ArticleJournal of general internal medicine2026
Permanent Supportive Housing and Cardiovascular Outcomes Among Veterans Experiencing Homelessness: A Difference-in-Differences Analysis.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVeterans experiencing homelessness have a high burden of cardiovascular disease (CVD). Identifying approaches that can improve the health of this population is crucial.
objectiveThe Department of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) provides permanent supportive housing (PSH) assistance. We examined whether obtaining PSH through HUD-VASH was associated with changes in outcomes among Veterans with CVD experiencing homelessness.
designUsing a difference-in-differences (DID) approach, outcomes among Veterans who received a HUD-VASH voucher and moved into PSH within one month (early group) were compared with those who received a voucher but remained unhoused for at least six months (delayed group).
participantsVeterans ≥ 18 years of age with CVD (coronary artery disease, heart failure, peripheral arterial disease, ischemic stroke/cerebrovascular disease, or atrial fibrillation) who experienced ≥ 6 months of homelessness and received a HUD-VASH voucher in 2016 to 2019.
interventionEntering PSH after receiving a HUD-VASH voucher. MAIN MEASURES: Six-month probability of a cardiovascular ED visit or hospitalization. KEY
resultsAmong 970 Veterans with CVD experiencing homelessness, 845 were in the early and 125 in the delayed PSH group. There was a significant decrease in the 6-month probability of cardiovascular ED visits or hospitalizations (16.3% [95% CI 13.9% - 18.7%] to 11.9% [95% CI 9.8% - 14.0%]) among Veterans who received a voucher and moved into PSH within one month, but no statistically significant change among Veterans who did not move into PSH for at least 6 months (13.4% [95% CI 8.0% - 18.8%] to 18.1% [95% CI 11.4% - 24.8%]) for a DID estimate of -9.1 (95% CI -17.7 - -0.5) percentage points, p = 0.04.
conclusionsObtaining PSH through HUD-VASH was associated with a significant decrease in the probability of CVD related ED visits or hospitalizations among Veterans with chronic CVD experiencing homelessness.
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