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In this op-ed, Cheyenne Garcia, senior research analyst at the Benioff Homelessness and Housing Initiative, calls for colleges to step up in helping students who experience homelessness. She outlines the how the school breaks disrupts the lives of students, as not every student has a place to go once classes are over. "The chronic stress of finding short-term housing break after break and year after year can take a toll on the mental and physical health of already stressed students." Ms. Garcia writes. This op-ed was published as part of the Public Voices Fellowship in partnership with The OpEd Project and funding from the California Health Care Foundation.

California accounts for about a third of the nation’s homeless population and among this population, seniors are the fastest growing group. Research shows that living on the streets prematurely ages and sickens people. “When talking about homelessness, 50 is the new 75,” said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative. “Whether it be measures of cognitive decline, mobility, problems with function falling, all of the things that we usually think of happening to people in late life just happen to people 20 or 30 years earlier,” said Dr. Kushel. “And tragically, people also die.”

In this op-ed, Tom Murphy, the Senior Director of Communications for the National Alliance to End Homelessness, calls congress to fully fund and expand veteran homelessness programs. He highlights the rise in veteran homelessness while also acknowledging the sterling track record of the federal government's veteran homelessness programs. "It is wholly unreasonable and inappropriate not to invest in resources that would protect veterans and the citizens on whose behalf they served. This op-ed was published as part of the Public Voices Fellowship in partnership with The OpEd Project and funding from the California Health Care Foundation.

Unhoused patients have worse surgical outcomes than the general population, resulting in premature mortality. Researchers conducted 26 semi-structured interviews of clinicians who care for patients with surgical disease. The researchers identified 5 themes, including, but not limited to: patients and clinicians face multiple challenges meeting preoperative requirements; although surgeons do not make major operative decisions based on housing status, some take it into consideration for minor care decisions; clinicians perceive that unhoused patients have negative postoperative experiences in the hospital.

In a cohort of over 100,000 patients who received care from the Department of Veterans Affairs (VA) health system, those experiencing homelessness were more likely to be diagnosed with stage IV colorectal cancer compared with those who had housing. The patients who experienced homelessness also had longer hospital stays for all the cancer types studied. However, the findings differed across healthcare settings. In a commentary accompanying the study, Maria C. Raven, MD, MPH, associate Professor and Chief of Emergency Medicine at UCSF, said "Reducing healthcare disparities for people experiencing homelessness is essential, and the [VA] can serve as an example of what it takes to do so."

In this commentary of the study "Housing Status, Cancer Care, and Associated Outcomes Among US Veterans", Maria C. Raven, MD, MPH, associate Professor and Chief of Emergency Medicine at UCSF, provides lessons from the Veterans Health Administration. In 2009, the VHA began a multipronged initiative designed to end and prevent homelessness among veterans, which led to a 45% reduction in veteran homelessness from 2009 to 2017. Dr. Raven writes, "The results of this study indicate that in addition to providing housing at comparatively high rates for unhoused veterans, the system’s initiative to prevent and end veteran homelessness has also likely helped reduce important disparities in oncologic care for this population."

Cancer is a leading cause of death among older people experiencing homelessness. In this retrospective cohort study, researchers sought to characterize the diagnosis, treatment, surgical outcomes, and mortality by housing status of patients who receive care from the US Department of Veterans Affairs (VA) health system for colorectal, breast, or lung cancer. Researchers found that homelessness was associated with later stages at diagnosis for colorectal cancer.

In this op-ed, Margot Kushel, MD,  professor of medicine and director of the Benioff Homelessness and Housing Initiative at UCSF, calls attention for the need of federal investments in affordable housing. She outlines that the federal governments disinvestment in affordable housing has forced local governments to use general funds to provide assistance, further highlighting it will take a coordinated effort between agencies to solve the crisis. "Increased federal funding is necessary, but not sufficient. Yet without it, it will be difficult to end homelessness. This crisis is solvable. Ensuring that people have housing that they can afford – through higher income, lower rents and dedicated rental assistance, as well as access to appropriate services – is essential." Dr. Kushel writes. This op-ed was published as part of the Public Voices Fellowship in partnership with The OpEd Project and funding from the California Health Care Foundation.

In the state of California, the three major utility companies, have nearly doubled electricity rates over the last decade. With growing increase in energy demands, the rising utility costs are pushing families already at the margins to the brink of homelessness. Many people are forced to making an impossible choice. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "I think recognizing energy insecurity as a contributor to this crisis, this is the next frontier that we need to really worry about."

An increase in the number of deadly attacks on people experiencing homelessness has coincided with a spike in people experiencing homelessness in the US. What concerns many is that the attacks occur regularly and without notice. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "This violence is happening every day, just outside of our vision."

Following is a statement by Dr. Margot Kushel, MD, Director of the Benioff Homelessness and Housing Initiative (BHHI) at the University of California, San Francisco on the 2023 Annual Homeless Assessment Report, released today by the U.S. Department of Housing and Urban Development.

The perception of people experiencing homelessness is often based on anecdote. On this episode of UCLA Housing Voice podcast, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, joins host Shane Phillips to talk about the California Statewide Study of People Experiencing Homelessness, and what it says about who experiences homelessness, why they become homeless, their experiences while living without housing, and barriers to re-entering stable housing. As the conversation moved to mental health, substance use disorder, and people experiencing homelessness, Dr. Kushel said, "People in those in depth interviews, talk to us really clearly, that while they might have been using these drugs before they became homeless, they're using them while homeless was a coping strategy."

Half of people experiencing homelessness are older than 50, and almost half of older homeless adults became homeless for the first time after they turned 50. This webinar is about the causes and consequences of homelessness in late life. Margot Kushel, MD, and other BHHI presenters will discuss findings from the Health Outcomes of People Experiencing Homelessness in Older Middle Age (HOPE HOME) project—a longitudinal cohort study following older adults experiencing homelessness in Oakland, CA, and the California Statewide Study of People Experiencing Homelessness (CASPEH)—the largest representative study of homelessness in the United States since the mid-1990s.

In this op-ed, Shannon Smith-Bernardin, PhD, MSN, RN, assistant professor of nursing, highlights sobering centers as an alternative to bringing an intoxicated individual to the emergency department or a jail. She emphasizes that sobering centers provide a safe, monitored environment for people to sober up, and various models have developed to serve the specific need of the communities and populations they serve. "The path to recovery often requires a comprehensive, individualized approach. A central function of sobering care is to take the opportunity to engage, motivate, and link individuals to community resources that may provide ongoing stabilization and recovery." Dr. Smith-Bernardin writes. This op-ed was published as part of the Public Voices Fellowship in partnership with The OpEd Project and funding from the California Health Care Foundation.

There is public skepticism when politicians promise to solve a crisis, and then little progress gets made. Los Angeles Mayor Karen Bass's policies have given new hope, but an increase in violence against people experiencing homelessness has pushed more into despair. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "I do really worry that it’s become normalized in public discourse to speak about people experiencing homelessness as, like, a problem for those who are not homeless — as opposed to fundamentally a massive societal failure that’s left usually older, vulnerable people terrified and totally unprotected."

Cancer is the leading cause of mortality for people experiencing homelessness (PEH). However, not much is known about cancer-related surgical outcomes among PEH. This retrospective cohort study aimed to characterize access to care among PEH, evaluate postoperative outcomes, and assess costs associated with surgery for malignancy among PEH. Researchers found that PEH were less likely to undergo surgery for malignancy at cancer centers than hose who are housed. People experiencing homelessness also had a higher risk of requiring unplanned surgery.

Mobile crisis services for people experiencing distress related to mental health or substance use are expanding in the US. In this mixed method study protocol, researchers plan to conduct an interrupted time series analysis to quantitatively examine the impacts of the Street Crisis Response Team (SCRT) on people experiencing homelessness who utilize the services in San Francisco. Researchers also plan to analyze racial and ethnic disparities to understand the impact on health equity.