Resource Center

Maria Raven, MD, spoke about a new UCSF Benioff Homelessness and Housing Initiative study that found 331 homeless San Franciscans died during the first 12 months of the coronavirus pandemic—more than double any previous year. Acute drug toxicity was the leading cause of death. Traumatic injuries, including suicide and homicide, were the second most common, followed by chronic medical conditions. Interventions like shelter-in-place hotels may have helped mitigate deaths due to COVID-19 and related health conditions, but lockdowns and increased isolation may have compounded other risks.

This study from UCSF BHHI researchers examined deaths among people experiencing homelessness in San Francisco during the first year of the COVID-19 pandemic. They found 82% of 331 deaths were associated with drug overdose, not COVID-19 infection. Traumatic injury, including homicide and suicide, was the second most common cause of death. This research highlights a need for strategies that address both homelessness and drug use, including housing, evidence-based treatment of opioid addiction, and overdose prevention programs.

CARE Courts, tiny homes in San Francisco, and more homelessness and housing news from the past week that you may have missed.

A study from UCSF Benioff Homelessness and Housing Initiative examined implementation of a rapid COVID-19 test and response model in congregate shelters in San Francisco. The pilot allowed for detection and isolation of cases among staff and residents. Researchers recommend frequent testing with rapid turnaround as an important public health intervention to improve accessibility and availability of testing, identification, and isolation of COVID-19 positive cases in shelters.

Unstable housing has been associated with a higher risk of kidney disease and kidney disease progression. In this review, researchers discussed the underlying mechanisms of housing and kidney disease. Several considerations should be taken into account when working with individuals experiencing unstable housing or at risk for kidney disease. This review sheds light on that housing interventions can improve outcomes.

A new federal housing bill, unleash the duplex, and more homelessness and housing news from the past week that you may have missed.

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.

In this special streaming series from NBC Bay Area, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, discussed findings from her study in Santa Clara of housing with supportive services. "It was resoundingly successful. These were the most challenging folks, and they spent 90% of their nights housed for 7 years after that. If we could do that for that population, the numbers would be so much better for everybody else," she said. "We have not been able to bring it to scale because of cost. California is the second worst state in the nation for housing affordability."

BHHI is hiring, a profile of the San Francisco Community Land Trust, and more homelessness and housing news from the past week that you may have missed.

About 70-80% of adults experiencing homelessness smoke cigarettes. Researchers examined guest support for on-property smoke-free policies within an homeless shelter amongst never smokers, former smokers, and current smokers. They found that 64% of participants supported a partial smoking ban, while 32% supported a full smoking ban. These findings illustrate that implementing smoke-free living/workplace policies in homeless shelters enjoys more support from guests.

Social housing, CEQA explained, and more homelessness and housing news from the past week that you may have missed.

Graham Pruss, PhD, UCSF Benioff Homelessness and Housing Initiative postdoctoral scholar, was quoted in this editorial discussing the rise in vehicle residency and possible ways to address it. Pruss suggests three basic options: lots for people living in cars where the goal is to move to house as quickly as possible; a supportive parking model for people in RVs who want to house, but it may take time; and a mobile home park where people stay indefinitely.

What rarely gets talked about in the news are the myths about why someone becomes, or continues to be, homeless. Speaking with Voice of San Diego, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, dispelled assumptions about the correlation between mental illness and homelessness. She explained, "What really determines whether an area — a city, a state, a country — has more homelessness or less homelessness is not how much mental health or substance use problems there are. It actually has much more to do with whether housing there is affordable. So even within our own country, we see that areas with the highest substance use and mental health problems don’t always have the highest homelessness. And in fact, they usually don’t. The areas that have the highest homelessness are the areas with the biggest disconnect between what housing costs and what people make."

Why a renter protections bill failed in the California legislature, and more homelessness and housing news from the past week that you may have missed.

In this UC San Diego Department of Medicine Grand Rounds, Margot Kushel, MD, one of the world’s leading experts on homelessness, discusses why the homeless population is aging, the health consequences of aging in the homeless population, and possible interventions and solutions. Dr. Kushel is a professor of medicine and directs both the UCSF Center for Vulnerable Populations and the UCSF Benioff Homelessness and Housing Initiative.

The homeless population is aging and adults who experience homelessness for the first time in older age are more likely to progress to chronic homelessness. To prevent or delay homelessness, many people live temporarily live with family or friends. In this qualitative study of homeless older adults, researchers conducted 46 semi-structured interviews. They found that structural barriers to family and friends providing housing for temporary or permanent exits from homelessness included housing regulations, geographic and transportation challenges, and environments inconducive to older adults.