Absence of conflict of interest.
Citation
Nunez, E., Gibson, G., Jones, J. A., & Schinka, J. A. (2013). Evaluating the impact of dental care on housing intervention program outcomes among homeless veterans. American Journal of Public Health, 103(S2), S368-S373.
Highlights
- The study examined the impact of the Veterans Affairs (VA) Homeless Veteran Dental Program on employment outcomes of homeless veterans.
- The authors used VA administrative data to compare the employment outcomes of veterans who received dental care through the VA Homeless Veteran Dental Program with those of veterans who did not.
- The study found that participating in the VA Homeless Veteran Dental Program was associated with greater employment and financial stability.
- The quality of causal evidence presented in this report is low because the authors did not ensure the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to the VA Homeless Veteran Dental Program; other factors are likely to have contributed.
Intervention Examined
VA Homeless Veteran Dental Program
Features of the Intervention
Veterans who participated in VA transitional housing programs for more than 60 days qualified for dental care under the VA Homeless Veteran Dental Program. Dental services offered included comprehensive examinations, X-rays, cleaning, fillings, extractions, and dentures.
Features of the Study
The final study sample consisted of 9,870 veterans. Those who received dental care through the VA Homeless Veteran Dental Program made up the intervention group. Veterans who did not receive dental care through the program served as the comparison group. Outcome data were collected when veterans exited the VA transitional housing program. The authors used VA administrative data and conducted statistical tests to compare the employment outcomes of the two groups.
Findings
Employment
- The study found that a higher percentage of veterans who participated in the VA Homeless Veteran Dental Program had a job or financial stability after discharge from VA transitional housing programs than did veterans who did not participate in the VA Homeless Veteran Dental Program.
Considerations for Interpreting the Findings
The authors did not establish that the intervention and comparison groups were similar before the intervention. Specifically, the authors did not account for differences in terms of gender and age between the groups. In addition, the authors did not assess whether the groups’ employment rates were similar more than one year before the intervention. Finally, veterans in the intervention group stayed in VA transitional housing programs longer than did those in the comparison group. These existing differences between the groups—and not the VA Homeless Veteran Dental Program—could explain the observed differences in outcomes.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the authors did not ensure the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to the VA Homeless Veteran Dental Program; other factors are likely to have contributed.