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This paper describes the qualitative component of a large mixed method study, the California Statewide Study of People Experiencing Homelessness. The qualitative study consisted of seven sub-studies across eight counties, each exploring different dimensions of homelessness. BHHI researchers recruited participants from the overall sample, a statewide representative sample of adults experiencing homelessness recruited in eight counties, based on their responses to questions from the survey interviews. The researchers' mereological study design presents an approach for developing complex qualitative policy studies across a range of topic areas.

Sleep is essential to health and affected by environmental and clinical factors. There is limited longitudinal research examining sleep quality in homeless older adults. This exploratory study examined the factors associated with poor sleep quality in a cohort of older adults in Oakland, California. Researchers found that participants had higher prevalence of poor sleep and worse Pittsburgh Sleep Quality Index (PSQI) scores than in studies of housed adults 20 years older.

In this op-ed, Tom Murphy, the Senior Director of Communications for the National Alliance to End Homelessness, brings attention to the frontline professionals who respond to homelessness. He highlights the demanding work and economic disparity among the frontline workers who engage with unhoused individuals. "If we truly want to end homelessness, we must honor frontline workers with a living wage" Mr. Murphy 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 this op-ed, Maria Raven, MD, MPH, associate director at the Benioff Homelessness and Housing Initiative, explains how homelessness is not just a housing issue, but a health care issue. She outlined the pertinent health needs of people experiencing homelessness and the barriers of treating illness against a background of homelessness. Dr. Raven writes, "The health care system in general, and emergency departments specifically, cannot solve this problem — we can only respond to its consequences." 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 this op-ed, Alma Yates, MSW, the Education Program Manager at the Benioff Homelessness and Housing Initiative, implores world leaders to do more in helping migrants and asylum seekers. She highlights her own story as a former refugee from Bosnia and Herzegovina who relocated to the United States following the Bosnian War. "Thousands of displaced people were living here, mostly elderly, women and children from Prijedor. The conditions were horrific" Ms. Yates writes. "I was able to leave this place to continue my long migration journey, which had its own twists and turns, but, unfortunately, thousands of others had no place to go." 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 this op-ed, Maria Raven, MD, MPH, associate director at the Benioff Homelessness and Housing Initiative, explains how homelessness is not just a housing issue, but a health care issue. She outlined the pertinent health needs of people experiencing homelessness and the barriers of treating illness against a background of homelessness. Dr. Raven writes, "The health care system in general, and emergency departments specifically, cannot solve this problem — we can only respond to its consequences." 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.

Nearly one-third of all Americans experiencing homelessness live in California. Starting in the fall of 2021, Aaron Shrank and Sam Comen conducted interviews and photographed unhoused people living in Los Angeles and Northern California as a companion piece to the University of California San Francisco Benioff Homelessness and Housing Initiative’s California Statewide Study of People Experiencing Homelessness to shed light on those affected. You can read a lightly condensed version of their stories. More of Comen and Shrank’s work is available at the website Unhoused CA.

In this op-ed, Cheyenne Garcia, senior research analyst at the Benioff Homelessness and Housing Initiative, calls for action to end generational homelessness. She characterizes the dire need for expanded funding for necessary resources, like an increase in housing choice vouchers, to end family homelessness. "As a society, it is imperative to assume an obligation to protect children." 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.

Self-storage prices are rising. With an unregulated industry, owners can raise rates to whatever the market will bear. People who experience homelessness often use storage units to safeguard important papers and other possessions. When folks are unable to pay for the storage unit, their belongings can get locked in the unit or sold off. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, “People wind up paying an enormous proportion of their income to sustain these units, and then wind up losing them anyway. That feels particularly tragic because it’s like the worst of all worlds.”

The Centers for Disease Control and Prevention recommends new covid-19 booster vaccines for all. A boost in protection is important to protect people against severe COVID and death. However, structural factors have prevented booster uptake among those who could benefit the most from the vaccine. Booster rates among people who experience homelessness is largely unknown. Tiana Moore, PhD, the Policy Director at the UCSF Benioff Homelessness and Housing Initiative is concerned that people experience homelessness face high barriers to vaccination. Dr. Moore said, "Many of our participants talked about concerns about leaving their belongings when unsheltered since they don’t have a door to lock."

The number of people experiencing homelessness who are older than 50 is increasing. The second half of the baby boomers were aging and came of age during back-to-back economic downturns, making them financially less secure. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "These are people who worked their whole lives. They had typical lives, often working physically demanding jobs, and never made enough to put money away."

A landmark study by UCSF Benioff Homelessness and Housing Initiative (BHHI) paints a different picture on people experiencing homelessness in California. The report released in June 2023, examines the demographics of people experiencing homelessness in California, how people enter and experience homelessness, factors that block or enable a person’s return to housing, and policy recommendations.

The Benioff Homelessness and Housing Initiative at the University of California San Francisco, released a groundbreaking report on the characteristics and causes of homelessness in California. The study used a mixed methods approach, collecting data from more than 3,000 surveys and 365 in-depth interviews. In addition to reinforcing the existing—and alarming—trends around both an aging population and disproportionate representation of communities of color among those experiencing homelessness, there were several findings from the report that stand out.

Drug overdose has increased in the U.S. since the COVID-19 pandemic began in 2020. In San Francisco, single-room occupancy (SRO) tenants are more likely to dive of opioid overdose than non-SRO residents. The SRO project aimed to reduce fatal overdoses in SROs. In this eight month ethnographic field work, researchers found that the SRO project increased awareness, access to, and understanding of naloxone, as well as, supporting the privacy and autonomy of tenants regarding their drug use.

Older adults experiencing chronic homelessness have low rates of advance care planning despite high rates of morbidity and mortality. Researchers explored if rehousing people who experience homelessness into permanent supportive housing (PSH) would present an opportunity to introduce advance care planning (ACP). Researchers identified behavioral determinants related to ACP for formerly chronically homeless adults in PSH.

As a board member of the UCSF Benioff Homelessness and Housing Initiative (BHHI) Lived Expertise Advisory Board that played a major role in the design and implementation of the California Statewide Study of People Experiencing Homelessness, my participation on the project was deeply influenced by my personal experience of homelessness. Having faced the challenges and uncertainties associated with housing instability firsthand, I have dedicated myself to making a positive impact and working towards finding lasting solutions for those facing similar struggles.

The California Statewide Study on People Experiencing Homelessness researchers included people who were formerly or are currently experiencing homelessness. In this op-ed, Claudine Sipili, one of the Lived Expertise Advisory Board co-chairs, writes about the landmark study and her experience participating with the project. She writes, "Throughout the study, the board members’ guidance helped create a safe and dignified space for survey participants to share their experiences openly. By involving individuals with lived experience, we gained deeper insights into the complexities of homelessness."