{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:02:26Z","timestamp":1789995746325,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Housing instability deleteriously affects health outcomes (i.e., lack of access to care, premature mortality). Veterans experiencing housing instability in rural areas\u2014which often lack housing options, transportation, and services\u2014have greater odds of residential relocation compared to urban Veterans, and they most frequently relocate to urban areas. Urban relocation is associated with changes in health outcomes, including increased services use, but studies have not examined the association between residential relocation and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used Veterans Affairs electronic health record data for 28,058 Veterans who experienced housing instability at a rural residence and then, within 2 years, changed their residential location by \u226540\u00a0mi or from a rural\u2010to\u2010urban location. We assessed the risk of mortality during the 6 months following residential relocation, controlling for sociodemographics, baseline comorbid health conditions, and time\u2010varying services use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      One\u2010third of the rural Veterans experiencing housing instability had a rural\u2010to\u2010rural relocation (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a07227), whereas the remaining had a rural\u2010to\u2010urban relocation (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a017,375). Veterans with a rural\u2010to\u2010rural relocation were older and had more comorbid medical conditions compared to Veterans with rural\u2010to\u2010urban relocation; however, Veterans with a rural\u2010to\u2010urban relocation had 28% greater odds of mortality during the 6 months following residential relocation than Veterans with rural\u2010to\u2010rural relocation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rural\u2010to\u2010rural relocation was associated with reduced odds of mortality, even when controlling for services utilization, age, and baseline comorbidities. Future research should explore if and how remaining in rural environments is protective and identify ways to support care coordination following residential relocations among Veterans with experience of housing instability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70146","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:49:36Z","timestamp":1775630976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between residential relocation and mortality among Veterans with experience of housing instability in rural areas"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4420-3526","authenticated-orcid":false,"given":"Ann Elizabeth","family":"Montgomery","sequence":"first","affiliation":[{"name":"Birmingham AL Veterans Affairs Health Care System  Birmingham Alabama USA"},{"name":"School of Public Health University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aerin","family":"deRussy","sequence":"additional","affiliation":[{"name":"Birmingham AL Veterans Affairs Health Care System  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Richman","sequence":"additional","affiliation":[{"name":"Birmingham AL Veterans Affairs Health Care System  Birmingham Alabama USA"},{"name":"Heersink School of Medicine University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily H.","family":"Wachtel","sequence":"additional","affiliation":[{"name":"School of Public Health University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7663-3638","authenticated-orcid":false,"given":"John","family":"Blosnich","sequence":"additional","affiliation":[{"name":"Center for Healthcare Evaluation, Research, and Promotion VA Pittsburgh Healthcare System  Pittsburgh Pennsylvania USA"},{"name":"Suzanne Dworak\u2010Peck School of Social Work University of Southern California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2023.01049"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDra2300123"},{"key":"e_1_2_8_4_1","unstructured":"HUD.The 2024 Annual Homelessness Assessment Report (AHAR) to Congress.HUD;2025.https:\/\/www.huduser.gov\/portal\/datasets\/ahar\/2024\u2010ahar\u2010part\u20101\u2010pit\u2010estimates\u2010of\u2010homelessness\u2010in\u2010the\u2010us.html"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/10511482.2020.1716823"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/10530789.2016.1138603"},{"issue":"2","key":"e_1_2_8_7_1","first-page":"138","article-title":"Gaining ground, losing ground: the paradoxes of rural homelessness","volume":"42","author":"Forchuk C","year":"2010","journal-title":"Can J Nurs Res"},{"key":"e_1_2_8_8_1","first-page":"29","volume-title":"Homelessness in America","author":"Hodas BS","year":"2008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10566-008-9052-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.17269\/s41997-022-00625-9"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010025\u201009494\u20107"},{"issue":"6","key":"e_1_2_8_12_1","first-page":"1273","article-title":"The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people","volume":"34","author":"Gelberg L","year":"2000","journal-title":"HSR"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/ort0000616"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-023-08127-1"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrurstud.2024.103552"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2023.2244534"},{"key":"e_1_2_8_17_1","unstructured":"U.S. Department of Agriculture Economic Research Service.Rural\u2010urban continuum codes. Accessed October 24 2025.https:\/\/www.ers.usda.gov\/data\u2010products\/rural\u2010urban\u2010continuum\u2010codes"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1037\/rmh0000024"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44184-022-00004-9"},{"key":"e_1_2_8_21_1","first-page":"1097","article-title":"Characterization of Veterans who contact the National Call Center for Homeless Veterans","volume":"10","author":"Montgomery AE","year":"2025","journal-title":"J. Public Health Manag. 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