Resource Center

This UCSF study examined deaths among people experiencing homelessness in San Francisco from 2016 to 2018. Although heart disease and cancer are the first and second causes of death for California’s general population, the leading causes of homeless deaths were acute intoxication (unintended overdose) and trauma (including homicide and suicide rates over triple that of the US general population). The authors advocate that these differences in cause-specific mortality should inform death prevention efforts within the homeless population differently than the general population.

The COVID-19 pandemic disrupted economic systems, social networks, and individual behaviors, altering patterns in health care use. In this study, researchers compared homeless and unstably housed (HSH) women who did and did not use an emergency department during the first 10 months of the pandemic. The researchers found that the rate of emergency department use among HUH women during the pandemic was similar to prior research.

The San Francisco Department of Public Health implemented the Coordinated Care Management System (CCMS) in 2007. The CCMS is used to develop High Users of Multiple Systems (HUMS) tp identify individuals with the highest use of emergency medical services. Researchers described the HUMS scoring system and the characteristics and service use of the highest scoring 100 individuals. Researchers found that nearly all of the individuals had a history of homelessness in SF, and over half were unsheltered at their last point of contact.

This UCSF study examined whether permanent supportive housing reduces the use of acute health care and other services among people experiencing chronic homelessness. The Permanent Supportive Housing program intervention was able to house 86% of chronically homeless adults randomized to the treatment group based on their high use of multiple systems. Even the most frequent clients of medical, psychiatric, and emergency services were housed successfully, as demonstrated in this study of Project Welcome Home in Santa Clara County.

Older homeless-experienced adults have low rates of advance care planning (ACP) engagement. In this cross-sectional qualitative study, researchers examined potential barriers and solutions to ACP engagement. Researchers found that participants believed that ACP is important, but acknowledge the multiple barriers to engagement. Potential solutions include capitalizing on opportunities outside health care setting and focusing on the period after housing and tailoring content.

The proportion of single homeless adults over the age of 50 is increasing. In this longitudinal cohort study, researchers examined the prevalence of and risk of falling in a cohort of older homeless adults. Researchers interviewed participants every 6 months for 3 years. They found a high prevalence of falls. Participants reported a prevalence of falls higher than older adults with a mean age of 78 in the general population. Researchers recommended identifying people at high risk of falls reducing unsheltered homelessness.

The median age of single homeless adults is over 50. Individuals who are homeless visit emergency departments (EDs) at higher rates than the general population. Researchers described the use of and factors associated with ED use in a sample of homeless adults 50 and older. They found that a sample of adults aged 50 and older who were experiencing homelessness at study entry had higher rates of ED use in the prior 6 months than the general US age-matched population. Within the sample, ED use rates varied based on individuals’ residential histories, suggesting that individuals’ ED use is related to exposure to homelessness.