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People experiencing homelessness in California face high rates of chronic illness and disability, and numerous barriers to care. These health challenges make it harder for people to obtain and retain housing, and homelessness worsens health, trapping people in a vicious cycle. As the homeless population ages, these burdens deepen, with profound implications for individuals, communities, and the systems that serve them. This webinar includes findings from our recent report, Toward Thriving: Understanding Health & Homelessness, with insights from the report’s lead author and experts from across the health and homelessness systems.

Homelessness is dynamic; some individuals cycle between homelessness and housing. BHHI examined the prevalence of and factors associated with exits from and returns to homelessness among adults aged 50 and older. With a median 4 years of follow-up, 80% of participants exited homelessness into housing. Having a permanent rental subsidy was associated with retaining housing.

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a report on the relationship between health and homelessness. Toward Thriving: Understanding Health & Homelessness reveals that nearly half of Californians experiencing homelessness rate their health as poor or fair—about four times the rate in the general U.S. population. The report documents high rates of chronic disease, disability, and steep barriers to care for Californians experiencing homelessness.

People with lived experience hold insights and networks that academic researchers alone cannot access. Building trust-based partnerships between researchers and lived experts takes time, vulnerability, and institutional change. But it’s essential to producing knowledge that leads to equitable and effective solutions.

SAN FRANCISCO (October 8, 2025) – Following is a statement by Dr. Margot Kushel, MD, Director of the UCSF Benioff Homelessness and Housing Initiative (BHHI) at the University of California, San Francisco, on the potential impact of proposed federal funding cuts to critical programs that address housing insecurity, hunger, and poverty. 

Older homeless-experienced adults are at higher risk of loneliness than general older adults, yet less is known about the factors contributing to loneliness for this group. Loneliness is associated with multiple adverse health and mental health outcomes. This study examines this gap in our knowledge.

The United States has fewer labor protections and wage guarantees than most wealthy nations, leaving many workers vulnerable to economic hardship from job loss, reduced hours, or work-related injuries. Based on data from the California Statewide Study of People Experiencing Homelessness (CASPEH), this study shows how income disruptions—through layoffs, unstable gig work, caregiving tied to housing, illness or injury, probation and parole demands, and COVID-19-related impacts—can quickly lead to homelessness when housing costs are high and wages are low.

People experiencing homelessness have lower rates of cancer screening than housed people, contributing to later stages of cancer diagnosis and poor outcomes. We examined whether gaining housing increased rates of cancer screening in a cohort of homeless veterans. This study of nearly 120,000 homeless veterans finds that gaining housing was linked to higher screening rates for both breast and colorectal cancer—key to detecting cancer earlier, reducing the need for emergency surgery, and saving lives.

The United States is taking a sharp turn in how it addresses homelessness after a new executive order calling for more "involuntary commitment," which is a process in which mental health workers can forcibly detain and medicate people against their will. Studies have shown that the housing first model is significantly cheaper and more effective than involuntary detention. "Americans want there to be no homelessness. And this is...a formula to worsen homelessness," says BHHI Director Dr. Margot Kushel of efforts to expand involuntary detentions & withdraw funding from communities that don't comply.

Globally, tobacco use causes 8.7 million deaths annually. Approximately 50 % of formerly homeless adults in permanent supportive housing (PSH) in the United States smoke cigarettes. Secondhand smoke exposure is high in the absence of smoke-free policies. There is a need to understand attitudes toward smoke-free policies and factors associated with smoke-free home adoption attempts among PSH residents.

What does it mean to be working, but still homeless? BHHI Director Dr. Margot Kushel joined Brian Goldstone on KQED Forum to discuss hidden homelessness and what needs to change.

People experiencing homelessness have significantly lower life expectancies than the general population, and among those aged ≥ 45, tobacco-related illnesses are the leading cause of death.[1] Compared to the general population, tobacco use among people experiencing homelessness is six times higher, and the quit ratio (ratio of former to ever-smokers) is five times lower. [2],[3] We used the largest representative study of people experiencing homelessness since the 1990s to estimate tobacco use prevalence and its association with shelter status, behavioral health, and health services use among adults experiencing homelessness in California to identify opportunities to address unmet tobacco treatment needs.