In a recently published study, Dr. Cronley analyzed the VI-SPDAT (Vulnerability Index – Service Prioritization and Decision Tool) scores for over 1,300 adults experiencing homelessness. The VI-SPDAT is widely used by service providers across the U.S. and in Canada to assess individual vulnerability in situations of homelessness and prioritize housing based on VI-SPDAT scores. In her research, Dr. Cronley found disturbing evidence of racial and gender bias in the VI-SPDAT.
Why are trauma and vulnerability important in homelessness? Trauma is endemic in the lives of people experiencing homelessness. When it intersects with gender- and race-based disadvantage, the risks for vulnerability escalate. Women face unique risks for homelessness compared to men, based on interpersonal violence, economic inequalities, unintended pregnancy, and single parenthood. Race is also a factor, and Black people comprise nearly half (40%) of all individuals experiencing homelessness in the U.S., despite making up just 15% of the general population. It is likely, then, that Black women are disproportionately at risk for trauma and vulnerability on the street.
The U.S. Department of Housing and Urban Development (HUD) has made funding for homeless services in the U.S. contingent on use of a standardized assessment tool within a coordinated entry system. As noted, many providers utilize the VI-SPDAT for this purpose, but the tool is not validated, and its development is troubling. The organization that created the VI-SPDAT, OrgCode Consulting, relied heavily on studies conducted with community samples in one city in the northeastern U.S. These samples were largely male, and data were analyzed for rate of death—and not for vulnerability thresholds.
Since its public release in 2010, the VI-SPDAT has never been analyzed for standard psychometric properties of validation and reliability. Community-level studies, however, show consistent evidence of racial bias and unreliability in its use.
One question on the VI-SPDAT asks whether a person’s homelessness is due to trauma. Dr. Cronley tested whether this single item predicts total VI-SPDAT scores and whether there are differences in this relationship based on gender (female vs. male), race (Black vs. white), and the intersection of gender and race (female and Black, female and white, male and Black, and male and white).
Dr. Cronley found a strong relationship between trauma and scores on the VI-SPDAT, but she found surprising differences between Black and White persons and males and females. Overall, White women scored the highest on the VI-SPDAT, and White men scored the second highest. This is despite the fact that both Black and White women reported similarly high odds of homelessness due to trauma. Black men showed the lowest VI-SPDAT scores.
In sum, the VI-SPDAT shows evidence of racial bias. Both Black and White women reported similarly high odds of homelessness due to trauma, but White women scored consistently higher on the VI-SPDAT. Closer inspection revealed that White women reported more visits to emergency rooms and formal healthcare use compared to Black women. They were also more likely to report engaging in risky behaviors like survival sex. It is possible that Black women are disproportionately at risk for trauma on the street, but are scoring lower on the VI-SPDAT, because they are less likely to use formal healthcare and more reluctant to report some risk behaviors compared to White women. This may be due to historic racism and mistreatment that has led minority communities to distrust form health systems and fear disproportionate retaliation in criminal justice as a result of discriminatory policing practices.
If biases persist within the assessment and coordinated entry process, over time more Black people who are experiencing homelessness will be without housing for longer periods of time compared to their white counterparts.
Since Dr. Cronley’s publication, OrgCode Consulting has posted a blog post announcing that the company will no longer support the VI-SPDAT. Communities must reconsider use of the VI-SPDAT for housing decisions. Revising the VI-SPDAT is insufficient. Its primary items are based on mortality risks, not vulnerability, and reflect experiences of people, largely male, living unsheltered in northern climates. Instead, researchers and policy makers should build new vulnerability assessments, perhaps with consideration to geographic, racial, and gender disparities in experiences of homelessness. Finally, greater advocacy from researchers and community advocates is needed to pressure HUD to promote alternatives to the VI-SPDAT and to acknowledge its flaws.
Click here to see the entire research blog: https://www.homelesshub.ca/blog/racial-and-gender-bias-vi-spdat