Aging and life expectancy in homeless veterans: nine questions

Homelessness has long been a public health issue in the U.S. Veteran population. A review of community surveys of Veteran homelessness conducted in 20141 showed that Veterans have been overrepresented in homeless populations since the 1980s. This finding was extended in 2016, when a national survey of homelessness2 showed that Veterans comprised 9.2% of all homeless adults, in contrast to 6.9% of the total U.S. population. A valuable perspective on homelessness3 proposes that causes and consequences could best be understood by taking into consideration structural factors and individual limitations. From a structural viewpoint, inadequate inventories of affordable housing, limited access to mental health services for the seriously mentally ill, high unemployment rates, and economic crises unquestionably contribute to homelessness. However, while these factors create the potential for homelessness, who becomes homeless is not determined randomly. Vulnerability to homelessness based on individual limitations is an equally important determinant of homelessness. These individual limitations include childhood trauma, poverty, low educational achievement, health conditions, combat stress, psychiatric disorders, and substance abuse. An important element in understanding health outcomes for homeless Veterans is that vulnerability factors for homelessness are also potent factors for accelerated aging and early death. Chronological age is the primary risk factor for debilitating chronic disorders such as heart disease. Vulnerability factors associated with homelessness can increase the impact of chronological aging on chronic diseases and subsequently reduce lifespan. In this brief we address nine questions focusing on these two related issues, aging and life expectancy.https://www.va.gov/HOMELESS/nchav/docs/Schinka_Byrne_AgingLifeExpectancyHomelessVeterans_Sept2018.pdfhttps://www.va.gov/HOMELESS/nchav/docs/Schinka_Byrne_AgingLifeExpectancyHomelessVeterans_Sept2018.pdfPublished versio