both found that female veterans were particularly at greater risk than other women ( 53 , 54 ). These findings suggest the substantial risk for homelessness among female veterans regardless of service era, perhaps because they have never been subject to a military draft and thus have always been volunteers susceptible to social selection effects ( 53 ).

The remaining cross-sectional studies were focused mainly on comparing sociodemographic and health characteristics between homeless veterans and homeless nonveterans ( 1 , 55 , 57 – 62 ). Some consistent differences in sociodemographic characteristics were found as homeless veterans were older, better educated, and more likely to be male, to be or to have been married, and to have health coverage (often through the VA). However, there were some mixed findings about race differences, which may reflect when the data were collected and the era in which the veterans under study served. Several of the earlier studies found that homeless veterans were more likely to be white than were homeless nonveterans ( 1 , 58 , 60 ), but fewer race/ethnic differences were found in more recent studies as the veteran population has become more racially/ethnically diverse and some studies found the reverse to be true with homeless veterans more likely to be nonwhite ( 54 , 55 , 57 , 61 ).

A high prevalence of physical, mental health, and substance abuse problems was found among both homeless veterans and homeless nonveterans, but there were inconsistent findings when they were compared. For example, 4 studies found that homeless veterans were more likely to have substance abuse problems ( 57 – 59 , 61 ), but 4 other studies found little to no difference in mental health or substance abuse problems ( 52 , 53 , 56 , 60 ). Additionally, 3 studies found that homeless veterans had more physical health problems than homeless nonveterans ( 59 , 62 , 63 ), which may partly reflect their greater age, while 2 other studies found no significant differences in physical health ( 60 , 64 ). Studies that have found greater physical health problems among homeless veterans reported that they were more likely to report a physical injury or medical problem that contributed to their homelessness ( 59 ) and to have 2 or more chronic medical conditions, including hypertension, hepatitis/cirrhosis, diabetes, and heart disease ( 62 ).

Finally, 2 studies suggested that adverse childhood experiences are less of a risk factor for homelessness for veterans than for nonveterans. One study found that homeless veterans reported fewer conduct disorder behaviors in childhood than did homeless nonveterans ( 61 ), and another study found that the association between adverse childhood experiences and adult homelessness was attenuated in veterans ( 65 ).

This systematic review provides an examination of data on risk factors for veteran homelessness spanning over 2 decades. Several consistent risk factors were found across both more rigorous and less rigorous studies. Probably the strongest risk factors identified, other than the pervasive risk factor of extreme poverty that plagues virtually all homeless people, were substance use disorders and mental illness. In particular, psychotic disorders such as schizophrenia and alcohol and drug use disorders were found to be associated with homelessness. This is consistent with research on homelessness in the general population, where schizophrenia and bipolar disorder have been found to have the greatest impact on risk for homelessness at the individual level, and substance abuse has been found to have the greatest impact at the population level ( 31 ).

It is noteworthy that PTSD, which is more prevalent in the veteran population than the general population, was not a particularly important risk factor relative to other mental disorders. Similarly, combat exposure, at least among Vietnam era veterans, was not found to be associated with increased risk for homelessness, perhaps, in part, because such veterans are more likely to receive VA compensation, pension, and health benefits. OEF/OIF war-zone veterans were not at greater risk for homelessness when compared with veterans of other eras, but they were at greater risk compared with non-OEF/OIF theater veterans of the same era (i.e., military service after September 11, 2001). There may be various reasons for this. OEF/OIF veterans likely have higher overall rates of mental disorders and substance abuse problems compared with their non-OEF/OIF counterparts because of their exposure to war-zone stress ( 66 , 67 ). OEF/OIF veterans are also more likely to experience traumatic brain injury and other neurological problems, which may be risk factors for homelessness as found in several studies reported in this review ( 37 , 48 ). Some veterans have never been deployed or served in a war zone, whereas OEF/OIF war-zone veterans have all been separated from family and friends for some time. This may have led to deterioration in social support networks after military service, which is another risk factor for homelessness identified in several of the studies considered in this review ( 28 , 46 , 47 ). Some of these factors may have been less salient during the Vietnam War because of different methods of warfare, conscription, stigma, and screening of mental health problems at the time. It is also possible that rates of homelessness among Vietnam veterans were much higher in the years immediately following their return from overseas than they have been in recent decades when homelessness among veterans has been subject to more extensive research. Homelessness was virtually unstudied at that time so data on the Vietnam cohort in the years immediately following their war-zone service are not available.

As mentioned above, another robust risk factor was low income and income-related variables, such as military pay grade and unemployment. This finding was not surprising as homeless individuals, almost by definition, are impoverished and deprived of economic resources. Additionally, many studies of homeless adults in the general population have identified low income and unemployment as common antecedents of homelessness ( 31 ). For veterans, access to a VA service-connected disability payment was found to be a protective factor against homelessness, which suggests that it is one way to prevent homelessness. Besides the amount of income veterans receive, one study in this review reported that money mismanagement of income is also a risk factor ( 41 ).

In fact, researchers working in some non-VA programs have developed money management services to help homeless adults manage their money ( 68 ), and the popular Housing First model of supported housing generally encourages clients to participate in money management and/or to have representative payees to ensure that their rent is paid ( 69 ). Within the VA, researchers have developed interventions to teach veterans with addictive disorders money management skills and to offer them voluntary representative payees ( 70 , 71 ), but these interventions have not yet been specifically tested or adapted for homeless veterans.

A third risk factor concerns a difficult construct to measure, which is deficient social support. Several studies indicated that lack of support from family and friends, weak social support networks, and social isolation are related to veteran homelessness. It is not clear whether veterans are particularly susceptible to this risk factor given the nature of military service (e.g., deployments and transfers, on-base housing), but the beneficial and protective effects of social support on stress, health, and overall functioning are well documented in the general population ( 72 , 73 ), as well as in the veteran population ( 74 , 75 ). Therefore, it is reasonable to theorize that the interruption of such support by military service can have deleterious effects and be associated with increased social isolation and, thus, homeless risk among veterans. However, further study with stronger research designs and comprehensive measures of social support is needed to determine the magnitude of this risk factor exactly.

Two other risk factors not commonly studied but appearing to be moderate risk factors—incarceration and adverse childhood experiences—deserve mention. Incarceration can lead to residential displacement, limited employment prospects, stigma, and disrupted personal relationships, which can ultimately increase risk for homelessness. It has been suggested that the general increase in homelessness in the United States during the 1980s was more related to mass incarceration secondary to the war on drugs than to deinstitutionalization of patients in state mental hospitals ( 76 ). Adverse childhood experiences and other premilitary factors may also set a pathway toward poverty and homelessness. Several studies have found that many homeless veterans report childhood behavioral problems, family instability, placement in foster care, and childhood trauma and abuse ( 28 , 49 , 65 ), and these early childhood problems have also been documented among the general, nonveteran homeless population as well ( 77 , 78 ). More recently, a large survey study found that men with military experience since the advent of the all-volunteer force had a higher prevalence of a range of adverse childhood events than adults without such experience ( 79 ), consistent with our findings of greater risk for homelessness among veterans of the all-volunteer force. However, more rigorous studies are needed to conclusively label these premilitary factors as well as incarceration as independent risk factors for homelessness among veterans and to understand the mechanisms behind their association with homelessness.

Although race and gender were not found to be substantial risk factors for homelessness among veterans, it is important to recognize that many homeless veterans are demographically different from other homeless adults. Comparative studies with nonveterans have shown consistently that veterans were at greater risk for homelessness and that homeless veterans were more likely to be male, to be better educated, and to be or have been married than homeless nonveterans. Certain groups of veterans may be at particularly greater risk for homelessness compared with their nonveteran counterparts, including male veterans who served during the early years of the all-volunteer force in the later 1970s and female veterans.

In many ways, the major risk factors for homelessness identified for veterans are similar to those that have been identified for adults in the general population. However, this finding does not suggest that all the risk factors are the same, as we did find some unique risk factors for veterans. Comparative studies between homeless veterans and nonveterans pointed to additional questions that future studies should seek to answer. Our review highlights these gaps in the research literature, which we suggest as important areas for future research.

Recommendations for future research

First, more rigorously designed studies are needed. We could find no prospective cohort or experimental studies, which admittedly could be prohibitively expensive or infeasible. As homelessness is a relatively rare event, large sample sizes would be needed, and there would be ethical concerns with random assignment. However, more retrospective cohort studies as well as case-control studies could be conducted. Also lacking are studies that utilize structured diagnostic assessments and comprehensive measures of sociodemographic, health, and psychosocial characteristics. Most existing studies used self-report measures assessing a few select domains. Future studies using measures that have been psychometrically tested and validated on homeless populations and are objective and/or corroborated by other data are needed. We did not conduct a meta-analytical review of risk factors because of the variety of different measures, research designs, samples, and statistical analyses used across studies. For that reason, we also could not definitively comment on the relative magnitude of different risk factors compared with each other. It may be worthwhile for future studies to use more standard methodologies so that meta-analyses may be possible.

Second, more studies are needed on certain subgroups of veterans, such as female veterans and veteran families. Nearly all studies in this review predominantly or exclusively sampled the male veteran, and all focused on veterans as single adults (rather than families). However, the demographics of the veteran population are changing, as more female and racial/ethnically diverse veterans enlist ( 80 , 81 ). Consequently, there is concern about the increasing number of homeless female veterans ( 54 , 82 ), their rates of sexual trauma ( 83 ), and the welfare of their children and families ( 54 , 82 ). Further research is needed on risk factors within these special subgroups.

Third, the pathways by which veterans become homeless and the specific role of military service in that process remain unclear. For example, one study found that mental illness diagnosed during the military predicted homelessness within 2 years after military discharge ( 37 ), while another study observed an average of 14 years between military discharge and the first episode of homelessness ( 47 ). Postdeployment social isolation and the possible disruptive effect of military service on relationships with family, friends, and other loved ones need to be studied in far more detail as they may be remedial features in pathways to veteran homelessness. Many veterans would not have become homeless if there were other people in their lives who could have offered emotional or instrumental support (e.g., money, place to stay).

Some studies have also gone beyond identifying specific risk factors to identifying constellations of factors or risk pro-files of homeless veterans ( 64 ). More detailed studies on the individual and synergistic effects of risk factors, mechanisms, and their time course are needed to elucidate these pathways to allow eventual development of a comprehensive model of the causes of veteran homelessness. With the exception of one model formulated 2 decades ago ( 28 ), there has not been much progress in developing comprehensive explanatory models for homelessness. Additionally, further work is needed to elucidate the interrelations between premilitary, military, and post-military factors to determine which ones are independent, addictive, or mitigative in increasing homeless risk.

A fourth area for future study is in understanding the differences in characteristics and risk factors between homeless veterans and homeless nonveterans. It appears that veterans of certain age cohorts appear to be at particularly greater risk for homelessness than nonveterans of the same age. Nonetheless, the paradox of certain cohorts of veterans being at greater risk despite being better off socioeconomically than nonveterans and being eligible for various health-care services and benefits through the VA needs to be further examined. Future research should address why veterans in some age cohorts differ or don't differ from nonveterans of similar age in their background and life experiences that may make them susceptible to homelessness, as this remains a question in the literature.

Finally, this review did not specifically identify risk factors that were modifiable or amenable to interventions, as there has been a paucity of research in this area. Future studies, however, should investigate which risk factors are most amenable to change and how to change them, information which will be important for ongoing prevention efforts. This review also focused on only individual risk factors, that is, micro-level factors, but did not examine system or institutional risk factors, that is, macro-level factors related to veteran homelessness. There may be factors, such as the dynamics of rental markets in areas with large populations of veterans, that put the veteran population or segments of the population at risk for homelessness beyond the effect of individual characteristics.

Implications for policy and practice

Policies and practices focused on assisting veterans to address the risk factors identified in this review should be supported. The VA's commitment to end veteran homelessness by 2015 depends on its ability not only to house veterans who are currently homeless but also to prevent veterans from becoming homeless in the future. Recent governmental reports have announced a decline in veteran homelessness ( 84 ), which may at least partly be due to the increased funding and development of VA homeless services. However, this apparent progress will likely need continued public attention and government support beyond 2015 to maintain reductions in veteran homelessness.

Homeless prevention efforts must be geared toward screening for the identified risk factors and ameliorating them, to the extent possible. The VA has recently implemented a 2-item homeless screening instrument at all facilities to identify veterans who are homeless or at risk of being homeless ( 85 ). This screener should be utilized to help target prevention interventions directly at those most vulnerable. Additionally, the Supportive Services for Veterans and Families (SSVF) Program was created in 2012 to prevent homelessness among veterans at imminent risk. The Supportive Services for Veterans and Families Program offers competitive grants to community-based organizations that can rapidly re-house homeless and at-risk veterans through time-limited case management, temporary financial assistance for moving expenses or rental fees, landlord mediation services, and other supportive services. Although not yet a well-defined program model, the Supportive Services for Veterans and Families Program holds promise in addressing many of the identified risk factors for veteran homelessness ( 86 ).

One main implication that can be drawn from our review is the crucial importance of connecting homeless and at-risk veterans with needed services and benefits. Access to mental health treatment, disability benefits, other income supports, and social services can help to prevent initial or subsequent episodes of homelessness. The VA, the largest integrated health-care network in the United States, offers an invaluable resource and a safety net for low-income and disabled veterans with multiple complex needs ( 25 , 87 ). Outreach to homeless and at-risk veterans eligible for VA care should be encouraged. Both veterans who are eligible and ineligible for VA care may become eligible for various medical, mental health, and social services outside the VA system as well. As the Affordable Care Act is implemented, hundreds of thousands of low-income and homeless veterans will be eligible for Medicaid in states that implement the Medicaid expansion ( 88 – 91 ) and/or have new affordable coverage options through the state-based health insurance exchanges that will be required to cover mental health and substance abuse services on par with medical services ( 92 , 93 ).

The findings of the review also support the use of supported housing as a direct response to homelessness. Permanent supported housing, which typically provides subsidized housing and case management services, has become one of the dominant service models for homeless adults, including veterans ( 94 – 97 ). Supported housing can help homeless veterans overcome their lack of income to pay for rent and provide linkages to mental health treatment that, as this review showed, are both factors strongly associated with homelessness. The VA's supported housing program, the Housing and Urban Development–Veterans Affairs Supportive Housing (HUD–VASH) Program, has been one of the centerpieces of the VA's plan to end homelessness among veterans ( 26 ). Although the HUD–VASH Program has been able to show substantial improvements in housing outcomes ( 94 ), less improvement has been observed in mental health, substance abuse, and quality-of-life outcomes. For example, some studies have found that many HUD–VASH clients continue to use substances after being housed ( 98 , 99 ) and that there are few improvements in psychiatric symptoms ( 100 ). These findings are important to consider because these factors may lead to a return to homelessness, as one of the studies in this review found ( 44 ). The HUD–VASH Program has officially adopted the Housing First model, which provides immediate access to subsidized housing with no requirements for mental health or substance abuse treatment. The Housing First model has shown great success in housing high-needs populations outside the VA ( 101 , 102 ), but it has not yet been formally evaluated in the HUD–VASH Program.

Similarly, there may also be a need for greater attention to the social and community integration of veterans after they obtain supported housing. Supported housing improves housing outcomes, but it seems to have little effect on social integration ( 103 , 104 ). Thus, if homeless veterans are socially isolated before supported housing, as our review suggests, then they may remain lonely and isolated after obtaining housing, which may put them at risk for subsequent homelessness. Additional interventions may be needed. For example, elements of one service model called the Critical Time Intervention ( 105 ) may hold potential in helping homeless individuals engage in their communities and develop natural support systems. Peer support and other social support interventions ( 106 – 108 ) may also help homeless or formerly homeless veterans expand their social support networks and integrate into their communities.

Finally, this review provides some support for 2 VA homeless programs recently created to help justice-involved veterans, namely, the Health Care for Re-entry Veterans (HCRV) and the Veterans Justice Outreach (VJO) programs. The Health Care for Re-entry Veterans Program helps recently incarcerated veterans to re-enter the community ( 109 ), while the Veterans Justice Outreach Program diverts recently arrested veterans to treatment rather than incarceration ( 110 ). These programs, created under the umbrella of VA homeless services, address the link between incarceration and homelessness, as well as connecting at-risk veterans with mental health and social services. Thus, in essence, these programs demonstrate how risk factors for homelessness can be addressed through policy and practice.

Conclusions

Male and female veterans have been found to be at greater risk for homelessness than their nonveteran counterparts, although the disparity has declined over time and is most prominent among veterans of the all-volunteer force. Veterans appear to have many of the same major risk factors for homelessness as other adults, with the strongest and most consistent ones being substance abuse, severe mental illness, and low income. However, several risk factors unique to veterans have been identified in the literature, including problematic military discharges, low military pay grade, and social isolation after military discharge. Combat exposure and PTSD do not seem to playa distinctivelystrong role in veteran homelessness, perhaps because veterans have special access to VA services designed to meet their medical, mental health, and financial needs.

There have been few studies with strong research designs on this topic. No prospective cohort studies or experimental studies could be found, although several rigorous retrospective cohort and case-control studies have been conducted. Further study is needed to understand the exact pathways to veteran homelessness, including comprehensive models that consider premilitary, military, and postmilitary events and experiences. Special homeless veteran subgroups, such as women and families, also require additional comprehensive study. Veterans have been recognized as an especially deserving group throughout American history and have been provided with a unique health and social welfare safety net. The puzzle of why some of them, albeit a relatively small proportion, remain at risk for homelessness is a public health problem that needs to be better understood so veteran homelessness can eventually be ended.

ACKNOWLEDGMENTS

This work was supported by the Department of Veterans Affairs Health Services Research and Development Service (CDA 10-212).

Abbreviations

The views presented here are those of the authors alone and do not represent the position of any state or federal agency or of the US Government.

Conflict of interest: none declared.

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The Problem of Veteran Homelessness: An Update for the New Decade

Affiliations.

• 1 VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Washington, District of Columbia; Department of Management, Policy and Community Health, UTHealth School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut. Electronic address: [email protected].
• 2 Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; U.S. Department of Veterans Affairs, National Center for PTSD, VA Connecticut Healthcare System, West Haven, Connecticut.
• 3 VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Washington, District of Columbia.
• PMID: 33583678
• DOI: 10.1016/j.amepre.2020.12.012

Introduction: There has been a decade-long federal commitment to prevent and end homelessness among U.S. military veterans. Substantial progress has been made; so, a question that stakeholders ask is: Is veteran homelessness still a problem?

Methods: To answer this question, 2 different data sources were analyzed in 2020: (1) a nationally representative community survey of 4,069 veterans conducted in 2019 and (2) national administrative data from the U.S. Department of Veterans Affairs on >6 million healthcare and homeless services in 2019.

Results: In the community sample, the lifetime prevalence of adult homelessness was 10.2%, with the highest prevalence found in participants aged 30-44 years (19.9% prevalence). In the Veterans Affairs administrative data, 4.2% of all Veterans Affairs service users used homeless services (n=290,515 Veterans Affairs homeless services); 27.9% of these were first-time Veterans Affairs homeless service users. Veterans who were racial/ethnic minorities were more likely to report any lifetime adult homelessness, more likely to be identified as homeless in Veterans Affairs records, and more likely to have used any Veterans Affairs homeless program. There was no sex difference in the lifetime prevalence of homelessness, but Veterans Affairs records showed that male veterans were more likely to be identified as homeless and to use homeless programs, suggesting possible underidentification of female veteran homelessness. Across age, sex, and racial/ethnic groups, 35.1% of Veterans Affairs homeless service users used emergency department services in the same year.

Conclusions: There is a continued need to dedicate resources to address veteran homelessness across sociodemographic groups, and these data serve as a benchmark before and after the onset of the COVID-19 pandemic.

Published by Elsevier Inc.

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Homelessness in the Veteran Community Research Paper

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Introduction

Target population, the effect of social problems on the target population, the scale of the problem, problem analysis from theoretical perspective.

Social issues are a source of conflicting opinions based on what is considered morally right or wrong in personal life or interpersonal decisions in social life. According to Zastrow, a social problem implies the existence of an “influential group asserting that a certain social condition affects a large number of people” (Zastrow, 2000, p. 3). A social problem is a problem that affects many people in a society. Many people seek to solve this group of common problems in modern society. This is often the result of factors beyond individual control. Based on the above definition, the current paper addresses two social issues: homelessness and the veteran community.

The target population is divided into two groups: homeless and veteran communities. Homelessness is an acute social problem that is becoming increasingly urgent every year. The attitude of state authorities and ordinary citizens towards the homeless is ambiguous, and the mechanisms for providing support and assistance to them are not effective enough. The homeless category includes those who huddle in basements and attics and live with friends in hostels or houses intended for demolition. The lost category consists of those who huddle in basements and attics and live with friends in hostels or houses designed for destruction. The second target population group is the veterans, who also require significant support and help in integrating back into the workforce or providing healthcare opportunities.

The social problems include the particular social conditions that affect the mentioned target population groups. Such social conditions may consist of bureaucracy, the lack of government investments, class distribution, the lack of ethical considerations within the scope of the legislation, and many others which can deprive the mentioned population of the necessities. All three levels of social existence are allocated. On a micro level, homeless people can be stigmatized or discriminated against. On the meso level, the social problem affects the personalities of the target populations. Homeless people’s self-perception is distorted because they cannot afford society’s necessities. For the veterans who spend much time on war events, the emotional damage to their ego can be mentioned. It is caused by the lack of opportunities to adapt to non-war living conditions, which require the support of a specialist. The macro level of the target population is also affected because people are deprived of the possibility to build up an ideology or plan the future because their basic needs at home or communication are not met.

Most people who find themselves homeless are homeless because they are not protected by society. Despite the current growth of ethical-related interventions in various countries focused on equality, many people still suffer from not having enough money to live. The social polarization of the population, unemployment, and the high cost of housing is by no means a complete list of problems that states need to solve in the first place. According to the Organization, at least 100 million people in the big world have no apartments ( Global homelessness statistics , n.d.). Therefore, the problem is relevant, having vast scales. The issue of veteran support is less relevant compared with homelessness. However, it is still extremely important. According to the current statistics in the USA collected by the National Center for Veterans, the number of currently living veterans is significantly small ( National Center for Veterans , n.d.). However, it is stated that the support for such people.

The social problems of such significance as homelessness can be solved only through utilizing complex macro-sociological theories such as functionalism. Some mechanisms can be redesigned using this approach to the government’s functioning (Zastrow, 2000). As a result, preventing unwanted effects on the target population can be achieved. At present, quite a lot of experience has been accumulated in providing practical assistance to people without a fixed place of residence. The most important system of assistance to persons without a fixed place of residence is practical social work with the homeless. It should be focused on preventing difficult life situations and the rehabilitation and adaptation of these groups to the conditions of life. The development of this system can be performed through the functional perspective minimizing the negative impact of homelessness on society.

At the same time, the issue of veteran support can be considered from another theoretical perspective. Veterans’ support mainly includes a system of state-guaranteed economic, legal and social support measures aimed at improving the quality of life of veterans. Therefore, the approaches from the micro-sociological level should be allocated. Behavioral and personality theories are usually used to help people understand themselves and adapt to new living conditions (Zastrow, 2000). Social support and the help to adapt to life in the modern world can be performed through the help of psychologists centered on socializing people.

Therefore, social problems affect almost all the people in society. However, more vulnerable groups are already experiencing adverse issues related to unmet physical or moral needs. The homeless and the veteran population require specific attention, support, and protection from the government and social workers. Different theories can be applied to modeling social issues solutions, but the primary key to positive societal changes lies in the equal treatment of people disregarding their living conditions or income. The kind and support from the other members of society and the government can help the vulnerable population to feel more needed.

Global homelessness statistics . (n.d.). U.S. Homeless World Cup. Web.

Zastrow, C (2000). Social problems . Wadsworth.

National Center for veterans: Analysis and statistics . (n.d.). U.S. Department of Veterans Affairs. Web.

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IvyPanda. (2023, December 10). Homelessness in the Veteran Community. https://ivypanda.com/essays/homelessness-in-the-veteran-community/

"Homelessness in the Veteran Community." IvyPanda , 10 Dec. 2023, ivypanda.com/essays/homelessness-in-the-veteran-community/.

IvyPanda . (2023) 'Homelessness in the Veteran Community'. 10 December.

IvyPanda . 2023. "Homelessness in the Veteran Community." December 10, 2023. https://ivypanda.com/essays/homelessness-in-the-veteran-community/.

1. IvyPanda . "Homelessness in the Veteran Community." December 10, 2023. https://ivypanda.com/essays/homelessness-in-the-veteran-community/.

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IvyPanda . "Homelessness in the Veteran Community." December 10, 2023. https://ivypanda.com/essays/homelessness-in-the-veteran-community/.

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Homeless Veterans

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From bullet shells, to bomb blasts, and potentially amputated limbs, U.S. soldiers face on the scariest and life threatening situations no man or woman could ever imagine. America’s military is one of the strongest forces in the world and consists of the toughest and strongest men and women in the US. These soldiers have risked their lives, lost limbs, their friends, their family, and their lives. The bravery and honor that any soldier musters up to go into battle can result in the ultimate sacrifice, all to keep this amazing country free and safe.

Even with all of their sacrifices to this country, veterans are neglected and become homeless, hungry, and scared. 2018 is the first time in seven years that the homeless veteran rate has increased, and has done so with nearly 2,500 new homeless veterans just on the west coast. A main contributor to these homeless veterans is the Department of Veterans Affairs (The V.A.), the people that are supposed to help and guide these heroes back into a regular way of life. A proposed solution to this problem is to crack down on the V.A.’s neglect of veterans looking for the help and aid, and to partake in public fundraisers and projects. Fundraisers on payment sites such as Patreon and GoFundMe have been blessings to the veterans who have had funds started up for them, and it is an obligation as U.S. citizens to give back and help those who gave up nearly everything to keep the sanctity of security for this country.

One of the main contributors to homelessness among veterans is mental illness, most commonly, Post Traumatic Stress Disorder (PTSD). PTSD affects many military veterans from a wide variety of different deployments and wars, though the rates differ depending on which war they served in, PTSD affected 30% of Vietnam veterans, 11% of Afghanistan veterans, 20% of Iraq veterans, and 10% of veterans who served in the Gulf War (Brainline). Half of veterans with PTSD do not receive the treatment they require and 20% – 50% of those who do receive treatment end up not completing the course to get better. The lack of treatment is paramount to these veterans’ health, considering that 45% of homeless veterans have some kind of mental illness (Very Well Mind). The homecoming of a veteran has been related to that veteran’s degree of PTSD. Veterans with a more active PTSD reception upon their arrival tend to have harsher, more negative degree of PTSD. It is no wonder then that, those who had the hardest time re-entering society, Vietnam veterans, among whom 30% have had PTSD, make up 47% of homeless veterans (Coalition for Homeless Veterans). These veterans had the hardest time out of any, they had earned the title of “”Baby Killers”” and were scorned for their actions. This critical hatred and negativity against these soldiers who just came back from a blood bath caused them to not speak up to deal with their PTSD. The sacrifice of these men and women have been underappreciated by many, but those who criticize have never survived the means of war. These soldier’s sufferings have gone on to be suppressed and seen as something that they don’t have a right to fix because they are labeled as “”murderers””; therefore, not going and seeking the healthcare and medication they need.

Another cause of Veterans ending up Homeless is resorting to substance abuse. The reason for this behavior is that they cannot acquire help from the VA. coalition in place, they still don’t initially help these veterans when the problems arise at the start. Without the initial care, veterans feel as if they are thrown to the wolves of society and expected to live on their own. Individuals who have been deployed several times, have been exposed repeatedly to war and other injuries, such as amputations, are at a higher risk of developing substance abuse issues. The risk of heavy drinking, binge drinking, smoking, or a setback to smoking are prominent in these veterans. However, perhaps the greatest common concern is prescription drug abuse and Over The Counter drug abuse. Veterans, like civilians, are at risk for addiction to opioid pain medicines that were prescribed due to combat-related injuries.

There are handfuls of solutions done around the country, but solutions that have been beneficial have been ones of selflessness and persistence. Giving these homeless heroes a couple bucks when you pass them on the street helps just a little, but others have gone above and beyond and started public donation funds on different payment sites such as PayPal, GoFundMe, and Patreon. But others who have served in the military know very well how much the VA does to neglect and suck money out of these helpless veterans. There have been projects and efforts to try to crackdown on the VA and their negligence towards homeless veterans, and with many successful outcomes, there seems to be a wave of people who want to take part in exposing this corruption. Proposing public fundraisers for the helpless veterans is a gift of enormous magnitude to them and is cost-effective, simplistic, almost free. Continuing to expand on the matter of the VA’s harsh treatment will serve well to the veteran community, possibly even taken into Government if the severity and success increases. Along with the expansion of exposing Veterans Affairs, the popularization of public fundraisers for homeless heroes will give the sense of hope back to many veterans in accordance to bring unity back into American societies.

In conclusion, continuing to have efforts towards helping the helpless, especially those who have sacrificed more than needed, will benefit the heart and mind of America and its people. Helping out our veterans by connecting with their struggle will educate us on a problem that has been stagnantly increasing over the years. Exposing corruption, helping our country’s heroes, and turning someone’s life around are all such positive effects that also have positive effects on society and, most importantly, our veterans. Doing our best to benefit and give back to those who have given everything for our safety and freedom is a civic duty to all of us U.S. citizens.

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