School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Birmingham Veterans Affairs Health Care System, Birmingham, AL, USA.
Public Health Rep. 2023 Nov-Dec;138(6):963-970. doi: 10.1177/00333549221149092. Epub 2023 Feb 1.
The transition from military to civilian life may present increased exposure to various stressful life events (SLEs) that can increase the risk of homelessness (eg, loss of employment, dissolution of romantic relationships). We assessed the extent to which exposure to SLEs occurring proximal to US Army soldier transitions out of active duty was associated with risk of homelessness.
A total of 16 589 respondents who were no longer on active duty but participated while on active duty during 2011-2014 baseline surveys completed follow-up surveys during 2016-2018 and 2018-2019. The follow-up surveys assessed SLEs and homelessness occurring in the past 12 months. We used modified Poisson regression models to evaluate how much differential SLE exposure and effects explained the aggregate association of a risk index with homelessness among a sample of 6837 respondents, weighted to represent the full sample.
More than half (n = 3510, 52.8%) of respondents reported experiencing any SLEs in the past 12 months. Most (60.5%) of the difference in prevalence of homelessness among respondents defined as being at high risk of homelessness (vs lower risk) was explained by differential exposure to, and/or effects of, these SLEs. Personal betrayal by a loved one and economic problems played the largest roles in adjusted risk differences (0.045 and 0.074, respectively).
Homelessness might be reduced by gearing interventions toward soldiers at high risk of homelessness who are transitioning out of active duty to reduce exposure to and effects of modifiable SLEs on experiencing homelessness.
从军队过渡到平民生活可能会增加接触各种压力性生活事件(SLEs)的机会,这可能会增加无家可归的风险(例如,失业、恋爱关系破裂)。我们评估了 SLEs 发生在美军士兵离开现役前的时间接近程度与无家可归风险之间的关系。
共有 16589 名不再服现役但在 2011-2014 年基线调查期间在现役期间参加的受访者完成了 2016-2018 年和 2018-2019 年的后续调查。后续调查评估了过去 12 个月中发生的 SLE 和无家可归情况。我们使用修正的 Poisson 回归模型来评估在一个由 6837 名受访者组成的样本中,差异 SLE 暴露和效应在多大程度上解释了风险指数与无家可归之间的总体关联,该样本经过加权以代表整个样本。
超过一半(n=3510,52.8%)的受访者报告在过去 12 个月中经历过任何 SLEs。在被定义为有高无家可归风险(而非低风险)的受访者中,无家可归患病率差异的大部分(60.5%)是由对这些 SLEs 的差异暴露和/或影响造成的。被所爱之人背叛和经济问题在调整后的风险差异中起着最大的作用(分别为 0.045 和 0.074)。
通过针对即将离开现役的高风险无家可归士兵的干预措施,减少接触和受 SLEs 影响的机会,可能会减少无家可归现象。