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American adults 50 and older are the fastest growing group falling into homelessness. In part 1 of this story, Viewpoints Radio covered the factors fueling this rise. In part  2 – host Gary Price talks with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and Dennis Culhane, PhD, professor, social policy, University of Pennsylvania about why this population is especially vulnerable out on the streets and why it’s so hard to find a way back once you’re in this position.

The new, unlikely face of homelessness: Working Americans with decent-paying jobs who cannot afford a place to live. Years of rising rents and a shortage of affordable housing have created a situation where even a strong labor market and rising wages haven’t been enough to offset the financial strains of inflation. About 1 in 4 renters spend at least half of their income on rent and utilities, making them at greater risk for eviction and homelessness. Margot Kushel, MD, director of the Benioff Homelessness and Housing Initiative at the University of California at San Francisco, said, "The general public doesn’t see these folks as homeless — they’re not as visible as the people who occupy public spaces, who have substance abuse issues or mental health problems."

On July 25th, 2024, Governor Gavin Newsom issued an executive order directing state agencies to clear "dangerous" homeless encampments from state land. State agencies will assess encampments to identify any “imminent threat to life, health, safety or infrastructure.” The new executive order faces criticism from civil rights groups and advocates for people experiencing homelessness. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "If we move people from one place to another place, that doesn’t meet our goal."

Governor Gavin Newsom issued an executive order on July 25, 2024, providing authority for state and local officials to clear unsafe homeless camps. The order advises local jurisdictions to adopt a version of the California Department of Transportation encampment policy, requiring officials to give people experiencing homelessness in encampments a 48-hour notice before a sweep and work with organizations to help anyone displaced. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "In the long term, ending homelessness in California will require increased investments in housing and support services, while simultaneously making it easier to rapidly develop affordable housing."

This topic brief examines who experiences pregnancy during homelessness, how they lost their housing, their experiences during homelessness, and barriers to regaining housing. The findings highlight the urgent need for the homelessness system to advance evidence-based strategies to meet the needs of pregnant people.

Homeless encampment cleanup activities do not appear to have long-term effects on the number of people living on the streets, a new study by Rand Corp has found. Another study by the Benioff Homelessness and Housing Initiative at UC San Francisco found that far more than the general population, people living on the streets and in shelters are victimized by violence and discrimination. Anita Hargrave, MD, assistant professor at UCSF and lead author on the impact of Intimate Partner Violence on Homelessness study, said, "There is so much tendency in the ongoing discourse on homelessness to dehumanize. When you read through people’s stories when they came to that point when they could no longer be housed, it’s such a powerful way of creating empathy."

Oakland begins a sweep of a homeless camp since the US Supreme Court's landmark ruling in City of Grants Pass v. Johnson last month loosed clearance rules. This sweep highlights the need for more housing and shelter. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "At the end of the day, what people really want is housing."

Each year, older adults make up a greater proportion of America’s homeless population and these numbers are only expected to keep rising. In part one of this story, Viewpoints Radio host Gary Price spoke with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and Dennis Culhane, PhD, professor, social policy, University of Pennsylvania, about the main societal factors driving this increase and why this group is particularly vulnerable to homelessness.

Intimate partner violence (IPV) is a risk factor for people experiencing homelessness. Few studies have examined the interplay between IPV, homelessness, and housing. Researchers purposefully sampled 104 adults who reported experiencing IPV in the California Statewide Study of People Experiencing Homelessness (CASPEH), a representative, mixed-methods study. They identified six primary themes regarding IPV and homelessness.

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.