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One hundred tiny home villages for people experiencing homelessness have opened in the US over the past five years. However, tiny homes, built mainly with philanthropic support, offer more patches than solutions to homelessness. Tiny homes can be built quickly, but issues with securing permits, financing, and local government approval can add costs and delays. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "I would say that tiny homes are an absolutely important part of the ecosystem, but they are not housing."

There’s a lot of misinformation about homelessness in California. It is one of the most prominent problems California faces today. Using data from the California Statewide Study of People Experiencing Homelessness, this article dispels several common myths.

Homelessness is associated with poor outcomes following cancer diagnosis. In this retrospective cohort study, researchers examined the association between housing status and acute care in adult patients treated for cancer at Zuckerberg San Francisco General Hospital. Researchers found that among patients receiving treatment for cancer at an urban public hospital, acute care use increased disproportionately in unhoused patients in the year of diagnosis, while psychiatric acute care use did not change.

In this op-ed, Morgan Philbin, PhD, MHS, associate director at the Benioff Homelessness and Housing Initiative and director of the Educations Program, and Emilie Bruzelius, PhD, MPH, a post-doctoral fellow in substance use epidemiology at Columbia University, advocates for rolling back punitive policies and creating non-stigmatizing medical environments that can support pregnant people who use drugs. They outline the unique barriers that people who are pregnant face. They write, "All stakeholders—healthcare providers and policymakers—must bring compassion to innovative drug policies that are fueled by science instead of stigma." 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, Morgan Philbin, PhD, MHS, associate director at the Benioff Homelessness and Housing Initiative and director of the Educations Program, highlights the lack of tailored programming and shelters where LGTBQ+ youth feel safe, resulting in youths feeling safer on the streets. She calls for state and local governments to invest in tailored services to support LGTBQ+ teenagers and youth. Dr. Philbin writes, "These programs should coordinate with each other to most effectively deliver the services within their expertise, while simultaneously ensuring every young person has their needs met." 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

The US Supreme Court's ruling in City of Grants Pass v. Johnson will make it easier for elected officials and law enforcement authorities nationwide to fine and arrest people who are experiencing homelessness. This decision could interrupt programs that expand street medicine services and other initiatives to help people experiencing homelessness find housing. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "What’s worse, though, is we are going to lose the trust that is so essential to getting people to take their medications or stop their drug use and, ultimately, getting people into housing."

In this op-ed, Margot Kushel, MD, professor of medicine and director of the Benioff Homelessness and Housing Initiative at UCSF, highlights the cruelty and counterproductive policies in light of the US Supreme Court's ruling in City of Grants Pass v. Johnson. She outlines the systemic issue of state and local governments punishing people who experience homelessness and calls for fixing the affordable housing problem. "It is now up to us to insist that our local and state officials instead enact policies that will end homelessness by providing safe, secure and affordable housing for all of us." 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.

The Supreme Court ruling in City of Grants Pass, Oregon v. Johnson, lets lawmakers impose fines and jail time on people experiencing homelessness who are sleeping outside. This decision will provide more clarity to state and local leaders about legal steps they can take to clear out encampments. However, advocates say that the ruling will enable lawmakers to effectively criminalize the state of being unhoused.  Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "It's expensive, it's inhumane, and actually there are real solutions that do work."

On June 28, 2024, the Supreme Court ruled that cities may arrest and fine people for resting outside, even when they have nowhere else to go. This is an extreme decision that will have a dangerous and negative impact on people experiencing homelessness and do nothing to end homelessness. Read BHHI Director Dr. Margot Kushel’s full statement on the Supreme Court’s decision in City of Grants Pass v. Johnson.

For the first time in six years, the number of people experiencing homelessness in Los Angeles decreased from the year before, according to the most recent point-in-time count. However, there has been less success in finding people experiencing homelessness permanent homes. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "If the underlying economic conditions don't change, and if the money gets cut, you're going to see an increase again."

In San Diego County, more than one-third of renters over 65 spend the majority of their income on rent. Along with a shallow rental subsidy pilot program, San Diego County is also working on adding more affordable housing units. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "The truth of the matter is that if we don't spend these small amounts of money we’re spending it on the back end but for really bad outcomes."

The number of older adults over the age of 50 experiencing homelessness is increasing in the US. Overall, 48% of the population of single homeless adults in California is 50 or older, with most of them living unsheltered. A new special report, Toward Dignity: Understanding Older Adult Homelessness, by the Benioff Homelessness and Housing Initiative at the University of California, San Francisco, took a deep look at the aging homeless population in California. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "We’re talking about older frail adults. That is who is outside."

The face of homelessness in America is growing older. Recent projections report that the population of unhoused older adults will triple between 2017 and 2030. As more generations reach retirement age, there is a need for policymakers to consider how housing and homeless services should be adapted to meet the needs of the aging unhoused population. Marc Dones, policy director at the UCSF Benioff Homelessness and Housing Initiative, said, "The country is in the midst of a housing crisis so severe that people who have worked their whole lives are suddenly becoming homeless."

In this op-ed, Dalma Diaz, MA, a health equity fellow at the California Health Care Foundation, highlights how housing supports other social determinants of health, providing a lifeline. She puts forward the idea of prescribing housing as a way to provide limited rental subsidies. Ms. Diaz writes, "Our housing was a lifeline. It meant that my family, which included two children under 12 — one with a developmental disability — had a stable place to live during one of the most frightening and precarious moments of our lives." 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.

Across San Francisco, there are 8,000 unhoused people on a given day and upward of 20,000 over the course of a year. With rising housing costs, some individuals have transitioned to living RVs on Winston Drive. However, new street parking restrictions will force people living in RVs to leave the area. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "People told us they preferred vehicles to shelters, but they would have preferred housing."

California's 'housing first' rule prohibits the use of housing funds on drug-free or sober housing facilities. However, there is growing support for changing policies to favor tolerance of drug use in housing for people experiencing homelessness. San Francisco supervisors announced a new plan to prioritize drug-free housing options for people who experience homelessness. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "You want to make sure that any relapse is not punished with homelessness, because to do so may turn something that is in fact a short backward step into a deep fall."

People over age 50 are the fastest-growing segment of people experiencing homelessness and makeup almost half of the total homeless population. These unhoused individuals typically have the health of someone 20 years older in the general population. DeDe Hancock, a CASPEH Lived Expertise Advisory Board member, discusses her own experience with becoming homeless when she was 52 years old, and Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, outlines the health impacts of older adult homelessness. Ms. Hancock said, "I was going from shelter to shelter. Over seven years, I was out on the street for maybe five days - otherwise, I was in a shelter."

Although only 9% of Sacramento's general population is Black, Black residents now comprise 35% of Sacramento's homeless population. A special report released by the UCSF Benioff Homelessness and Housing Initiative on Black Californians' experiences of homelessness highlights the systemic causes that have left so many unhoused. Kara Young Ponder, PhD, director of community engagement and racial justice at the UCSF Benioff Homelessness and Housing Initiative, said, "When you consider (leaving) homelessness, you think about the requirements needed to get back into housing — waiting lists, who gets a voucher, who doesn’t get a voucher. It’s hard to get housing or a room. It’s even harder for Black Americans."