Help the Homeless? There's an App for That
Two doctors in Boston may have found a way to identify which homeless people are most in need of urgent medical care
- By Abigail Tucker
- Smithsonian.com, May 17, 2012, Subscribe
Just over a decade ago, Boston doctors began monitoring a population of 119 homeless people with health problems. The subjects’ average age was 47. Today roughly half of them are dead.
That toll is not atypical: a homeless person of any medical background is roughly four times more likely to die than a housed person of the same age. These deaths are often lonely, anonymous affairs. After being warehoused in a city coroner’s office for months, the body may be cremated and buried in a pauper’s field.
“Somebody dying on our streets—I think that’s as bad as it gets in America,” says Rebecca Kanis, director of the 100,000 Homes Campaign, a movement of more than a hundred community groups aiming to house most of the nation’s 110,000 chronically homeless by 2014. “We can do better than this.”
The campaign is introducing an unlikely tool to prevent these tragedies: a potentially life-saving mobile app being tested in several communities this summer. The “Homeless Connector” will eventually allow ordinary Americans on their way to class or home from work to identify the people most at risk of dying on the street, and to find them help.
The app is based on the research of Jim O’Connell, an internist with Boston’s Health Care for the Homeless program who earned the trust of the city’s street people over decades in part by doing shifts on a sandwich wagon.
O’Connell (often working with another doctor, Stephen Hwang) realized gradually that certain widespread theories about homeless people’s health didn’t hold up. His patients didn’t die more often in the winter, as was commonly supposed; they died throughout the year, and fall was actually the more lethal season. “It was in the transition between fall and winter,” he says, because that’s when people who check out of homeless shelters after the summer are exposed to cold for the first time.
Also, the dead weren’t people who avoided institutional treatment and “fell through the cracks,” as previously believed. Many had checked into emergency rooms and detox centers just days before death. And certain health conditions that are relatively common in the homeless population marked patients for greatly increased risk of dying. For instance, frostbite doesn’t typically kill people, but, in part because it suggests that the patient isn’t aware of his surroundings, it is a key indicator of more catastrophic troubles to come.
In the mid-2000s, Kanis mined O’Connell’s research to develop a questionnaire called the Vulnerability Index. Along with basic biographical questions, the survey asks a homeless person about eight risk factors that lead to an elevated risk of dying: Are you 60 or older? Have you been hospitalized more than three times in the last year? Have you visited the emergency room more than three times in the last three months? Do you suffer from cirrhosis of the liver? End-stage renal disease? HIV/AIDS? Do you have any other chronic medical conditions combined with psychiatric and substance abuse problems? Do you have a history of hypothermia or frostbite?
Roughly 43 percent of the homeless answer yes to at least one question. These medically fragile people become the 100,000 Homes Campaign’s priorities. Finding them housing fast can lengthen their lives (many homeless people don’t take vital medication, for instance, because it dulls their senses, making it harder to stay vigilant on the dangerous streets). Others, already dying, are able to die with dignity in a home of their own.
The Vulnerability Index was first used in New York City. Now more than 60 communities across the country affiliated with the campaign have adopted it. Typically, volunteers canvass an area between 4 a.m. and 6 a.m. three days in a row. They wake everyone they see sleeping on the streets; about 70 percent agree to be surveyed. In addition to collecting the medical and biographical data, volunteers take a picture of the person. Back at headquarters, this information becomes the basis for future strategy: “they can write the names on a dry erase board: this is who we’re getting this week,” Kanis says.
Being launched in five communities in June, the “Homeless Connector” mobile app is a version of the Vulnerability Index that, through the 100,000 Homes Campaign website, will eventually be available to anyone with a tablet or smartphone. Encountering a homeless person on the street, the volunteer electronically enters the survey answers and (with permission) snaps a cell phone picture. The information (along with the homeless person’s geographic coordinates, recorded via smartphone) is routed to the headquarters of the nearest community group participating in the 100,000 Homes Campaign.
“We want to create a country in which every homeless person is known by name and health condition,” Kanis says. “We want to strip away the anonymity of homelessness.”
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Comments (11)
amazing
Posted by amya on March 1,2013 | 02:28 PM
How to stimulate the economy and help the Homeless There are endless Private Foundations all over the world, giving millions of dollars away for free, each year, you just have to find the right Foundation and ask. Here is a list of Grants that you may apply for to help you stimulate the economy. I hope that you might find this helpful. Good luck and God Bless you. … The William Randolph Hearst Foundation pays hundreds of thousands of dollars each year to the Homeless, medical care and dental care for the homeless and drug re-habilitation programs private hospitals and various Art programs … .. http://www.hearstfdn.org/fp_home.html http://www.grants.gov/ Government Grants http://www.sba.gov/ Start a small business Grants http://en.wikipedia.org/wiki/Grant_Writing How to write a grant George Soros, Hungarian-American business magnate, investor, and philanthropist. He is the chairman of Soros Fund Management. Soros supports progressive-liberal causes. He is known as "The Man Who Broke the Bank of England" because of his US$1 billion in investment profits during the 1992 Black Wednesday UK currency crisis. Between 1979 and 2011, Soros gave away over $8 billion to human rights, public health, and education causes. He played a significant role in the peaceful transition from communism to capitalism in Hungary (1984–89), and provided Europe's largest higher education endowment to Central European University in Budapest. Soros is also the chairman of the Open Society Institute. Open Society Foundations http://www.soros.org/contact-us 400 West 59th Street New York, NY 10019 USA .. Free Water Wells FREE SOLAR WATER WELL PUMPS Water for Life Institute To bring clean water to people. http://www.waterforlife.org/ …. Free Livestock Heifer International http://heifer.com/
Posted by Carol Ann Rouse Gallegos on November 2,2012 | 07:15 PM
really you can have apps for homeless people but yet docotrs dont do what there suppose to do prime example why my papa died cause doctors are dicks who are money hungry!
Posted by moe on September 22,2012 | 11:31 AM
I recently became homeless at the age of 28.It's hard for me because I am A.D.D and just had a little girl in 4/15/2012.Don't know what 2 do.I live in my 96 ford mustang in Atlanta Ga .I thank God everyday for my life but it's is a horrible Time in my life.I am glad there people who still care about the lost in america. It would be nice to hear from people who are from 18-28 of age who have A.D.D and homeless .Thank you for your story but there are all passed my age,who had everything and loss it.What about the 18-28 who never had anything ,A.D.D or something worse.Thank you for your testImoany of the people with there story .It's help to form my tactics in my situation.Gob bless y'all ;)
Posted by Cristian R Velasquez on June 27,2012 | 03:25 PM
The comment about liberals putting people on the street for individual rights is only part of the problem. The other part is the conservatives creating an environment of "for profit" businesses that then use the individual rights issue as justification to put people in horrible conditions and make money is the other side of the coin. The liberals never set enough rules or regulations - the reason for this could be debated and possibly substantiated - and the conservatives throw out the assistance without concern for people. Why aren't these two issues addressed at the same time?
Posted by Arnold Lewis on June 24,2012 | 10:35 AM
I would also like to help. Do you need donations?
Posted by Jan ALlison on June 10,2012 | 04:35 PM
Great Article. Dr. Jim O'Connell is an Un-household name among Boston's homeless community and very well loved and respected. I only hope this App will not be accessible to just anyone.
Posted by Michael Bancewiz on June 7,2012 | 10:25 AM
Sounds worthwhile, but smacks of "big brother" so many of the high teck and organized efforts to help the poor have become "businesses" that exploit. We already have PLENTY of them.
Posted by mamaport on June 5,2012 | 05:10 PM
Now we just need an app for those who will soon become homeless because of their medical bills.
Posted by Chris on June 3,2012 | 05:39 PM
I remember when the state had homes for those who could not care for themselves, for one reason or another. Then came the liberals who were so worried about everyone's right to freely choose. What happened is they were forced out of the institutions and ended up on the streets. These people went from safe and cared for, to unspeakable conditions. We would not put our dog on the street like this. All for the sake of individual rights.
Posted by Barbara on June 3,2012 | 12:49 PM
I would like to help.
Posted by Joe Ruark on May 17,2012 | 11:28 AM