Our Research

Housing status is a significant upstream determinant of access to healthcare. In this literature review, researchers identified areas of concern unique to patients experiencing homelessness with surgical disease. Researchers found that there was a gap in the surgical literature with regards to the impact of housing status on optimal surgical care. More studies are needed to accurately characterize the surgical care of patients experiencing homelessness and identify areas for care improvement.

Managed alcohol program (MAPs) manage alcohol consumption by providing eligible individuals with regular doses of alcohol as a part of a structured program and often offer housing and other social services. UCSF BHHI researchers found that benefits of MAPs included improved quality of life, reduced alcohol consumption, less hazardous consumption, and potential stabilizations in biological markers of alcohol use during MAP participation. Researchers found MAP participants reported substantial benefits, including increased feelings of safety and security, reconnection with community, sense of belonging, improved self-efficacy, and a positive reconciliation of internalized shame and stigma.

The homeless population in the United States is aging, however, there is limited studies on the neurologic etiologies of cognitive impairment in this population. Researchers observed a wide range of focal neurological deficits in the study participants, most notably deficits in cranial nerve function, motor function, coordination, and peripheral sensory functions. This study lays the foundation for the development of a longitudinal study of neurocognitive health among unhoused older adults in San Francisco.

People experiencing homelessness (PEH) have a high rate of tobacco use. Researchers examined factors associated with cigarette consumption and quit attempts. They found having an encounter with staff in the past week was associated with a 40% reduction in weekly consumption. The findings highlight the role of community-based pharmacists to expand smoking cessation services in homeless shelters.

People living with HIV (PLH) experiencing homelessness or unstable housing have lower rates of viral suppression compared to people who are housed. In 2020, only 20% of PLH experiencing homelessness in San Francisco were virally suppressed, compared to 71% of those who were housed. Researchers examined case preferences among PLH experiencing homelessness during the COVID-19 pandemic in San Francisco. They found that the strongest preference were for the same provider, visit incentives, and drop-in visits.

Recently the demographic characteristics of people experiencing individual homelessness have changed; more individuals over the age of 50 are experiencing homelessness. BHHI researchers examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with family or friends. Researchers found barriers to stay such as feelings of shame and concerns about burdening the hosts. Findings suggest that family members and friends may play an important role in supporting older adults experiencing homelessness.

In the United States there has been a simultaneous rise of mass incarceration and homelessness. Both of these phenomena are driven by the same structural factors, housing being the most important. Researchers present evidence-based approaches to improve housing strategies for reentry populations, prevent homelessness among those in community supervision, and rehouse members of the reentry community experiencing homelessness.

In this cross-sectional study, researchers studied the association between residential relocation and health outcomes in people who inject drugs (PWID). PWID are at an increased risk of low socioeconomic status and homelessness. Researchers found that any residential movement in the past 30 days was associated with increased odds of bad health outcomes.

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.