About 7 percent of Americans overall are veterans – but veterans account for about 11 percent of the nation’s homeless population. Because it’s a problem that disproportionately affects veterans, the Department of Veterans Affairs (VA) attacks homelessness on several fronts: VA medical and dental providers examine and treat homeless veterans at dozens of locations around the country. Trained staff at the National Call Center for Homeless Veterans offer counseling and referral services to link veterans and their families to the services they need. The oldest federal health care program for veterans, the Domiciliary Care Program, was established by post-Civil War legislation, and continues to provide care and rehabilitation in residential settings on VA medical center grounds.

VA homelessness researchers conduct population-based research that examines risk factors for veteran homelessness and how to prevent it, as well as program-specific investigations aimed at improving housing and health outcomes for veterans. Many of these studies are conducted with support from VA’s Health Services Research and Development Service (HSR&D).

In 2009, former VA Secretary Eric Shinseki and President Barack Obama announced the ambitious goal to end homelessness among veterans. The U.S. Interagency Council on Homelessness, representing 19 federal agencies, drafted the first-ever national strategy to end homelessness. In order to promote recovery-oriented care for homeless or at-risk veterans, the VA established its National Center on Homelessness among Veterans. The center works with community partners, university affiliates, and VA researchers across the country to analyze policy; develop and implement programs; educate and disseminate information about the problem of veteran homelessness; and conduct research.

Over the past eight years, more than 85,000 housing vouchers have been distributed through the HUD-VA Supportive Housing (HUD-VASH) program, a collaboration with the Department of Housing and Urban Development to provide rental subsidy and support services to help veterans and their families sustain permanent housing.

The results so far have been encouraging: According to HUD’s 2015 Point-in-Time (PIT) count, a snapshot of homelessness on a given night in America, veteran homelessness has declined by 36 percent since 2010. But much work remains to be done: The 2015 PIT count reported more than 47,700 veterans were homeless on a given night.

VA homelessness researchers conduct population-based research that examines risk factors for veteran homelessness and how to prevent it, as well as program-specific investigations aimed at improving housing and health outcomes for veterans. Many of these studies are conducted with support from VA’s Health Services Research and Development Service (HSR&D).

Soon after it had been established, the National Center on Homelessness among Veterans partnered with HSR&D to launch the VA Homelessness Health Services Research Initiative, which funded studies aimed at implementing best practices and improving outcomes for homeless and at-risk veterans participating in four VA programs:

Housing First: Throughout the United States, the traditional approach to subsidized housing has strings attached: People are promoted into more stable, longer-term housing options after they find work or complete addiction or mental health treatment programs. This approach has worked well for some, but not so well for others, and in 2012, based on a mounting evidence base, the VA joined a growing list of U.S. and international government agencies in formally adopting a different approach, known as Housing First.

Housing First’s underlying philosophy stands the traditional approach on its head: It proposes that people have a better chance of moving forward on issues of recovery and employment after they’ve established permanent access to housing. Through the HUD-VASH program, housing vouchers are unconditional, and VA support services are offered in conjunction with – and not contingent upon – this housing. Studies of the Housing First approach have revealed better long-term housing outcomes for participants, as well as better health care outcomes – fewer emergency room visits and more outpatient care visits.