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Loss of income is considered the number one factor for why Californians experience homelessness, according to new research from UCSF. The new findings highlight the idea that money is not only the main cause of the homelessness, but also a potential solution. "I think it’s really important to note how desperately poor people are, and how much it is their poverty and the high housing costs that are leading to this crisis" said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative and principal investigator of the landmark study.

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.”

SAN FRANCISCO – The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today 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.

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.”

Conducted by the UCSF Benioff Homelessness and Housing Initiative, the California Statewide Study of People Experiencing Homelessness (CASPEH) is the largest representative study of homelessness in the United States since the mid-1990s. The study provides a comprehensive look at the causes and consequences of homelessness in California and recommends policy changes to shape programs in response.

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.

In many parts of the world, communities experience water, sanitation, and hygiene (WaSH) insecurity. While WaSH insecurity is prevalent in many low and middle-income countries, it is also a problem in high-income countries, like the United States, as is evident in vulnerable populations, including people experiencing homelessness. This study examined WaSH access among unhoused communities in Los Angeles, California. Researches found that WaSH services for unhoused communities in LA is most difficult at night, however community differences exist.

In this podcast episode of Marketplace, host Kai Ryssdal spoke with Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative about the complicated role mental health plays in the homelessness crisis. Dr. Kushel said, "Homelessness is devastating to one's mental health. The constant violence that people are exposed to...the lack of sleep, the stress and uncertainty, the humiliation - all of these worsen people's mental health."

Nearly a quarter of a million people 55 years or older are estimated to be homeless in the US. Communities are trying to come up with a novel solution. Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, said, "It's just a catastrophe. This is the fastest-growing group of people whoa re homeless."

People who use drugs (PWUD) commonly experience housing instability due to intersecting structural vulnerabilities. Researchers conducted a qualitative study in Vancouver, Canada's downtown eastside, interviewing PWUD who were recently evicted fron the downtown eastside. Narratives from the interviewees provided context on how the demands of the institutional circuit deepened vulnerablitities and prolonged experiences in homelessness. Researchers suggested that interventions that address survival needs and preserve agency will be necessary to mitigate risks within the institutional circuit.

In this podcast episode of In Clear Terms with AARP California, host Dr. Thyonne Gordon spoke with Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative. Dr. Gordon and Dr. Kushel talk about the state of older adult homelessness in California, and the complex interactions between health and homelessness, and potential solutions to prevent and address the issue. Dr Kushel said, "The reason so many people are homeless in California, is we do not have the housing. If you ask the question though, 'Why is this person homeless', then you can see how things like illness, including mental health or substance use, can leave you vulnerable."