Changes in All-Cause, Overdose, and Suicide Mortality Risk in the First 2 Years of Supported Housing, United States, 2017-2021.

Abstract

<b>Objectives.</b> To examine whether there are reduced or elevated risks for all-cause, overdose, and suicide mortality after moving into supported housing. <b>Methods.</b> A national retrospective cohort study compared a census of 60 888 veterans experiencing homelessness in the US Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program with a 1:1 propensity-score matched group of veterans experiencing homelessness from 2017 to 2021. <b>Results.</b> Rates for all-cause mortality in the matched HUD-VASH group significantly increased after 6 months, and risk of all-cause mortality was slightly higher in the HUD-VASH group than the matched comparison cohort at 24-month follow-up. Overdose mortality risk was twice as high among the HUD-VASH cohort across all time points, and there was no significant group difference in suicide mortality risk across time. <b>Conclusions.</b> Supported housing was associated with an initial lower risk of all-cause mortality that was not sustained over the course of 2 years. Veterans in supported housing were consistently more likely to die from drug overdose than were other veterans experiencing homelessness. <b>Public Health Implications.</b> The timely provision of substance use treatment in supported housing could be important to prevent drug overdose deaths. (<i>Am J Public Health.</i> 2026;116(5):665-673. https://doi.org/10.2105/AJPH.2025.308371).