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Am J Public Health. 2013 Dec;103 Suppl 2:S255-61. doi: 10.2105/AJPH.2013.301432. Epub 2013 Oct 22.

Risk factors for becoming homeless among a cohort of veterans who served in the era of the Iraq and Afghanistan conflicts.

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Stephen Metraux, Dennis P. Culhane, and Vincent Kane are with the National Center for Homelessness among Veterans, US Department of Veterans Affairs, Philadelphia, PA. Stephen Metraux is also with the Department of Health Policy and Public Health, University of the Sciences, Philadelphia. Dennis P. Culhane is also with the School of Social Welfare Policy and Practice, University of Pennsylvania, Philadelphia. Limin X. Clegg and John D. Daigh are with the Office of Inspector General, US Department of Veterans Affairs, Washington, DC. Dennis P. Culhane and Vincent Kane are both guest editors for this supplement issue.



In this population-based cohort study, we assessed baseline risk factors for homelessness, including the role of service in the Iraq or Afghanistan conflicts, among a large cohort of recent veterans.


Data for this study came from administrative records for 310,685 veterans who separated from active military duty from July 1, 2005, to September 30, 2006. We used survival analysis methods to determine incidence rates and risk factors for homelessness, based on baseline data for military factors, demographic characteristics, and diagnoses of behavioral health disorders and traumatic brain injury.


Service in Iraq or Afghanistan and, more specifically, posttraumatic stress disorder among veterans deployed there, were significant risk factors of modest magnitude for homelessness, and socioeconomic and behavioral health factors provided stronger indicators of risk. Gender was not a significant indicator of differential risk.


Although service in Iraq and Afghanistan was significant, socioeconomic and behavioral health indicators show more promise in efforts to use administrative data to inform prevention efforts by identifying veterans who are at elevated risk for becoming homeless upon their return to civilian life.

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