Temporary Financial Assistance for Housing Expenditures and Mortality and Suicide Outcomes Among US Veterans.
Temporary Financial Assistance for Housing Expenditures and Mortality and Suicide Outcomes Among US Veterans.
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针对美国退伍军人的住房支出以及死亡率和自杀结果的临时财政援助。
DOI：
10.1007/s11606-023-08337-7
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发表时间：
2024
影响因子：
5.7
通讯作者：
Byrne,Thomas
中科院分区：
文献类型：
--
作者：
Nelson,RichardE;Montgomery,AnnElizabeth;Suo,Ying;Effiong,Atim;Pettey,Warren;Gelberg,Lillian;Kertesz,StefanG;Tsai,Jack;Byrne,Thomas
目前尚不清楚旨在提高住房稳定性的干预措施是否也能改善健康状况，如降低死亡风险和自杀发病率。本研究的目的是估计美国退伍军人事务部（VA）提供的住房相关费用临时财政援助（TFA）对健康结局的潜在影响，包括全因死亡率，自杀企图，方法我们对2015年10月至2015年9月期间进入退伍军人家庭支持服务（SSVF）计划的退伍军人进行了一项回顾性全国队列研究。2018.我们使用多变量考克斯比例风险回归方法和治疗加权的逆概率来评估TFA和健康结果之间的关联。我们对我们的整个队列以及SSVF的快速重新安置（RRH）和无家可归预防（HP）组成部分中的人群进行了这些分析。结果是全因死亡率，自杀企图，自杀意念在365和730天后，在SSVF.ResultsOur分析队列包括41,969独特的退伍军人与平均（SD）的持续时间为87.6（57.4）天的SSVF程序。在SSVF入组后365天，TFA与全因死亡率（HR：0.696，p < 0.001）和自杀意念（HR：0.788，p < 0.001）的风险降低相关。我们在730天时发现了相似的结果（全因死亡率HR：0.811，p = 0.007，自杀意念HR：0.881，p = 0.037）。这些结果主要是由参加SSVF RRH部分的个人推动的。我们没有发现TFA和自杀attempts.ConclusionWe之间的关联发现，提供住房相关的经济援助，个人面临住房不稳定与改善重要的健康结果，如全因死亡率和自杀意念。如果是因果关系，这些结果表明，提供住房援助的方案对个人生活的其他重要方面具有积极的溢出效应。
IntroductionIt is unclear whether interventions designed to increase housing stability can also lead to improved health outcomes such as reduced risk of death and suicide morbidity. The objective of this study was to estimate the potential impact of temporary financial assistance (TFA) for housing-related expenses from the US Department of Veterans Affairs (VA) on health outcomes including all-cause mortality, suicide attempt, and suicidal ideation.MethodsWe conducted a retrospective national cohort study of Veterans who entered the VA Supportive Services for Veteran Families (SSVF) program between 10/2015 and 9/2018. We assessed the association between TFA and health outcomes using a multivariable Cox proportional hazards regression approach with inverse probability of treatment weighting. We conducted these analyses on our overall cohort as well as separately for those in the rapid re-housing (RRH) and homelessness prevention (HP) components of SSVF. Outcomes were all-cause mortality, suicide attempt, and suicidal ideation at 365 and 730 days following enrollment in SSVF.ResultsOur analysis cohort consisted of 41,969 unique Veterans with a mean (SD) duration of 87.6 (57.4) days in the SSVF program. At 365 days following SSVF enrollment, TFA was associated with a decrease in the risk of all-cause mortality (HR: 0.696,p< 0.001) and suicidal ideation (HR: 0.788,p< 0.001). We found similar results at 730 days (HR: 0.811,p= 0.007 for all-cause mortality and HR: 0.881,p= 0.037 for suicidal ideation). These results were driven primarily by individuals enrolled in the RRH component of SSVF. We found no association between TFA and suicide attempts.ConclusionWe find that providing housing-related financial assistance to individuals facing housing instability is associated with improvements in important health outcomes such as all-cause mortality and suicidal ideation. If causal, these results suggest that programs to provide housing assistance have positive spillover effects into other important aspects of individuals’ lives.