Changes in All-Cause, Overdose, and Suicide Mortality Risk in the First 2 Years of Supported Housing, United States, 2017-2021.

Objectives. To examine whether there are reduced or elevated risks for all-cause, overdose, and suicide mortality after moving into supported housing. Methods. A national retrospective cohort study compared a census of 60 888 veterans experiencing homelessness in the US Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program with a 1:1 propensity-score matched group of veterans experiencing homelessness from 2017 to 2021. Results. Rates for all-cause mortality in the matched HUD-VASH group significantly increased after 6 months, and risk of all-cause mortality was slightly higher in the HUD-VASH group than the matched comparison cohort at 24-month follow-up. Overdose mortality risk was twice as high among the HUD-VASH cohort across all time points, and there was no significant group difference in suicide mortality risk across time. Conclusions. Supported housing was associated with an initial lower risk of all-cause mortality that was not sustained over the course of 2 years. Veterans in supported housing were consistently more likely to die from drug overdose than were other veterans experiencing homelessness. Public Health Implications. The timely provision of substance use treatment in supported housing could be important to prevent drug overdose deaths. (Am J Public Health. 2026;116(5):665-673. https://doi.org/10.2105/AJPH.2025.308371).