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  • American Public Health Association  (6)
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  • American Public Health Association  (6)
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  • 1
    Online Resource
    Online Resource
    Population Attributable Fractions of Psychiatric Disorders and Behavioral Outcomes Associated With Combat Exposure Among US Men
    American Public Health Association ; 2002
    In:  American Journal of Public Health Vol. 92, No. 1 ( 2002-01), p. 59-63
    Details
    In: American Journal of Public Health, American Public Health Association, Vol. 92, No. 1 ( 2002-01), p. 59-63
    Abstract: Objectives. This study determined the percentage of adverse outcomes in US men attributable to combat exposure. Methods. Standardized psychiatric interviews (modified Diagnostic Interview Schedule and Composite International Diagnostic Interview assessments) were administered to a representative national sample of 2583 men aged 18 to 54 in the National Comorbidity Survey part II subsample. Results. Adjusted attributable fraction estimates indicated that the following were significantly attributable to combat exposure: 27.8% of 12-month posttraumatic stress disorder, 7.4% of 12-month major depressive disorder, 8% of 12-month substance abuse disorder, 11.7% of 12-month job loss, 8.9% of current unemployment, 7.8% of current divorce or separation, and 21% of current spouse or partner abuse. Conclusions. Combat exposure results in substantial morbidity lasting decades and accounts for significant and multifarious forms of dysfunction at the national level.
    Type of Medium: Online Resource
    ISSN: 0090-0036 , 1541-0048
    URL: Article
    DOI: 10.2105/AJPH.92.1.59
    RVK:
    XA 10000
    Language: English
    Publisher: American Public Health Association
    Publication Date: 2002
    detail.hit.zdb_id: 2054583-6
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Overrepresentation of Women Veterans Among Homeless Women
    American Public Health Association ; 2003
    In:  American Journal of Public Health Vol. 93, No. 7 ( 2003-07), p. 1132-1136
    Details
    In: American Journal of Public Health, American Public Health Association, Vol. 93, No. 7 ( 2003-07), p. 1132-1136
    Abstract: Objectives. This study estimated the proportion of veterans among homeless women and their risk of homelessness relative to that of nonveterans. Methods. Data came from 2 surveys of homeless women (1 clinical and 1 nonclinical) and 1 survey of domiciled women. Results. The proportion of veterans (4.4%, 3.1%) among homeless women was greater than the proportion among domiciled women (1.3%, 1.2%). When we computed odds ratios for being a veteran among homeless women compared with nonhomeless women, homeless women were significantly more likely than nonhomeless women to be veterans. Conclusions. Women veterans are at greater risk for homelessness than are nonveterans. Further study is needed to determine whether increased risks for veterans are a product of military service or reflect volunteers’ self-selection into the armed forces. (Am J Public Health. 2003;93:1132–1136)
    Type of Medium: Online Resource
    ISSN: 0090-0036 , 1541-0048
    URL: Article
    DOI: 10.2105/AJPH.93.7.1132
    RVK:
    XA 10000
    Language: English
    Publisher: American Public Health Association
    Publication Date: 2003
    detail.hit.zdb_id: 2054583-6
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    Online Resource
  • 3
    Online Resource
    Online Resource
    When Health Insurance Is Not a Factor: National Comparison of Homeless and Nonhomeless US Veterans Who Use Veterans Affairs Emergency Departments
    American Public Health Association ; 2013
    In:  American Journal of Public Health Vol. 103, No. S2 ( 2013-12), p. S225-S231
    Details
    In: American Journal of Public Health, American Public Health Association, Vol. 103, No. S2 ( 2013-12), p. S225-S231
    Abstract: Objectives. We examined the proportion of homeless veterans among users of Veterans Affairs (VA) emergency departments (EDs) and compared sociodemographic and clinical characteristics of homeless and nonhomeless VA emergency department users nationally. Methods. We used national VA administrative data from fiscal year 2010 for a cross-sectional study comparing homeless (n = 64 091) and nonhomeless (n = 866 621) ED users on sociodemographics, medical and psychiatric diagnoses, and other clinical characteristics. Results. Homeless veterans had 4 times the odds of using EDs than nonhomeless veterans. Multivariate analyses found few differences between homeless and nonhomeless ED users on the medical conditions examined, but homeless ED users were more likely to have been diagnosed with a drug use disorder (odds ratio [OR] = 4.12; 95% confidence interval [CI]  = 3.97, 4.27), alcohol use disorder (OR = 3.67; 95% CI = 3.55, 3.79), or schizophrenia (OR = 3.44; 95% CI = 3.25, 3.64) in the past year. Conclusions. In a national integrated health care system with no specific requirements for health insurance, the major differences found between homeless and nonhomeless ED users were high rates of psychiatric and substance abuse diagnoses. EDs may be an important location for specialized homeless outreach (or “in” reach) services to address mental health and addictive disorders.
    Type of Medium: Online Resource
    ISSN: 0090-0036 , 1541-0048
    URL: Article
    DOI: 10.2105/AJPH.2013.301307
    RVK:
    XA 10000
    Language: English
    Publisher: American Public Health Association
    Publication Date: 2013
    detail.hit.zdb_id: 2054583-6
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Latent Homeless Risk Profiles of a National Sample of Homeless Veterans and Their Relation to Program Referral and Admission Patterns
    American Public Health Association ; 2013
    In:  American Journal of Public Health Vol. 103, No. S2 ( 2013-12), p. S239-S247
    Details
    In: American Journal of Public Health, American Public Health Association, Vol. 103, No. S2 ( 2013-12), p. S239-S247
    Abstract: Objectives. We identified risk and need profiles of homeless veterans and examined the relation between profiles and referrals and admissions to Department of Veterans Affairs (VA) homeless service programs. Methods. We examined data from the VA’s new Homeless Operations Management and Evaluation System on 120 852 veterans from 142 sites nationally in 2011 and 2012 using latent class analyses based on 9 homeless risk factors. The final 4-class solution compared both referral and admission to VA homeless services. Results. We identified 4 latent classes: relatively few problems, dual diagnosis, poverty–substance abuse–incarceration, and disabling medical problems. Homeless veterans in the first group were more likely to be admitted to the VA’s permanent supportive housing program, whereas those in the second group were more likely to be admitted to more restrictive VA residential treatment. Homeless veterans in the third group were more likely to be admitted to the VA’s prisoner re-entry program, and those in the fourth group were more likely to be directed to VA medical services. Conclusions. The heterogeneous risk and need profiles of homeless veterans supported the diversity of VA homeless services and encouraged the development of specialized services to meet their diverse needs.
    Type of Medium: Online Resource
    ISSN: 0090-0036 , 1541-0048
    URL: Article
    DOI: 10.2105/AJPH.2013.301322
    RVK:
    XA 10000
    Language: English
    Publisher: American Public Health Association
    Publication Date: 2013
    detail.hit.zdb_id: 2054583-6
    Location Call Number Limitation Availability
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    Online Resource
  • 5
    Online Resource
    Online Resource
    Impact of Health Insurance Status and a Diagnosis of Serious Mental Illness on Whether Chronically Homeless Individuals Engage in Primary Care
    American Public Health Association ; 2012
    In:  American Journal of Public Health Vol. 102, No. 12 ( 2012-12), p. e83-e89
    Details
    In: American Journal of Public Health, American Public Health Association, Vol. 102, No. 12 ( 2012-12), p. e83-e89
    Abstract: Objectives. We evaluated the impact of a diagnosis of serious mental illness on use of a primary care provider (vs the emergency department [ED]) as a source of care by people who were chronically homeless. Methods. We used data from 750 chronically homeless adults enrolled in the 11-site Collaborative Initiative to Help End Chronic Homelessness and identified demographic and clinical characteristics independently associated with using a primary care provider rather than an ED. Results. The factor most strongly associated with using the ED as a regular source of medical care was previous-year lack of health insurance. Despite high rates of serious mental illness, neither a diagnosis of serious mental illness nor increased severity of psychiatric symptoms was associated with such use. Conclusions. Findings suggest that people who are chronically homeless and have chronic medical illness would be more likely to access care if they had health insurance. Individual states’ deciding not to expand Medicaid coverage will likely have a tremendous impact on the health outcomes and health care costs associated with this and other vulnerable populations.
    Type of Medium: Online Resource
    ISSN: 0090-0036 , 1541-0048
    URL: Article
    DOI: 10.2105/AJPH.2012.301025
    RVK:
    XA 10000
    Language: English
    Publisher: American Public Health Association
    Publication Date: 2012
    detail.hit.zdb_id: 2054583-6
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    Online Resource
  • 6
    Online Resource
    Online Resource
    Uninsured Veterans Who Will Need to Obtain Insurance Coverage Under the Patient Protection and Affordable Care Act
    American Public Health Association ; 2014
    In:  American Journal of Public Health Vol. 104, No. 3 ( 2014-03), p. e57-e62
    Details
    In: American Journal of Public Health, American Public Health Association, Vol. 104, No. 3 ( 2014-03), p. e57-e62
    Abstract: Objectives. We examined the number and clinical needs of uninsured veterans, including those who will be eligible for the Medicaid expansion and health insurance exchanges in 2014. Methods. We analyzed weighted data for 8710 veterans from the 2010 National Survey of Veterans, classifying it by veterans’ age, income, household size, and insurance status. Results. Of 22 million veterans, about 7%, or more than 1.5 million, were uninsured and will need to obtain coverage by enrolling in US Department of Veterans Affairs (VA) care or the Medicaid expansion or by participating in the health insurance exchanges. Of those uninsured, 55%, or more than 800 000, are likely eligible for the Medicaid expansion if states implement it. Compared with veterans with any health coverage, those who were uninsured were younger and more likely to be single, Black, and low income and to have been deployed to Iraq and Afghanistan. Conclusions. The Patient Protection and Affordable Care Act is likely to have a considerable impact on uninsured veterans, which may have implications for the VA, the Medicaid expansion, and the health insurance exchanges.
    Type of Medium: Online Resource
    ISSN: 0090-0036 , 1541-0048
    URL: Article
    DOI: 10.2105/AJPH.2013.301791
    RVK:
    XA 10000
    Language: English
    Publisher: American Public Health Association
    Publication Date: 2014
    detail.hit.zdb_id: 2054583-6
    Location Call Number Limitation Availability
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    Online Resource
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