ORIGINAL RESEARCH article
Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1639888
This article is part of the Research TopicExploring the Multidimensional Impact of Homelessness on Health and Social InclusionView all 16 articles
Traumatic Brain Injury and VA Service Use among Native Hawaiian and Pacific Islander Veterans Experiencing Homelessness
Provisionally accepted
Ryan Holliday*
Lindsey Monteith
Shawn LiuSara Lum
Marissa Sia
Gayle IwamasaDarrin AaseAlexandra SmithRishi DekaShiloh JordanChristine KindlerJack Tsai
Lisa Anne Brenner- US Department of Veterans Affairs Veterans Health Administration, Washington, United States
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United States Veterans experiencing homelessness often experience myriad health concerns that can impact their functioning. Native Hawaiian or Pacific Islander (NHPI) homeless Veterans are up to 82% more likely to have a traumatic brain injury (TBI) diagnosis than non-NHPI homeless Veterans, which can further impact these Veterans’ psychosocial functioning. The Department of Veterans Affairs (VA) offers services to address the health and social needs of these Veterans. We examined VA electronic medical record data from 12,205 NHPI Veterans identified as homeless from 1/2005-7/2024. We calculated VA service use (i.e., homeless, justice, emergency, primary care, rehabilitative, mental health, and all other VA service settings) among NHPI homeless Veterans using Veteran electronic medical record data. After accounting for sex, age, and VA service-connected disability, NHPI homeless Veterans with a documented TBI diagnosis were significantly more likely to access and use VA services across service settings. NHPI homeless Veterans with TBI histories likely access various types of VA services; as such, wraparound care (e.g., Homeless Patient Aligned Care Teams; case management) are critical for managing care needs. Future research should examine factors that facilitate engagement in and benefit from VA health and social services among these Veterans.
Keywords: Traumatic Brain Injury, Homelessness, veteran, Native Hawaiian and Pacific Islander, Veterans Affairs
Received: 06 Jun 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Holliday, Monteith, Liu, Lum, Sia, Iwamasa, Aase, Smith, Deka, Jordan, Kindler, Tsai and Brenner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ryan Holliday, US Department of Veterans Affairs Veterans Health Administration, Washington, United States
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