Polypharmacy and its association with dementia, Parkinson's disease, and mortality risk in UK adults: a multistate modeling approach.

Polypharmacy is common among older adults and has been linked to adverse outcomes such as dementia, Parkinson's disease (PD), and mortality. However, its influence on transitions between these health states remains understudied in large, population-based cohorts. Using data from 361,970 UK Biobank participants aged 50 and older with up to 15 years of follow-up, we examined the association between polypharmacy, defined as the use of five or more medications, and transitions between health states: healthy, dementia, PD, and mortality.

Experiencing Housing Instability in Rural North America and Access to Health Care and Supportive Services: A Scoping Review.

Objective: We conducted a scoping review of 45 peer-reviewed articles to characterize the intersection of housing instability and homelessness, care, and services in rural North America. We sought gaps in literature related to geographically based health disparities among people experiencing housing instability and identify practices that may promote better health outcomes. We offer practical implications for health care and service provision for people experiencing housing instability in rural areas.

Use, Benefits, and Barriers to Financial and Credit Counseling Among Veterans According to Financial Counselors and Other Subject Matter Experts.

Introduction: Over a million U.S. veterans report an income below the poverty line.

Developing an Intervention to Enhance Aging in Place for Older Veterans Living in Permanent Supportive Housing.

Background And Objectives: The Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program provides rental subsidies, case management, and supportive services to Veterans who are currently or formerly homeless, 77% of whom are ages ≥50. Few interventions have been developed to address the needs of older Veterans in HUD-VASH.

Research Design And Methods: We conducted a 2-stage study to inform the development of an intervention to promote aging in place in HUD-VASH.

Addressing racial and ethnic disparities in premature exits from permanent supportive housing among residents with substance use disorders.

Background: Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management-including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted ("negative") PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation's largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups.

Cardiovascular disease, bone fracture, and all-cause mortality risks among postmenopausal women by arthritis and veteran status: A multistate Markov transition analysis.

Arthritis, a chronic inflammatory condition linked to cardiovascular disease (CVD) and bone fracture, is more frequent among military veterans and postmenopausal women. This study examined correlates of arthritis and relationships of arthritis with risks of developing CVD, bone fractures, and mortality among postmenopausal veteran and non-veteran women. We analyzed longitudinal data on 135,790 (3,436 veteran and 132,354 non-veteran) postmenopausal women from the Women's Health Initiative who were followed-up for an average of 16 years between enrollment (1993-1998) and February 17, 2024.

Brief Scoping Review of Pathways Community Hubs for the Care of Pregnant Mothers and Their Infants.

Objectives: Pathways Community Hub (PCH) programs help connect pregnant women to healthcare and social services. A scoping review of peer-reviewed studies on PCHs that reported quantitative outcomes was conducted.

Methods: A search of academic databases from 1901 to 2024 initially yielded a total of 1,312 articles, which was ultimately reduced to 4 articles after duplicates were removed, and two levels of screening were conducted to determine whether studies met the inclusion criteria of evaluating a community hub for pregnant women, was written in English, was peer-reviewed, and reported quantitative outcomes.

Characteristics of injury deaths among homeless and non-homeless US veterans (2017-2021).

Objective: The objective of this study is to assess whether experiencing homelessness may be associated with future risk of injury death and characterise these injury deaths by homelessness status among veterans who received healthcare through the US Department of Veterans Affairs (VA).

Methods: A retrospective cohort study was conducted among 6 128 921 veterans (399 125 homeless and 5 729 796 non-homeless) who received VA healthcare between 2017 and 2020 and were followed until 2021 using linked data from VA's Corporate Data Warehouse, Homeless Operations Management System and the VA/Department of Defense Joint Mortality Data Repository. Injury death rates were estimated by homelessness status with 95% CIs using the exact Poisson method.

Usual prevention in unusual settings: A scoping review of place-based health interventions in public-facing businesses.

Place-based health interventions may help reach underserved populations. This scoping review summarizes the peer-reviewed literature on the type and effects of place-based health interventions in unconventional public-facing business settings (e.g.

A Meta-analysis of the Prevalence of Food Insecurity Among People Experiencing Housing Insecurity and Homelessness in the United States.

Objectives: Studies suggest that people experiencing housing insecurity and homelessness (HIH) have varying experiences with food insecurity. We estimated the prevalence of food insecurity and identified the factors associated with it among people experiencing HIH in the United States.

Methods: We conducted a meta-analysis of the prevalence of food insecurity among people experiencing HIH and a systematic review of associated factors through a comprehensive search of 8 academic databases.

Characteristics and healthcare utilization among aging veterans in supported housing: A comparison with independently housed age-matched veterans.

Background And Objectives: There is a large and growing population of older, formerly homeless adults living in permanent supportive housing, and there are concerns about how to address their healthcare needs. This study compared veterans aged 55 years and older residing in the Department of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program to an age-matched group of independently housed veterans receiving care through the U.S.

The effect of a Veterans Affairs rapid rehousing and homelessness prevention program on long-term housing instability.

Objective: To evaluate the effect of enrolling in Supportive Services for Veteran Families (SSVF) on short- and long-term housing outcomes among Veterans experiencing housing instability.

Study Setting And Design: We analyzed data from the Department of Veterans Affairs (VA) electronic health record (EHR) between October 2015 and December 2018 using the target trial emulation framework. Veterans were included in one or more trials if they were 18 years or older, had recent evidence of housing instability, had received care in VA for at least 1 year, and had never before enrolled in SSVF.

Staff Safety and Experiences with Electronic Safety Devices among a Sample of Veterans Affairs Homeless Service Providers.

The current survey examined Veterans Affairs (VA) homeless service providers' experiences with electronic personal protective safety devices (EPPSDs). The survey was completed by 153 homeless service providers based at VA medical centers in New York, New Jersey, and Florida. The survey asked about feelings of safety while performing work duties, safety incidents, use of EPPSDs, and experiences with EPPSDs.

Functional limitations and firearm purchases among low-income U.S. military veterans.

Objectives: Functional limitations may be associated with firearm ownership among veterans by amplifying perceptions of vulnerability and the need for security, yet their role remains underexplored despite emerging research on health-related factors influencing firearm acquisition in this group. This study examines the relationship between the number of functional limitations and recent firearm purchasing among a sample of low-income US military veterans.

Methods: Data are from the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study, which surveyed US veterans in households under 300% of the US federal poverty level.

Pathways From Socioeconomic Factors to Major Cardiovascular Events Among Postmenopausal Veteran and Nonveteran Women: Findings From the Women's Health Initiative.

Background: Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.

Methods And Results: A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which 16 108 major CVD events were documented.

Haven for Hope: A Transformational Campus Model to Address Homelessness.

Haven for Hope is a 501(c)(3) nonprofit organization that has been rarely described in the research literature but has become nationally known for its comprehensive homeless response system in San Antonio, Texas. Haven for Hope operates a 22-acre campus that includes a Transformational Campus and a Courtyard that serves over 9,000 clients annually, including chronically homeless individuals, veterans, children, and families. Haven for Hope offers a "one-stop" design that allows dozens of community partner organizations to provide housing, meals, healthcare, job training, education, childcare, and pet services on-site.

Identifying diagnosed major chronic diseases associated with recent housing instability among aging adults: data from the 'All of Us' research program.

Background: Housing instability is a known barrier to healthcare utilization potentially affecting the prevention, diagnosis and treatment of chronic diseases among diverse groups of adults. We examined the intersection of recent housing instability with prevalent cardiovascular disease, diabetes, cancer and psychiatric diagnoses among aging adults.

Methods: Cross-sectional data on 147 465 participants of the 'All of Us' Research Program (6 May 2018-1 July 2022), ≥50 years of age at enrollment, were analyzed.

Correlates of six-month housing instability among U.S. adults by veteran status: Exploratory study using data from the All of Us Program.

Housing instability (HI) is a social determinant of health affecting adults in the United States (U.S.).

Association of multiple sclerosis with psychiatric disorders and homelessness among veterans in the United States Department of Veterans Affairs healthcare system.

Objective: To describe and compare the prevalence of psychosocial and psychiatric disorders among veterans with multiple sclerosis (MS) and a propensity-score-matched group of veterans without MS, and to identify sociodemographic and clinical characteristics associated with comorbid psychosocial and psychiatric problems among veterans with MS.

Methods: Data were linked and extracted from the Veterans Affairs (VA) Homeless Operations Management and Evaluation System and the Corporate Data Warehouse. The total sample comprised 27,342 veterans in the VA healthcare system between January 1, 2022, and June 30, 2023, who met eligibility criteria for an MS diagnosis (n=13,671) and 1:1 propensity-score-matched sample of veterans who did not have MS (n=13,671).

Longitudinal change and association between four types of social support and mental health among low-income U.S. veterans.

Aims: This study sought to examine how perceived social support changes over time for U.S. veterans and how social support relates to their mental health longitudinally.

Applying Concepts of Successful Aging in Measuring and Promoting Whole Person Health.

Countries around the world have large aging adult populations. There is wide public health concern about the health and well-being of aging adults, and a movement to transform healthcare systems to become age-friendly. The concept of "successful aging" recognizes the importance of aging and expands the goal beyond the absence of disease to functioning and well-being.

Cost-Effectiveness of Temporary Financial Assistance for Veterans Experiencing Housing Instability.

Importance: The US Department of Veterans Affairs (VA) partners with community organizations (grantees) across the US to provide temporary financial assistance (TFA) to vulnerable veterans through the Supportive Services for Veteran Families (SSVF) program. The goal of TFA for housing-related expenses is to prevent homelessness or to quickly house those who have become homeless.

Objective: To assess the cost-effectiveness of the SSVF program with TFA vs without TFA as an intervention for veterans who are experiencing housing insecurity.