Women Veterans are at increased risk of both housing instability and intimate partner violence compared with their non-Veteran counterparts. The objectives of the present study were (1) to assess the ...relationship between women Veterans’ experience of intimate partner violence and various indicators of housing instability, and (2) to assess what correlates help to explain experiences of housing instability among women Veterans who experienced past-year intimate partner violence.
Data were collected from U.S. Department of Veterans Affairs electronic medical records for 8,427 women Veterans who were screened for past-year intimate partner violence between April 2014 and April 2016 at 13 Veterans Affairs’ facilities. Logistic regressions performed during 2017 assessed the relationship between past-year intimate partner violence and housing instability.
A total of 8.4% of the sample screened positive for intimate partner violence and 11.3% for housing instability. Controlling for age and race, a positive intimate partner violence screen increased odds of housing instability by a factor of 3. Women Veterans with past-year intimate partner violence were more likely to have an indicator of housing instability if they identified as African American, had screened positive for military sexual trauma, or had a substance use disorder; receiving compensation for a disability incurred during military service and being married were protective.
For women Veterans, intimate partner violence interventions should assess for both physical and psychological housing needs, and housing interventions should coordinate with intimate partner violence programs to address common barriers to resources.
Research is limited about whether and to what extent registered sex offenders (RSOs) face an increased risk of housing instability. The intersection of RSO and housing instability is particularly ...salient for veterans as there are disproportionately higher rates of veterans among both RSOs and homeless populations. This study assessed the relationship between RSO status and risk of housing instability and homelessness among military veterans. We matched a list of 373,774 RSOs obtained from publicly available sex offender registries in 19 states with a cohort of 5.9 million veterans who responded to a brief screening for housing instability administered throughout the Veterans Health Administration between 2012 and 2016. Logistic regression estimated adjusted odds of any housing instability and homelessness among veterans identified as RSOs. Veterans identified as RSOs had 1.81 (95% confidence interval CI 1.46–2.25) and 2.97 (95% CI 1.67–5.17) times greater odds of reporting any housing instability and homelessness, respectively, than non-RSOs. Findings represent some of the strongest evidence to date for the high risk of housing instability and homelessness among RSOs, suggesting a clear gap in policy and programmatic responses to their unique housing needs. Evidence-based alternative approaches to residence restriction laws may reduce recidivism and protect public safety.
This work examines power dynamics at play in the early child-saving movement as illuminated in the case records and annual reports of the Pennsylvania Society to Protect Children from Cruelty (SPCC) ...from 1878 to 1881 and triangulated with other historical records.
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We draw on ecological systems theory and urban ecology to examine social and spatial relationships between child-saving institutions, communities, and individuals and families. The paper adapts template analysis for archival research as a replicable approach for studying historical power dynamics embedded in social welfare institutions. This approach highlights the changing role of community members in identifying and responding to neglect and abuse and uncovers common themes that continue to impact the modern child welfare system.
BACKGROUND:Prior research has explored the patterns and dynamics of homelessness; such an understanding is necessary to improve policy and programmatic responses and prevent new episodes of housing ...instability.
OBJECTIVES:The objectives of this study are to identify correlates of veterans’ transitions into housing instability and inform initiatives aimed to address their needs, with a focus on how to prevent new episodes of housing instability.
METHODS:The cohort for this study includes 4,633,069 veterans who responded to the Veterans Health Administration’s universal screen for housing instability at least twice between October 1, 2012, and September 30, 2016; 1.2% reported recent housing instability and 98.8% reported ongoing housing stability. The χ or Fisher exact tests, as appropriate, compared veterans’ characteristics by housing status. A multivariate logistic regression identified independent risk factors associated with recent housing instability, controlling for sociodemographic, military service, diagnostic, and health services use variables.
RESULTS:Sociodemographic and health services use variables increased veterans’ odds of transitioning into housing instability. The diagnoses with the greatest effect sizes were drug use disorder (adjusted odds ratio=1.50, 95% confidence interval1.45–1.55) and opioid use disorder, which was associated with a >2-fold increase in the odds of experiencing recent housing instability (adjusted odds ratio=2.22, 95% confidence interval2.04–2.41).
CONCLUSIONS:The present study provides evidence to inform existing and future interventions to prevent new episodes of housing instability. Veterans with opioid use disorder were at greatest risk of becoming unstably housed; increasing access to medication-assisted treatment in homeless-focused services is needed.
To address homelessness among Veterans, a growing proportion of permanent supportive housing units supported by the U.S. Departments of Housing and Urban Development and Veterans Affairs Supportive ...Housing (HUD-VASH) program are allocated to programs where multiple Veterans with a history of homelessness live in a particular building, referred to as single-site housing. This mixed-methods study-including administrative data from Veterans who moved into HUD-VASH housing and qualitative data from focus groups with services providers at 10 single-site programs-describes the characteristics and needs of Veterans who moved into single-site HUD-VASH programs, the rationale for developing single-site HUD-VASH programs, and the services provided in single-site programs that are responsive to Veterans' needs. Based on quantitative analyses, Veterans who were older and had chronic medical and mental health conditions and sought related care were at increased odds of receiving single-site housing. Qualitatively, we found that HUD-VASH programs developed single-site programs for two reasons: to ensure that the most vulnerable Veterans remained housed through the provision of supportive services and to increase housing options for hard-to-house Veterans, including those who require more support because of medical, mental health, or substance use disorders; physical disabilities; or lack of ability to live independently for other reasons. Due to the high needs of Veterans served by single-site programs, development of these programs should consider both space and staffing needs. Future research should assess the relationship between assignment to housing type and health and housing outcomes for participants as well as service enhancements to address Veterans' needs.
Public Policy Relevance Statement
Permanent supportive housing is a preferred policy response for addressing homelessness among high-need individuals. One variant of permanent supportive housing-the use of single-site buildings to house multiple formerly homeless individuals-is understudied. Results indicate that these programs serve particularly high-need individuals, with implications for both program and policy responses.
Physical inactivity is a major public health concern. Though active transportation through bicycling and walking can increase physical activity and thereby positively affect health, factors that ...influence people's decisions to commute using active transportation modes remain underexplored and often fail to capture equity-related barriers. Increases in active transportation during the COVID-19 pandemic call for a better understanding of these influences. This study examines the commute mode choices of essential workers in Philadelphia, Pennsylvania, USA to explore the extent to which active transportation to work is explained by individual, social, and environmental factors and whether active transportation choices reflect inequalities.
Drawing on the theory of planned behavior and the social-ecological model, this study utilizes data from an online survey (N = 213) completed between June and August 2020. Bivariate analyses compare respondents who commuted using active transportation modes to those who did not using chi-square and ANOVA tests. A series of logistic regression models using forward stepwise selection, controlling for demographic characteristics and commute distance, identify salient individual, social, and environmental factors associated with active transportation.
Nearly half of respondents changed their commute mode during the pandemic, most often to limit exposure to COVID-19. The full model, accounting for 54% of variation in active transportation commuting, indicated significantly lower odds of active transportation use among non-white (Odds Ratio OR: 0.155) respondents and those who reported time constraints (OR: 0.450), concerns about safety from traffic (OR: 0.482), and greater satisfaction with community support for bicycling and pedestrian issues (OR: 0.551) and significantly higher odds among those who reported safety concerns around germs (OR: 1.580).
Structural and social investments that make bicycling and walking safer commuting alternatives during COVID-19 could protect essential works and contribute to sustained behavior change. Community engagement is essential for implementation efforts.
•Essential workers increased active transportation commuting during COVID-19.•Decreased odds of active transportation use was associated with non-white race.•Active commuters report less satisfaction with community support.
•Cash transfers, universal basic income, and guaranteed income have re-emerged as potential solutions to income volatility.•Methods used in Stockton's guaranteed income experiment, are testing how GI ...can exist alongside existing safety net benefits.•A multi-tiered approach to mitigating potential means tested benefits loss is both effective and ethically sound.
Objectives: Little research has assessed the nature of veterans' departures from permanent supportive housing (PSH), which may be of positive valence (e.g., moving into more independent housing). ...This study aimed to identify participants appropriate for "graduation" from PSH and how to support their transitions. Method: This mixed methods study used qualitative data from PSH program staff, 445 PSH participants' responses to a survey assessing their experiences and administrative records, and qualitative data from a subsample of 10 participants who graduated from the program. Participants were classified as "stayers" (retained in PSH for at least 600 days); "graduates" (exited with improvement in community integration); or "involuntary leavers" (exited for reasons of negative valence). Template analysis of qualitative data from PSH staff described graduation processes; qualitative data from participants were analyzed using a thematic analysis approach. The study compared veterans' characteristics using chi-square and analysis of variance (ANOVA) tests; a multinomial logistic regression assessed correlates of graduates' and involuntary leavers' exits from PSH. Results: Approximately one half of participants who exited the program were graduates. Processes used by program staff to identify potential graduates varied. Participants' self-report of substance use and mental health problems was associated with involuntary leaver status. Frequency of case management, a trusting relationship between participant and case manager, and participants' receipt of compensation related to disability incurred during military service were associated with graduation. Conclusions and Implications for Practice: To support successful transitions from PSH, programs should focus on providing high-quality case management that may respond flexibly to participants' varying recovery needs.
Objective: This study assessed how patients who screened positive for housing instability in a clinical outpatient setting perceived stable housing and threats to housing stability—understanding that ...will help to ensure that their housing needs are addressed. Method: We conducted qualitative interviews with 60 patients (40 men, 20 women) who sought services at a Veterans Affairs Medical Center in a large northeastern city and screened positive on the Veterans Health Administration Homelessness Screening Clinical Reminder. We used a modified grounded-theory approach and constant comparative method to analyze data. Results: Participants identified four core concepts of stable housing: affordable, permanent, comfortable and safe, and structurally and functionally adequate; they also identified three primary threats to housing stability: uncertain finances, the volatile nature of available housing, and personal stressors. Results reflect both physical housing elements and psychological features of home. Conclusions: Health care systems should consider appropriate screening items for their particular service population, ensuring that patients’ needs are addressed along a continuum of housing instability. In addition, it is important to integrate each domain identified by patients into services to mitigate homelessness; existing interventions may have limited capacity to fulfill the domain of comfort and safety.
To assess the relationship between LGBTQ status and (1) current, recent, and lifetime experiences of housing instability, (2) risk of housing instability due to fears of interpersonal violence, and ...(3) perceived housing challenges, this study examined online survey data from individuals with a household income <$35,000 (N = 1,270). Analyses compared LGBTQ and cisgender heterosexual respondents using chi-square tests and logistic regression. Over their lifetime, LGBTQ respondents had increased odds of sleeping outdoors (adjusted odds ratios AOR = 1.580) or in a car (AOR = 1.465) because they had nowhere else to stay. They also had increased odds of reporting housing challenges related to violence from family/friends (AOR = 3.278), substance abuse (AOR = 3.063), and mental health (AOR = 2.048). Interventions serving LGBTQ adults should prioritize safety concerns and consider providing services to both individuals and families. In addition, providers should increase sensitivity toward issues of sexual orientation and gender identity and the unique needs of LGBTQ adults.
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