A Novel Measure to Assess Variation in Hepatitis C Prevalence Among Homeless and Unstably Housed Veterans, 2011-2016. (March 2019)

• Record Type: Journal Article
• Authors: Byrne, Thomas; Troszak, Lara; Midboe, Amanda M.; Fincke, B. Graeme; Shwartz, Michael; Gifford, Allen L.; McInnes, D. Keith
• Is Part Of: Public health reports. Volume 134:Number 2(2019)
• Page Start: 126
• Page End: 131
• Publication Date: 2019-03
• Subjects: hepatitis -- homelessness -- housing -- veterans' health -- health care delivery; Public health -- United States -- Periodicals; 614.0973
• DOI: 10.1177/0033354918821071
• Languages: English
• ISSNs: 0033-3549

Abstract

We constructed a novel measure of homelessness to examine differences in hepatitis C virus (HCV) prevalence across 3 categories of unstably housed and homeless veterans and across US Department of Veterans Affairs Medical Center facilities. We used Veterans Affairs administrative data to classify a cohort of 434 240 veterans as at risk of homelessness, currently homeless, or formerly homeless, and we examined variation in HCV prevalence by using descriptive measures and mixed-effect logistic regression models. HCV prevalence was highest among veterans who were formerly homeless (16.7%; 32 490 of 195 000), followed by currently homeless (12.4%; 22 050 of 178 056) and at risk of homelessness (8.2%; 5015 of 61 184). Veterans Affairs Medical Center–level prevalence ranged from 5.4% to 21.5%. Differences in HCV prevalence were significant by sex, race/ethnicity, and age. Targeting specific populations of homeless veterans for tailored HCV interventions and allocating additional resources to certain Veterans Affairs Medical Centers may be warranted.