Geographic and psychosocial correlates of homelessness or unstable housing among US veterans in the Midwest.

The purpose of this study was to explore (1) the prevalence of physical and mental health conditions among veterans stratified by homelessness and unstable housing (HUH) in several Midwestern states, and (2) the correlation between HUH and sociodemographic, military, financial, risky behavior, health, and geographical characteristics. The study cohort consisted of 7260 HUH veterans and stably housed veterans in 2018-2022 in Veterans Integrated Service Network (VISN) 23. A multivariate logistic regression analysis was performed which revealed the strongest associations with HUH were any incarceration experience (adjusted odds ratio [AOR] = 0.21) and rural location (AOR = 0.33). Frontier and remote location scores (AOR = 1.23) were associated with increased risk of HUH among veterans. Our results suggest potential differences in risk for HUH among veterans living in rural versus frontier and remote locations, which may be important to consider to provide care to the many veterans in these areas.