Homelessness More Prevalent among Female Veterans
BACKGROUND:
Over the past three decades, the number of women on active duty expanded by more than 300%. As a direct result of their growing role in the military, the number of female Veterans grew by 12% between 2006 and 2008 and is projected to increase by another 17% by 2033. This growth will continue to be accompanied by an increased demand for VA healthcare services. Meeting the healthcare and housing needs of homeless female Veterans also will continue to be a challenge for both VA and other systems of care. VA has placed a priority on meeting the unique needs of homeless Veterans' families, many of whom are headed by female Veterans, as part of its plan to end homelessness among Veterans by 2015. This review of the literature sought to assess and summarize the body of knowledge on homelessness among female Veterans, in order to inform policy and highlight important gaps in this literature that could be filled by future research. Searching the literature published between 1988 and July 2012, investigators identified 26 relevant studies: 14 were epidemiologic, 7 focused on healthcare and other service utilization, and 5 were intervention studies.
FINDINGS:
- Recent studies indicate that female Veterans now comprise a larger share of the homeless Veteran population than of the overall Veteran population.
- Homeless female Veterans are characteristically different from their male counterparts, both with respect to demographic and clinical factors. For example, homeless female Veterans are younger, have higher levels of unemployment, and have lower rates of drug or alcohol dependence or abuse, but they have higher rates of mental health problems than homeless male Veterans.
- Female Veterans are at an increased risk of homelessness relative to the non-Veteran female population.
- Studies identified factors that may increase the risk of homelessness among women Veterans, including: unemployment, disability, PTSD, sexual assault or harassment during military service, anxiety disorder, poor health status, and older age.
LIMITATIONS:
- The majority of studies in this review used samples that were biased, as they recruited solely from recipients of VA healthcare or participants in VA homeless programs. Thus, the findings of the reviewed studies cannot be presumed to be representative of homeless female Veterans who use non-VA homeless programs. It also remains unclear whether female Veterans who use non-VA homeless programs are different, why they use non-VA programs, and how VA might better engage these Veterans.
- One of the most significant gaps in the existing research was the limited information about the type of housing-based solutions that were effective for ending homelessness among female Veterans. And only two studies focused on access to healthcare and other services among homeless women Veterans. As a result, an understanding of the facilitators and barriers to access of needed healthcare and social services among homeless women Veterans remains incomplete.
AUTHOR/FUNDING INFORMATION:
Dr. Dichter is supported by an HSR&D Career Development Award and is part of HSR&D's Center for Health Equity Research and Promotion, Philadelphia, PA. Drs. Byrne and Montgomery are part of VA's National Center on Homelessness among Veterans, also located in Philadelphia.
Byrne T, Montgomery A, and Dichter M. Homelessness among Female Veterans: A Systematic Review of the Literature. Women & Health June 26, 2013;e-pub ahead of print.
