Homeless Vulnerability Index

Public health methodology

This article is about the Vulnerability Index used in homeless enumeration counts worldwide. For other uses, see Vulnerability index.

The Vulnerability Index is a survey and analysis methodology for "identifying and prioritizing the street homeless population for housing according to the fragility of their health".[1][2] It is a pragmatic methodology based on concern and inquiry into the reasons for recurring fatalities of homeless living in the outdoor urban context. It was developed by Jim O'Connell of Boston Health Care for the Homeless Program.[3]

According to its proponents, his work succeeded in pinpointing the health problems that led to homeless persons being "most at risk for dying on the street". He lists eight conditions, in medical terminology called "markers". According to Common Ground, a national organization to house the homeless, 40% of the Boston mortality was attributable to those factors.[3]

In its formulation as currently promulgated by Common Ground, the index includes these factors: hospitalizations/emergency department visits in a year, age, HIV-AIDS, liver disease or kidney disease, history of frostbite, immersion foot, or hypothermia, and tri-morbidity. Tri-morbidity is co-occurring disorder (psychiatric, substance abuse) with a chronic medical condition.[4]

A national drive is underway by Common Ground to piggy back data collection for the VI onto the bi-annual homeless enumeration count mandated for communities participating in the Continuum of Care grant program of the US Department of Housing and Urban Development.[5] Its proponents contend that such demand side data will assist in placements and getting needy individuals off the street, whereas critics argue that it is intrusive and not likely to lead to increased supply of housing.[6]

The Vulnerability Index has been used outside of the north eastern United States. Cities include Charlotte, North Carolina,[7] Albuquerque, New Mexico, Santa Monica, California.[8] Los Angeles, California, Santa Barbara,[9] California, New Orleans, Louisiana,[1] and Chicago, Illinois.[10] By June 2011, it had also been deployed in various cities in Australia.

## Antecedent use of the concept[edit]

Main article: Vulnerability index

A vulnerability index for the environmental concerns was developed by the South Pacific Applied Geoscience Commission (SOPAC) with the United Nations Environment Programme (UNEP).[2] They noted that the concept of vulnerability could be applied to various "levels or issues". They specifically noted that it could be applied to "a single issue... or to assess a complex entity such as a country." In sociological research, a distinction is made between indexes and scales. The former often weights variables equally but in any case does not register patterns of data. A scale on the other hand presents a structure in which certain patterns of the variables tend to aggregate at one end of the scale and go together in ascending order.[citation needed][11]

### Earliest use[edit]

Papers associated with Small independent developing societies research used the term "vulnerability index" long before its adoption by O'Connell. United Nations – DPCSD (1997). This took two forms; the term was used in combination with a qualifier. Examples are "environmental vulnerability index" and "Economic Vulnerability Index". However, the raw term "Vulnerability Index" appeared in an epinonymous background paper cited by Professor Lino Briguglio,[12] University of Malta, an expert on "the development of indices for measuring the economic and environmental vulnerability of small island developing states".[13]

### Critique of the Index[edit]

There are critics of the index[14] that suggest that it is overly positivistic and reductivist – reducing the experience of homelessness by those persons to counts, numbers and statistics. Instead critics suggest more nuanced information from the disenfranchised and more varied perspectives on the homelessness issue be included in assessment of needs.[15] For example, feminists and qualitative input. The suggestion is that the research relies too heavily on "experts" and governmental organizations and think-tanks. The Ontario Coalition Against Poverty was openly critical of the homogenizing effects the survey could lead to as it was employed to shape homelessness services policies, leading to a reductive and overly simplistic approach to meeting this population's needs.

The index is also credited, erroneously perhaps, on reducing homelessness[16] where we see comments like "The launch of the 100,000 Homes Campaign by Common Ground has since given communities across the country innovative new methods and tools to house our homeless neighbors. One such tool is the Vulnerability Index." The tool then is being conflated with an increase in the housing of the most vulnerable and chronically homeless persons. However, it is the use of the tool within the context of a model of Housing First that appears to be the vehicle that shapes the experience and perceptions of homeless persons by the outreach workers administering the VI and it is this change that further motivates those outreach workers to assist these homeless persons into housing proper. Accordingly, the index itself it not the tool that moves persons out of homelessness it is their assessment of vulnerability taken into and within the model of housing first, brought to a systematized program of intake that values and makes that VI score a priority over other kinds of evidence that may or may not be included in that assessment. Evidence on how the VI could be contributing to changes in affective experience by outreach workers of homelessness persons risk assessment then needs documentation to verify that experiential profiling is not leading to self-selection and lack of validity of the tool in its current application framework.

## References[edit]

1. ^ a b "Vulnerability Index: Prioritizing the Street Homeless Population by Mortality Risk" (PDF). endhomelessness.org.
2. ^ a b "Homeless Vulnerability Index". MedicBD Health. Archived from the original on March 25, 2012.[circular reference]
3. ^ a b Ibid
4. ^ "Co-occurring Disorders". NMHA.
5. ^ LLC, Common Ground. "Common Ground".
6. ^ "Competitively Awarded Homeless Programs (Continuum of Care)". Hud.gov. Archived from the original on December 24, 2007.
7. ^ "Vulnerability Index: Fact Sheet". March 8, 2010. Archived from the original on August 10, 2010.
8. ^ "Vulnerability Index".
9. ^ A Brief Preview of Registry Week
10. ^ "Chicago Central Referral System Assessment Tool".
11. ^ "Environmental Vulnerability – The Issue". Global EVI Website. Archived from the original on May 18, 2006.
12. ^ "SELECTED READING". United Nations Environment Programme (UNEP). Archived from the original on February 15, 2007.
13. ^ Vulnerability Index (Revised Background Paper). SD-SIDS Unit.
14. ^ Federman, Mark (2 April 2009). "Homelessness and Complex Problems". Retrieved 2014-03-07.
15. ^ Ontario Coalition to End Poverty. "Open Letter to Mayor David Miller, Councilor Joe Mihevc and Streets To Homes Manager Iain De Jong". Retrieved 2014-03-07.
16. ^ Hands On Hartford. "About the Vulnerability Index". Retrieved 2014-03-07.

* v
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* e

Homelessness

People|

* Aged people
* Cyber-homeless
* Families
* McRefugee
* Mole people
* Street people
* Street children
* Social orphan
* Vagrants
* Bergie
* Tramps
* Hobos
* Youth

Issues|

* Anti-homelessness legislation
* Bill of Rights
* Bumvertising
* Discrimination
* Mental health
* Patient dumping
* Popular culture
* Spirituality
* Vulnerability Index
* Pets
* Survival sex
* Social cleansing
* Slum clearance

Responses|

* Soup kitchen
* Hygiene program
* Homeless ministry
* Homelessness services
* List
* Street newspaper
* List

| Shelters|

* Homeless shelter
* Cooling center
* Drop-in center
* Four penny coffin
* Penny sit-up
* Warming center
* Women's shelter
* Homeless Friendly Precincts

|

Housing|

* Foyers
* Housing First
* Rapid Re-Housing
* Right to housing
* Single-room occupancy (SRO)
* Squatting
* Tent city
* Transitional housing

Awareness|

* Homelessness Action Week
* Homeless Persons' Week
* Homeless World Cup
* International Year of Shelter for the Homeless
* Street Child World Cup
* Youth Homelessness Matters Day

By country|

| Africa|

* Algeria
* Egypt
* Ghanaian children
* South Africa

|

Americas|

* Canada
* Vancouver
* Latin American children
* United States
* LGBT youth
* Veterans
* Women
* California
* San Francisco
* Colorado
* Columbus
* Florida
* Minneapolis
* New Mexico
* Oregon
* Seattle
* Elsewhere

Asia|

* Bangladeshi children
* China
* India
* children
* Indonesia
* Iraq
* Israel
* Japan
* North Korea
* Filipino children
* Thai children

Europe|

| East|

* Eastern European children
* Hungary
* Russia

|

North|

* Denmark
* Finland
* Ireland
* Sweden
* United Kingdom
* England
* Scotland

South|

* Greece
* Portugal
* Spain
* Vatican City

West|

* France
* Germany
* Netherlands
* Switzerland

Oceania|

* Australia
* Papua New Guinea
* New Zealand

Category

* v
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* e

Deprivation and poverty indicators

Social|

| Topics:|

* Acting out
* Child abuse
* Disadvantaged
* Diseases of poverty
* Environmental degradation
* Environmental racism
* Fushūgaku
* Governance failure
* Hikikomori
* Mental illness
* Relative deprivation
* Self-image
* Social deprivation
* Social exclusion
* Social stigma
* Social vulnerability
* Social determinants of health in poverty
* Violence against women
* Vulnerability

|

Measures:|

* Social Progress Index

Psychological|

| Topics:|

* Cruel, inhuman or degrading treatment
* Learned helplessness
* Psychological abuse
* psychological poverty
* Poverty and mental health
* Social determinants of mental health

|

Economic|

| Topics:|

* Asset poverty
* Culture of poverty
* Debt bondage
* Energy poverty
* Extreme poverty
* Housing stress
* Human trafficking
* Income deficit
* Poverty threshold
* Precariat
* Precarious work
* Secondary poverty
* Social determinants of health in poverty
* Survival sex
* Water scarcity

|

Measures:|

* Below Poverty Line (India)
* Homeless Vulnerability Index
* Misery index (economics)
* Gini coefficient
* Genuine progress indicator (GPI)
* Legatum Prosperity Index
* Poverty gap index

Physical|

| Topics:|

* Disability and poverty
* Food insecurity
* Physical abuse
* Sex trafficking
* Social determinants of health
* Poverty and violence

|

Measures:|

* India State Hunger Index
* Global Hunger Index
* Disability-adjusted life year (DALYs)
* Global Peace Index (GPI)

Complex measures|

* Human Poverty Index (HPI)
* Human Development Index (HDI)
* Multidimensional Poverty Index (MPI)
* Physical Quality of Life Index (PQLI)
* Laeken indicators (EU)
* Scottish index of multiple deprivation
* Townsend deprivation index
* Living Planet Index (LPI)
* Progress out of Poverty Index

Gender|

| Topics:|

* Feminization of poverty

|

Measures:|

* Gender-related Development Index (GDI)
* Gender Parity Index

Other|

Categories: Income inequality metrics · Measurements and definitions of poverty · Social responsibility organizations

* v
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* e

Indices of Deprivation

National (general deprivation)|

* Carstairs
* Multiple Deprivation 2000 (IMD2000)
* Deprivation 2004 (ID2004)
* Deprivation 2007 (ID2007)
* Deprivation 2010 (ID2010)
* Townsend

National (subject specific deprivation)|

* Underprivileged area score
* Department of Environment's

Commons categories: Information graphics about poverty · Poverty-related maps

* v
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* e

Poverty

Other aspects|

* Measuring poverty
* Concentrated poverty
* Cost of poverty
* Disability and poverty
* Diseases of poverty
* Climate change and poverty
* Child poverty
* Chronic poverty
* Cycle of poverty
* Guaranteed minimum income
* Universal basic income
* List of basic income models
* Poverty reduction
* Sustainable Development Goals

Metrics|

* Homeless Vulnerability Index
* Misery index (economics)
* Gini coefficient
* Genuine progress indicator
* Legatum Prosperity Index
* Poverty gap index
* Human Poverty Index
* Multidimensional Poverty Index
* Scottish Index of Multiple Deprivation

By Location|

| Africa|

* Algeria
* Democratic Republic of the Congo
* Egypt
* Ethiopia
* Kenya
* Namibia
* Niger
* Nigeria
* South Africa
* Tanzania
* Uganda
* Zimbabwe

|

Asia|

* Afghanistan
* Armenia
* Bangladesh
* Cambodia
* China
* Cyprus
* East Timor
* India
* Indonesia
* Israel
* Japan
* Lebanon
* North Korea
* South Korea
* Malaysia
* Nepal
* Pakistan
* Philippines
* Singapore
* Sri Lanka
* Vietnam
* Yemen

Europe|

* Cyprus
* France
* Germany
* Greece
* Italy
* Moldova
* Norway
* Poland
* Romania
* Switzerland
* Turkey
* Ukraine
* United Kingdom

Oceania|

* Australia
* New Zealand

The Americas|

* Argentina
* Bolivia
* Brazil
* Canada
* Colombia
* Cuba
* Guatemala
* Haiti
* Honduras
* Jamaica
* Mexico
* Paraguay
* Peru
* United States
* Uruguay
* Venezuela

Other|

* Theories of poverty
* Well-being
* Welfare
* Welfare culture
* Welfare trap
* Welfare's effect on poverty
* Criticism of welfare
* Wellness
* Quality of life
* Self-perceived quality-of-life scale
* Subjective well-being (SWB)
* Stress
* Rural access issues
* Providing Urban Amenities to Rural Areas
* Post-materialism
* Pen's parade
* Culture of poverty
* Causes of poverty
* List of global issues

* v
* t
* e

Diseases of poverty

Diseases of poverty|

* AIDS
* Malaria
* Tuberculosis
* Measles
* Pneumonia
* Diarrheal diseases
* Plague

Neglected diseases|

* Cholera
* Chagas disease
* African sleeping sickness
* Schistosomiasis
* Dracunculiasis
* River blindness
* Leishmaniasis
* Trachoma

Miscellaneous|

* Malnutrition
* Priority review voucher

See also
List of countries by percentage of population living in poverty · Deprivation and poverty indicators
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