Resource Center

Managed alcohol program (MAPs) manage alcohol consumption by providing eligible individuals with regular doses of alcohol as a part of a structured program and often offer housing and other social services. UCSF BHHI researchers found that benefits of MAPs included improved quality of life, reduced alcohol consumption, less hazardous consumption, and potential stabilizations in biological markers of alcohol use during MAP participation. Researchers found MAP participants reported substantial benefits, including increased feelings of safety and security, reconnection with community, sense of belonging, improved self-efficacy, and a positive reconciliation of internalized shame and stigma.

The homeless population in the United States is aging, however, there is limited studies on the neurologic etiologies of cognitive impairment in this population. Researchers observed a wide range of focal neurological deficits in the study participants, most notably deficits in cranial nerve function, motor function, coordination, and peripheral sensory functions. This study lays the foundation for the development of a longitudinal study of neurocognitive health among unhoused older adults in San Francisco.

Recently, a spate of assaults and murders have highlighted how people without housing are vulnerable to violence. Margot Kushel, MD, Director of BHHI, sheds light on the longstanding crisis of violence against people who are homeless.

This radio news story reports how mayoral candidates in LA propose addressing homelessness in Los Angeles. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, discusses how solving homelessness requires a big systemic fix. "The underlying drivers of homelessness are the lack of deeply affordable housing, income inequality, and structural racism. It’s going to be hard to solve this problem without effort from the federal government."

In this op-ed, Margot Kushel, MD, Tomiqua Moss, and Jen Loving explain how scaling evidence-based solutions to prevent and end homelessness can yield tangible results. They characterize the underlying, interlocking causes of homelessness as structural racism, income inequality, and lack of affordable housing for low-income households. "The research is clear: When there is more affordable housing in a community, fewer people experience homelessness," they write. "Providing affordable housing with permanent subsidies and supportive services, if needed, is the best way to end homelessness. Such programs have for years successfully housed more than 90% of those with the most severe disabilities."

This radio program takes an in-depth look at how more people experiencing homelessness in Las Vegas are now living in vehicles. UCSF Benioff Homelessness and Housing Initiative Postdoctoral Scholar Graham Pruss, PhD, describes how BHHI research in Oakland showed that people living in vehicles need a variety of temporary and long-term parking spaces, which could mean safe parking programs and long-term supportive parking programs. Pruss noted it can take months or even years for a transition into permanent housing.

In Los Angeles, 85 people experiencing homelessness were murdered last year—the highest number ever recorded, according to LA Police Department data. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, noted that the trend of unhoused homicide victims may seem contrary to what many think of when discussing homelessness. Countering the common misperception that unhoused people are dangerous, she explained how people experiencing homelessness are vulnerable to violent crime. Dr. Kushel said, "What I hear when I spend time with many people experiencing homelessness is how terrified they are and how terrifying the experience is, and this is layered on top of a public who is afraid of them."

People experiencing homelessness (PEH) have a high rate of tobacco use. Researchers examined factors associated with cigarette consumption and quit attempts. They found having an encounter with staff in the past week was associated with a 40% reduction in weekly consumption. The findings highlight the role of community-based pharmacists to expand smoking cessation services in homeless shelters.

People living with HIV (PLH) experiencing homelessness or unstable housing have lower rates of viral suppression compared to people who are housed. In 2020, only 20% of PLH experiencing homelessness in San Francisco were virally suppressed, compared to 71% of those who were housed. Researchers examined case preferences among PLH experiencing homelessness during the COVID-19 pandemic in San Francisco. They found that the strongest preference were for the same provider, visit incentives, and drop-in visits.

The lack of affordable housing, systemic racism, and weak safety nets are the leading causes of Silicon Valley’s homeless crisis. UCSF Benioff Homelessness and Housing Initiative Director, Margot Kushel, MD, was a featured speaker for this event that San José Spotlight and nonprofit Destination: Home hosted as part of a series on the root causes of homelessness and possible solutions. The panel also featured Dontae Lartigue, founder, and CEO of Raising The Bar and board chair of the Santa Clara County lived experience advisory board; Jeff Olivet, executive director of the U.S. Interagency Council on Homelessness; and Tomiquia Moss, founder, and CEO of All Home. Destination: Home CEO Jennifer Loving moderated the conversation.

This news article reports on varying methods quantifying homelessness in San Francisco. These metrics — the PIT count, city data, and others — are often mere snapshots of the whole picture, or require people to reach out for services, said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative. That means a lot of people are left unseen. People drift in and out of homelessness; a person who was homeless at some point in the year may not be any more, she said.

The number of individuals incarcerated in the United States has increased since the 1970s. Frequent emergency department (ED) use and incarceration can both be driven by underlying structural factors and social needs. Researchers conducted a retrospective, cross-sectional analysis to assess whether an increased frequency of ED use was associated with incarceration. They found that ED use is independently associated with incarceration.

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.

In the United States there has been a simultaneous rise of mass incarceration and homelessness. Both of these phenomena are driven by the same structural factors, housing being the most important. Researchers present evidence-based approaches to improve housing strategies for reentry populations, prevent homelessness among those in community supervision, and rehouse members of the reentry community experiencing homelessness.

In this cross-sectional study, researchers studied the association between residential relocation and health outcomes in people who inject drugs (PWID). PWID are at an increased risk of low socioeconomic status and homelessness. Researchers found that any residential movement in the past 30 days was associated with increased odds of bad health outcomes.

This New York Times article reports on increasing deaths among people experiencing homelessness and highlights a recent JAMA Network Open study from UCSF Benioff Homelessness and Housing Initiative researchers. BHHI faculty members Maria Raven, MD, and Margot Kushel, MD, are quoted.