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California’s homeless crisis is reaching unprecedented levels. In this podcast episode of Invisible People, Margot Kushel, MD, director of the UCSF Center for Vulnerable Populations and the UCSF Benioff Homelessness and Housing Initiative, breaks down the findings of the California Statewide Study of People Experiencing Homelessness (CASPEH). Dr. Kushel said, "We need to have a maniacal focus on creating more housing."

Depression is common in adults experiencing homelessness. In this cohort study, researchers examined the association between residential status and depressive symptoms in adults 50 years or older experiencing homelessness. Researchers found that continued homelessness was associated independently with increased odds of depressive symptoms.

In this episode of KPFA Letters and Politics, host Mitch Jeserich spoke with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, about the myths and misinformation about homelessness. Dr. Kushel said, "This idea of a max exodus is simply not true. "

As the number of people experiencing homelessness in California has grown, so has the pressure on state and local leaders to improve the situation. On July 25th, 2024, Governor Gavin Newsom issued an executive order directing state agencies to clear encampments from state-owned land. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "This didn’t happen overnight. … It’s hard to unwind 40 years of bad policies in four years."

Governor Newsom of California and advocates agree that the homelessness crisis is decades in the making, but opinions differ over whether Governor Newsom's conservative policy approach will help fix the issue. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "There is no easy way out of this. I have deep compassion for everybody’s frustration. I’m frustrated. I want this problem to be over. I understand this is unacceptable, but I think when you’re in a hole, you need to stop digging."

More than 3,000 of the 11,500 people who died while unhoused in Los Angeles County between 2014 and 2023 were 60 and older. This crisis has grown over time. In a groundbreaking study on homelessness in California by Benioff Homelessness and Housing Initiative researchers found that nearly half of unhoused adults were age 50 and older. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "They talk about how ashamed and stigmatized they feel – they know the public thinks they’re bad because they’re outside. And they just feel incredibly alone in the world."

On June 28, 2024, the US Supreme Court ruled in City of Grants Pass, Oregon v. Johnson, that arresting and fining people experiencing homelessness who are camping and sleeping in public spaces does not violate their Eighth Amendment rights against cruel and unusual punishment. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, speaks with Jeffery Norris on the likely impacts in California and across the country.

The UCSF Benioff Homelessness and Housing Initiative released a special report on Intimate Partner Violence (IPV) and homelessness. The report found that 8 percent of the unhoused experienced IPV, a more formal term for much domestic violence, including 17 percent of all women living on the streets or in homeless shelters. Domestic violence causes and prolongs homelessness. More should be done to prevent domestic violence.

How many people are experiencing homelessness in San Francisco? The annual one-night tally, or point-in-time count (PIT), counted about 8,300 people experiencing homelessness. However, there is another metric that counts how many people accessed San Francisco's homelessness services. Using that measure, there were at least 20,100 people experiencing homelessness in 2023. Experts recommend that counties should pair the PIT count with other sources of data. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "They’re two different methodologies that are serving different purposes. And together they give us a fairly (accurate) picture of what's going on."

American adults 50 and older are the fastest growing group falling into homelessness. In part 1 of this story, Viewpoints Radio covered the factors fueling this rise. In part  2 – host Gary Price talks with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and Dennis Culhane, PhD, professor, social policy, University of Pennsylvania about why this population is especially vulnerable out on the streets and why it’s so hard to find a way back once you’re in this position.

The new, unlikely face of homelessness: Working Americans with decent-paying jobs who cannot afford a place to live. Years of rising rents and a shortage of affordable housing have created a situation where even a strong labor market and rising wages haven’t been enough to offset the financial strains of inflation. About 1 in 4 renters spend at least half of their income on rent and utilities, making them at greater risk for eviction and homelessness. Margot Kushel, MD, director of the Benioff Homelessness and Housing Initiative at the University of California at San Francisco, said, "The general public doesn’t see these folks as homeless — they’re not as visible as the people who occupy public spaces, who have substance abuse issues or mental health problems."

On July 25th, 2024, Governor Gavin Newsom issued an executive order directing state agencies to clear "dangerous" homeless encampments from state land. State agencies will assess encampments to identify any “imminent threat to life, health, safety or infrastructure.” The new executive order faces criticism from civil rights groups and advocates for people experiencing homelessness. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "If we move people from one place to another place, that doesn’t meet our goal."

Governor Gavin Newsom issued an executive order on July 25, 2024, providing authority for state and local officials to clear unsafe homeless camps. The order advises local jurisdictions to adopt a version of the California Department of Transportation encampment policy, requiring officials to give people experiencing homelessness in encampments a 48-hour notice before a sweep and work with organizations to help anyone displaced. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "In the long term, ending homelessness in California will require increased investments in housing and support services, while simultaneously making it easier to rapidly develop affordable housing."

This topic brief examines who experiences pregnancy during homelessness, how they lost their housing, their experiences during homelessness, and barriers to regaining housing. The findings highlight the urgent need for the homelessness system to advance evidence-based strategies to meet the needs of pregnant people.

Homeless encampment cleanup activities do not appear to have long-term effects on the number of people living on the streets, a new study by Rand Corp has found. Another study by the Benioff Homelessness and Housing Initiative at UC San Francisco found that far more than the general population, people living on the streets and in shelters are victimized by violence and discrimination. Anita Hargrave, MD, assistant professor at UCSF and lead author on the impact of Intimate Partner Violence on Homelessness study, said, "There is so much tendency in the ongoing discourse on homelessness to dehumanize. When you read through people’s stories when they came to that point when they could no longer be housed, it’s such a powerful way of creating empathy."

Oakland begins a sweep of a homeless camp since the US Supreme Court's landmark ruling in City of Grants Pass v. Johnson last month loosed clearance rules. This sweep highlights the need for more housing and shelter. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "At the end of the day, what people really want is housing."

Each year, older adults make up a greater proportion of America’s homeless population and these numbers are only expected to keep rising. In part one of this story, Viewpoints Radio host Gary Price spoke with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and Dennis Culhane, PhD, professor, social policy, University of Pennsylvania, about the main societal factors driving this increase and why this group is particularly vulnerable to homelessness.

Intimate partner violence (IPV) is a risk factor for people experiencing homelessness. Few studies have examined the interplay between IPV, homelessness, and housing. Researchers purposefully sampled 104 adults who reported experiencing IPV in the California Statewide Study of People Experiencing Homelessness (CASPEH), a representative, mixed-methods study. They identified six primary themes regarding IPV and homelessness.