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Conducted by the UCSF Benioff Homelessness and Housing Initiative, the California Statewide Study of People Experiencing Homelessness (CASPEH) is the largest representative study of homelessness in the United States since the mid-1990s. The study provides a comprehensive look at the causes and consequences of homelessness in California and recommends policy changes to shape programs in response.

A large new study, conducted by the UCSF Benioff Homelessness and Housing Initiative asked people experiencing homelessness from all over California about what would have helped them avoid losing their housing. Margot Kushel, MD, the study’s principal investigator and director of UCSF BHHI, spoke with TIME about the studies key findings and recommendations. “You can’t build a homelessness prevention program only around eviction prevention. Those programs are important, but you’re going to miss a big chunk of people.” said Dr. Kushel.

There are a lot of myths about people who are homeless in California: They’re from another state. They don’t want a job. They don’t want a home. A new study published by the University of California, San Francisco, paints a different picture, one of people who were working and living in poverty in the state until they suddenly lost their homes. Not knowing where to turn, they ended up on the street, where they endure violence and poor health as they try for years to climb back to stability. “Something goes wrong, and then everything else falls apart,” said the study’s lead researcher, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative. “Everything in their life gets worse when they lose their housing: their health, their mental health, their substance use.”

With modern home prices out of reach for many California residents on fixed incomes, older adults have become the fastest-growing segment of the unhoused population across the state, according to new research from UCSF. California makes up 30% of the nation’s unhoused population and is home to half of all the country’s unsheltered population, according to the landmark study, which looks at how people in the Golden State become unhoused, experience homelessness, and exit homelessness. Nearly half of all unhoused adults in the study were age 50 or older, and Black and Native American residents were “dramatically overrepresented,” the study shows. “The results of the study confirm that far too many Californians experience homelessness because they cannot afford housing,” said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative and principal investigator of the landmark study.

California’s homeless population is predominantly made up of people who lived in the state before losing their housing, with nearly half older than 50 and a disproportionate number who are Black and indigenous, according to a new statewide study. “We have got to bring housing costs down, and we’ve got to bring incomes up,” said Margot Kushel, MD, the study’s principal investigator and director of UCSF’s Benioff Homelessness and Housing Initiative. “We need to solve the fundamental problem—the rent is just too high.”

The United States has an aging population, and sufficient end-of-life care is a growing problem. For people adults who are unhoused, long-term medical care is often inaccessible. There are a few facilities across the country that provide end-of-life hospice care to people experiencing homelessness, but there is not much known about mortality figures among the unhoused. Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, said, "The truth of the matter is most of the country is entirely unprepared for this."