A new study at London Health Sciences Centre Research Institute (LHSCRI) and ICES Western is using artificial intelligence and community partnerships to advance equitable care for people experiencing homelessness.
The study led by Stephanie Dixon, a professor of medicine and epidemiology and biostatistics at Schulich School of Medicine & Dentistry, will develop a new frailty score that accounts for the health impacts of experiencing homelessness. Frailty scores are tools used to assess a person's overall health and risk of complications.
Through the project, Dixon and collaborators will use anonymous health data from more than 35,000 Ontarians who have a history of homelessness. Working alongside community partners, health-care providers and individuals with lived experience, the team will identify factors that can help create a more accurate picture of health risks for individuals who have experienced homelessness.
"Data can tell us a great deal, but it only captures one part of the story," said Dixon, who is also a research scientist at LHSCRI and ICES Western. "By bringing together data, lived experience and frontline expertise, we hope to build something that helps people see health needs earlier and connect individuals with the care and support they need."
The long-term goal is to develop a tool that can help physicians and shelter-based care providers identify people who may be at increased risk of poor health outcomes earlier and to deliver more proactive care. The project will also document important gaps in existing health data collection to help researchers better understand where the experiences of people experiencing homelessness are less visible in health care systems.
Professor Stephanie Dixon and collaborators are working on tools to help assess health risks for those with histories of homelessness. (LHSCRI)
The study is supported through the AMS Healthcare Leadership in Compassion and Artificial Intelligence Fellowship, a year-long program that brings together health-care leaders, researchers and innovators to explore how AI can be developed and applied with compassion at its core. Through the fellowship, Dixon is collaborating with an interdisciplinary team, community partners, and individuals with lived experience to develop both the frailty score and a broader framework for compassionate, equity-informed AI in health research.
Existing frailty scores help health-care providers identify people at greater risk of illness, hospitalization or other serious health complications. However, most were developed for older adults living in stable housing and often fail to capture the cumulative impacts of homelessness, including stressors such as trauma, chronic stress, substance use, mental health concerns and barriers to accessing care.
Research suggests that people experiencing homelessness can experience the effects of frailty years earlier than the general population. This can make it difficult to identify who may benefit from additional supports or interventions.
To develop a new frailty score, Dixon is collaborating with community partners and individuals with lived experience to create a model that accounts for the health impacts of experiencing homelessness. The AI-driven tool will incorporate stressors not typically included in existing frailty scores, which often place greater emphasis on a person's age than their life experiences and health challenges.
"We are using a co-designed approach," says Dixon, who has worked with ICES Western for nearly 15 years. "Together we can identify commonly missed stressors such as the cumulative effects of adverse childhood experiences, substance use, infectious disease history, and mental health concerns."
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