A classification model of homelessness using integrated administrative data: Implications for targeting interventions to improve the housing status, health and well-being of a highly vulnerable population

PLoS One. 2020 Aug 20;15(8):e0237905. doi: 10.1371/journal.pone.0237905. eCollection 2020.

Abstract

Homelessness is poorly captured in most administrative data sets making it difficult to understand how, when, and where this population can be better served. This study sought to develop and validate a classification model of homelessness. Our sample included 5,050,639 individuals aged 11 years and older who were included in a linked dataset of administrative records from multiple state-maintained databases in Massachusetts for the period from 2011-2015. We used logistic regression to develop a classification model with 94 predictors and subsequently tested its performance. The model had high specificity (95.4%), moderate sensitivity (77.8%) for predicting known cases of homelessness, and excellent classification properties (area under the receiver operating curve 0.94; balanced accuracy 86.4%). To demonstrate the potential opportunity that exists for using such a modeling approach to target interventions to mitigate the risk of an adverse health outcome, we also estimated the association between model predicted homeless status and fatal opioid overdoses, finding that model predicted homeless status was associated with a nearly 23-fold increase in the risk of fatal opioid overdose. This study provides a novel approach for identifying homelessness using integrated administrative data. The strong performance of our model underscores the potential value of linking data from multiple service systems to improve the identification of housing instability and to assist government in developing programs that seek to improve health and other outcomes for homeless individuals.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Data Management
  • Female
  • Health Status
  • Housing / standards*
  • Humans
  • Ill-Housed Persons / classification*
  • Logistic Models
  • Male
  • Massachusetts
  • Middle Aged
  • Social Problems / prevention & control*
  • Social Problems / psychology
  • Substance-Related Disorders / epidemiology
  • Vulnerable Populations
  • Young Adult

Grants and funding

One author (Marc Dones) was employed by a commercial entity, the Center for Social Innovation, at the time work on the manuscript was completed. The funder provided support in the form of salaries for authors [insert relevant initials], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of this author are articulated in the ‘author contributions’ section.