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California’s homelessness crisis is a homegrown problem that is deepening amid a shortage of affordable housing and emergency shelter, and it’s often the brutal conditions of living on the street that trigger behavioral health problems, such as depression and anxiety, researchers found in a comprehensive study on homelessness. The new findings show that at least 90% of adults who are experiencing homelessness in the state became homeless while living in California. “This idea that homeless people are rushing into California is just not true,” said Margot Kushel, a physician who treats homeless people, and the lead investigator of the study for the UCSF Benioff Homelessness and Housing Initiative. “There’s so much myth-making around this magnet theory that people who are homeless flock to California, but this is our own problem.”

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.

Public policy and common perception have long tied the road to homelessness with mental illness and drug addiction. But a new study—the largest and most comprehensive investigation of California’s homeless population in decades—found another cause is propelling much of the crisis on our streets: the precarious poverty of the working poor, especially Black and brown seniors. “These are old people losing housing,” said Margot Kushel, MD, the lead investigator on the study and the director of the UCSF Benioff Homelessness and Housing Initiative.

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.”

Homeless people in California are already a vulnerable group, often struggling with poor health, trauma and deep poverty before they lose their housing, according to a new study on adult homelessness. The study attempts to capture a comprehensive picture of how people become homeless in California, and what impeded their efforts at finding permanent housing. Researchers at the UCSF Benioff Homelessness and Housing Initiative hope that the study will strengthen public support for policies that focus on offering housing and emergency rental assistance—rather than policies emphasizing punishment or stigma. “People are homeless because their rent is too high. And their options are too few. And they have no cushion,” said Margot Kushel, MD, UCSF's BHHI director and lead investigator. “And it really makes you wonder how different things would look if we could solve that underlying problem.”

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 University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) has released the largest representative study of homelessness in the United States since the mid-1990s, providing a comprehensive look at the causes and consequences of homelessness in California and recommending policy changes to shape programs in response. The California Statewide Study of People Experiencing Homelessness (CASPEH) used surveys and in-depth interviews to develop a clear portrait of homelessness in California, where 30% of the nation’s homeless population and half of the unsheltered population live.

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."

In this episode of the Prioritizing Equity series, Dr. Emily Cleveland Manchanda speaks with a panel about health care planning and caring for patients experiencing houselessness. The panel included, Dez Martinez, Denise De Las Nueces, MD, Margot Kushel, MD, Stephen Brown, MSW, and Yinan Lan, MD. Dr. Kushel, director of UCSF’s Benioff Housing and Homelessness Initiative, said, "If you look at the states with the highest percentage of their population experiencing houselessness, those are the states with the lowest level of housing. So, we need to raise our voices and say every place we can that the solution to homelessness is housing."

This news piece describes the complex economics surrounding homelessness. Margot Kushel, MD, director of UCSF's BHHI, emphasizes “Homelessness is a symptom of our country's failure to prioritize housing as a human right.” Highlighting the societal costs of homelessness, it underscores the urgency for comprehensive policy interventions and a paradigm shift towards viewing housing as a fundamental human need rather than a commodity.