VA May Need to Do More to Help Women Veterans Who Are Homeless or At Risk for Homelessness, Study by RWJF/VA Scholar Finds
Oni Blackstock, MD, is a primary care physician and Robert Wood Johnson Foundation/U.S. Department of Veteran’s Affairs (VA) Clinical Scholar at the Yale University School of Medicine and the VA Connecticut Healthcare System. Her study, available online now and to be printed in the April issue of Medical Care, examines gender differences in the use of Veterans Health Administration specialized homeless services programs among Veterans of the conflicts in Afghanistan and Iraq, also known as Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF).
Human Capital Blog: Tell us why you decided to look at this group of Veterans specifically. What makes them—and the time they are returning from service—unique from other Veteran cohorts?
Blackstock: I was interested in understanding use of VA homeless services programs among OEF/OIF Veterans for two primary reasons. The first reason is that many of these Veterans are returning to a country in the midst of an economic recession and housing crisis; therefore, characterizing use of VA homeless services programs among this group is particularly important. The second reason is that this group of Veterans has the largest proportion of women to serve and to be exposed to combat (about 12 percent of OEF/OIF Veterans are women). I wanted to know if women in this group of Veterans were using VA homeless services programs and how their use compared to their male counterparts.
HCB: Veterans are disproportionately represented among the homeless in the United States. What kind of aid does the VA offer in its homeless services programs?
Blackstock: The VA is acutely aware of the overrepresentation of Veterans among the country’s homeless and, consequently, offers a comprehensive set of services to Veterans who are homeless or at risk for homelessness. The homeless services programs provide different types of housing support including temporary, transitional, and permanent housing. They offer opportunities for job training and employment for Veterans. These programs also help connect Veterans to needed health care including treatment for serious mental illness or addiction disorders.
HCB: Your study looked at the use of these services by gender. What did you find?
Blackstock: Among OEF/OIF Veterans, about one in 50 Veterans, or roughly two percent, used a VA homeless services program over an average of three years. More specifically, we found women were as likely as men to use a VA homeless services program. Women who used a homeless program were more likely to have a diagnosis of major depression, but less likely to have a substance or alcohol use disorder compared to their male counterparts. Both women and men who used these programs had high rates of post-traumatic stress disorder.
HCB: What kind of implications does this have for the VA as it works to end homelessness among Veterans?
Blackstock: We believe our study findings have several implications for the VA as it moves forward to end Veteran homelessness. Although, in the general population, women are less likely to be homeless compared to men, women are more likely to use homeless services programs. As a result, our finding—that women were as likely as men to use a homeless services program—may actually represent underutilization of these programs by women. It’s possible that women Veterans, who are more likely to be accompanied by children and to be single parents than their male counterparts, may be seeking services outside of the VA health care system. This suggests that VA homeless services programs may need to improve their outreach to women. These programs also must be prepared to address the needs of female Veterans including being able to provide housing that can accommodate women and families and providing care in areas that disproportionately affect women such as major depression.
HCB: How did your experience as a Robert Wood Johnson Foundation Clinical Scholar help you with this work?
Blackstock: As a VA Scholar in the Clinical Scholars Program, I had the tremendous opportunity to learn about women in the VA health care system; they are a patient population with unique health care needs. Not only was I able to provide care to women Veterans in the women’s health center at the West Haven VA, but was also able to collaborate with and receive mentorship from VA researchers whose work focuses on characterizing and improving health care outcomes for women Veterans.