Rates and predictors of returns to homelessness among Veterans, 2018–2022

Abstract: Introduction: The progress made by the U.S. Department of Veterans Affairs toward ending veteran homelessness requires that attention be paid to preventing returns to homelessness. Methods: Using national Veterans Affairs data on 293,820 exits from a Veterans Affairs homeless program to a permanent housing destination between January 2018 and December 2022, rates and predictors of returns to homelessness among veterans were examined. Analyses were conducted in June–August 2023. A return to homelessness was operationally defined as a return encounter with a Veterans Affairs homeless program. Results: A total of 5.8% of successful exits to permanent housing resulted in a return to homelessness within 6 months, 10.2% resulted in a return within 12 months, and 16.7% resulted in a return within 24 months. In the total sample, veterans who were male (hazard ratio=1.47), were widowed (hazard ratio=1.29), had diagnoses of drug use disorder (hazard ratio=1.40) or psychotic disorder (hazard ratio=1.20), and had used more inpatient or urgent care services in the previous year (hazard ratio=1.05–1.15) were at significantly greater risk of returning to homelessness. Many of these predictors remained significant in subgroup analyses of female veterans, veterans aged ≥65 years, and veterans in the Housing and Urban Development-Veterans Affairs Supportive Housing program. Conclusions: Most homeless veterans served by Veterans Affairs who exit to permanent housing do not return to homelessness within two years. The most critical period seems to be the first year, when 1 in 10 veterans return to homelessness. Knowledge of these risk factors may be important in planning secondary and tertiary prevention efforts for homelessness.