Association Between Use of Services To Address Adverse Social Determinants of Health and Documented Suicide Attempt Among Patients in the Veterans Health Administration.
Suicide prevention is a top priority for the US Department of Veterans Affairs (VA), and suicide is often associated with adverse social factors (e.g., financial, legal, and housing problems). The VA provides social services integrated with healthcare services, which may increase the opportunities t...
| Publicado en: | Journal of Community Health Vol. 50; no. 5; pp. 783 - 796 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
| Publicado: |
Springer Nature
Oct2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=188314380&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 188314380 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00945145 JCH jtl: Journal of Community Health issn: 00945145 maglogo: N pubinfo: dt: Oct2025 vid: 50 iid: 5 pid: 237 pub: Springer Nature artinfo: ui: 188314380 10.1007/s10900-025-01467-5 ppf: 783 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P size: 1MB tig: atl: Association Between Use of Services To Address Adverse Social Determinants of Health and Documented Suicide Attempt Among Patients in the Veterans Health Administration. aug: au: Blosnich, John R. DeRussy, Aerin Richman, Joshua S. Dichter, Melissa E. True, Gala Montgomery, Ann Elizabeth affil: https://ror.org/05rsv9s98 U.S. Department of Veterans Affairs, Center for Health Equity Research and Promotion, Pittsburgh, PA, USA https://ror.org/03taz7m60 Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34th Street, 90089, Los Angeles, CA, USA https://ror.org/05rsv9s98 U.S. Department of Veterans Affairs, Birmingham VA Health Care System, Birmingham, AL, USA https://ror.org/05rsv9s98 U.S. Department of Veterans Affairs, Center for Health Equity Research and Promotion, Philadelphia, PA, USA https://ror.org/00kx1jb78 School of Social Work, Temple University, Philadelphia, PA, USA https://ror.org/02hd1sz82 U.S. Department of Veterans Affairs, South Central Mental Illness Research, Education, and Clinical Center, New Orleans, LA, USA https://ror.org/01qv8fp92 Louisiana State University Health Sciences Center-New Orleans, School of Medicine, New Orleans, LA, USA https://ror.org/008s83205 Department of Health Behavior, University of Alabama at Birmingham, School of Public Health, Birmingham, AL, USA su: United States. Dept. of Veterans Affairs Suicide risk factors Life change events Public housing Social determinants of health Social services Social factors Unemployment Sex distribution Help-seeking behavior Age distribution Retrospective studies Suicidal behavior Race Social support Criminal justice system Homelessness Patients' attitudes Medical care use Statistical correlation Research funding Medical care of veterans Data analysis Logistic regression analysis Descriptive statistics Military sexual trauma Chi-squared test Longitudinal method Odds ratio Electronic health records Research Medical records Acquisition of data Statistics Housing stability Confidence intervals Data analysis software sug: subj: Suicide risk factors Life change events Public housing Social determinants of health Social services Social factors Unemployment Sex distribution Help-seeking behavior Age distribution Retrospective studies Suicidal behavior Race Social support Criminal justice system Homelessness Patients' attitudes United States. Dept. of Veterans Affairs Other Justice, Public Order, and Safety Activities Lessors of social housing projects Other Individual and Family Services Administration of Veterans' Affairs Medical care use Statistical correlation Research funding Medical care of veterans Data analysis Logistic regression analysis Descriptive statistics Military sexual trauma Chi-squared test Longitudinal method Odds ratio Electronic health records Research Medical records Acquisition of data Statistics Housing stability Confidence intervals Data analysis software keyword: Legal problems Medical and Health Sciences Public Health and Health Services Suicide attempt Veterans Legal problems Medical and Health Sciences Public Health and Health Services Suicide attempt Veterans ab: Suicide prevention is a top priority for the US Department of Veterans Affairs (VA), and suicide is often associated with adverse social factors (e.g., financial, legal, and housing problems). The VA provides social services integrated with healthcare services, which may increase the opportunities to detect and document suicide attempt in EHR records. Using VA administrative data, we examined three cohorts of all patients from 2014 to 2018 who had housing instability (n = 659,987), justice involvement (n = 200,487), and unemployment (n = 346,556). Administrative records were used to determine ordinal indicators of receipt of VA social services (no services, low, or high). The outcome was suicide attempt noted in the healthcare record (i.e., documented suicide attempt) in the 1–6 months following the incident adverse social factor. We conducted logistic regressions utilizing a discrete-time survival framework with person-month as the unit of analysis, which facilitated accounting for covariates while isolating the independent association of social service utilization. After adjusting for covariates, high receipt of housing services (vs. no services) was significantly associated with documented suicide attempt during the 6-month observation period (aOR = 1.14, 95%CI = 1.06–1.22). A similar association was observed for high vs. no use of justice programs (aOR 1.24; 95% CI:1.12–1.37). There was no significant association between employment services utilization and documented suicide attempt during the 6-month observation period. Our finding that utilization of social services as positively associated with documented suicide attempt likely reflects increased suicide attempt surveillance and documentation with social service involvement. Future research should explore operationalizing patient-level distress in administrative data. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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