Resource Center

Recently the demographic characteristics of people experiencing individual homelessness have changed; more individuals over the age of 50 are experiencing homelessness. BHHI researchers examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with family or friends. Researchers found barriers to stay such as feelings of shame and concerns about burdening the hosts. Findings suggest that family members and friends may play an important role in supporting older adults experiencing homelessness.

This study from UCSF BHHI researchers examined deaths among people experiencing homelessness in San Francisco during the first year of the COVID-19 pandemic. They found 82% of 331 deaths were associated with drug overdose, not COVID-19 infection. Traumatic injury, including homicide and suicide, was the second most common cause of death. This research highlights a need for strategies that address both homelessness and drug use, including housing, evidence-based treatment of opioid addiction, and overdose prevention programs.

This UCSF study examined deaths among people experiencing homelessness in San Francisco from 2016 to 2018. Although heart disease and cancer are the first and second causes of death for California’s general population, the leading causes of homeless deaths were acute intoxication (unintended overdose) and trauma (including homicide and suicide rates over triple that of the US general population). The authors advocate that these differences in cause-specific mortality should inform death prevention efforts within the homeless population differently than the general population.

The homeless population is aging and adults who experience homelessness for the first time in older age are more likely to progress to chronic homelessness. To prevent or delay homelessness, many people live temporarily live with family or friends. In this qualitative study of homeless older adults, researchers conducted 46 semi-structured interviews. They found that structural barriers to family and friends providing housing for temporary or permanent exits from homelessness included housing regulations, geographic and transportation challenges, and environments inconducive to older adults.

The homeless population is aging and people experiencing homelessness are at a heightened risk of experiencing physical and sexual victimization. This study examined whether homelessness is independently associated with experiencing physical or sexual abuse. Researchers found that older homeless adults experience high rates of victimization.

The San Francisco Department of Public Health implemented the Coordinated Care Management System (CCMS) in 2007. The CCMS is used to develop High Users of Multiple Systems (HUMS) tp identify individuals with the highest use of emergency medical services. Researchers described the HUMS scoring system and the characteristics and service use of the highest scoring 100 individuals. Researchers found that nearly all of the individuals had a history of homelessness in SF, and over half were unsheltered at their last point of contact.

A new study from UCSF Benioff Homelessness and Housing Initiative and the San Francisco Department of Public Health describes how San Francisco rapidly scaled a hotel-based isolation and quarantine (I/Q) system of care for people experiencing homelessness during the COVID-19 pandemic. Researchers found the program safely delivered integrated medical and behavioral health support to more than 1000 individuals outside the hospital setting, while helping to preserve hospital capacity.

Older homeless-experienced adults have low rates of advance care planning (ACP) engagement. In this cross-sectional qualitative study, researchers examined potential barriers and solutions to ACP engagement. Researchers found that participants believed that ACP is important, but acknowledge the multiple barriers to engagement. Potential solutions include capitalizing on opportunities outside health care setting and focusing on the period after housing and tailoring content.

The proportion of single homeless adults over the age of 50 is increasing. In this longitudinal cohort study, researchers examined the prevalence of and risk of falling in a cohort of older homeless adults. Researchers interviewed participants every 6 months for 3 years. They found a high prevalence of falls. Participants reported a prevalence of falls higher than older adults with a mean age of 78 in the general population. Researchers recommended identifying people at high risk of falls reducing unsheltered homelessness.

Over 2.5 million people experience homelessness yearly in the United States. Black persons are overrepresented by three-fold among those experiencing homelessness. Researchers aimed to understand the relationship between race and the experience of homelessness for older adults. They developed a theoretical model of the way experiences with overt and structural racism may lead to and perpetuate homelessness for older Black adults. Researchers recommend that efforts aimed at ending homelessness target the effects of structural racism with polices.

The homeless population has a higher prevalence of mental health and substance use problems than the general population. Researchers aimed to examine the prevalence of and factors associated with unmet needs for mental health and substance use treatment in older homeless adults. They used logistic regression to examine factors associated with unmet treatment needs. Researchers found that older homeless adults have a high prevalence of unmet behavioral health treatment needs and need targeted services.

Difficulty performing activities of daily living (“functional impairment”) is common in homeless adults aged 50 and older. Homeless adults develop aging-related conditions earlier than individuals in the general population, including difficulty with basic activities of daily living (ADLs) that are essential for independence. Researchers conducted a prospective cohort study to assess functional trajectories based on self-reported difficulty performing 5 activities of daily living. They found functional impairment improved in some homeless adults, it persisted or worsened in many others.

The US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity. Researchers conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. They found older homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups.

The median age of single homeless adults is approximately 50 years. Older homeless adults have poor social support and experience a high prevalence of chronic disease, depression, and substance use disorders. This study aimed to describe the access to and use of mobile phones, computers, and the Internet among a cohort of 350 homeless adults over the age of 50 years. Researchers found that participants with phones used them for social support and communication with healthcare providers; however, few had annual phone contracts.

People experiencing homelessness have inadequate resources for regular dental hygiene and a higher prevalence of risk for tooth loss, including smoking and substance use. This study aimed to describe the prevalence of and factors associated with oral health measures in a sample of older homeless adults in Oakland, CA. Researchers conducted a cross-sectional analysis of data from a population-based study of 350 homeless adults aged ≥50. They found that tooth loss and oral pain are highly prevalent in older homeless adults.