Examining Veterans’ Health Behaviors After Homelessness: A Brief Review

Introduction: Veterans with a history of homelessness are at greater risk of developing chronic medical and mental health conditions than veterans who have never been homeless. Further, these veterans have a higher risk of suicide. Interventions aimed at improving housing stability may reduce adverse health outcomes. Eligible veterans can transition into permanent supportive housing (PSH), which provides housing support and case management services for individuals who are chronically homeless. However, after moving into PSH, veterans may not engage in health behaviors, which may lead to poor health management and reduced life expectancy. Methods: This brief review was not systematic, but rather a targeted thematic review with the primary aim of analyzing themes related to the effects of living in PSH on veterans’ health behaviors. A secondary aim was to review the literature and government reports about suicidality among veterans with a history of homelessness for broader implications. Ten articles were included in the analysis, representing 87,263 veterans. Results: The impact of homelessness on veterans' health is substantial. Veterans who have experienced homelessness are diagnosed with more chronic health conditions and have significantly higher rates of mental health challenges compared to veterans with no history of homelessness. Although access to health care and mental health support improved after moving into PSH, the long-term health outcomes are still uncertain. Conclusions: PSH is a protective factor that positively impacts the health behaviors of formerly homeless veterans. Barriers within PSH include securing affordable housing units, access to transportation, and frequent turnover among case managers. To improve veterans' health behaviors and quality of life following homelessness, providers and staff who support veterans living in PSH should provide opportunities for social engagement, establish primary care providers, and foster positive relationships.