Medical Debt, Credit Card Debt, and Other Financial Debt Among Veterans Who Receive Homeless Assistance in the Veterans Affairs Healthcare System.

The US Department of Veterans Affairs (VA) healthcare system is dedicated to preventing veteran homelessness, but there is limited research on the specific sources of financial debt among homeless veterans. We investigated the proportion of veterans seeking VA homeless services reporting any debt and specific types of outstanding debt, associations between homelessness experiences and debt, and whether these associations vary by sex. Using VA administrative data, we cross-sectionally evaluated various types of outstanding debt among 118 594 homeless and at-risk veterans in the VA healthcare system from fiscal years 2023-2024. Multivariable logistic regression models were constructed for history of homelessness experiences in relation to any and different types of financial debt, overall, and by sex. About 48% of veterans in VA homeless programs had outstanding debt, with credit cards being the most prevalent contributors to debt. Outstanding debt related to student loans, child support, medical expenses, and tax bills were significantly associated with greater episodes of recent homelessness. Medical expenses, fines, or other legal obligations were significantly associated with lifetime homelessness duration. Housing loans were associated with shorter duration and fewer episodes of homelessness (over the past 3 years). Similar patterns were observed among male and female veterans. Financial debt is linked to prolonged homelessness among veterans, necessitating increased social services for financial literacy, debt consolidation, and other interventions to mitigate risks.