Predicting Homelessness Among U.S. Army Soldiers No Longer on Active Duty

• Published in: American journal of preventive medicine Vol. 63; no. 1; pp. 13 - 23
• Main Authors: Koh, Katherine A., Montgomery, Ann Elizabeth, O'Brien, Robert W., Kennedy, Chris J., Luedtke, Alex, Sampson, Nancy A., Gildea, Sarah M., Hwang, Irving, King, Andrew J., Petriceks, Aldis H., Petukhova, Maria V., Stein, Murray B., Ursano, Robert J., Kessler, Ronald C.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.07.2022; Elsevier Science Ltd
• Subjects: Armed forces; Cohort analysis; High risk; Homeless people; Humans; Ill-Housed Persons; Longitudinal Studies; Military Personnel; Polls & surveys; Post traumatic stress disorder; Prediction models; Predictions; Prospective Studies; Psychological trauma; Resilience; Risk Assessment; Risk factors; Soldiers; Trauma; United States; Veterans; United States; United States > US
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/j.amepre.2021.12.028

The ability to predict and prevent homelessness has been an elusive goal. The purpose of this study was to develop a prediction model that identified U.S. Army soldiers at high risk of becoming homeless after transitioning to civilian life based on information available before the time of this transition. The prospective cohort study consisted of observations from 16,589 soldiers who were separated or deactivated from service and who had previously participated in 1 of 3 baseline surveys of the Army Study to Assess Risk and Resilience in Servicemembers in 2011–2014. A machine learning model was developed in a 70% training sample and evaluated in the remaining 30% test sample to predict self-reported homelessness in 1 of 2 Longitudinal Study surveys administered in 2016–2018 and 2018–2019. Predictors included survey, administrative, and geospatial variables available before separation/deactivation. Analysis was conducted in November 2020–May 2021. The 12-month prevalence of homelessness was 2.9% (SE=0.2%) in the total Longitudinal Study sample. The area under the receiver operating characteristic curve in the test sample was 0.78 (SE=0.02) for homelessness. The 4 highest ventiles (top 20%) of predicted risk included 61% of respondents with homelessness. Self-reported lifetime histories of depression, trauma of having a loved one murdered, and post-traumatic stress disorder were the 3 strongest predictors of homelessness. A prediction model for homelessness can accurately target soldiers for preventive intervention before transition to civilian life.