Our Research

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.

Tobacco use is common in people who experience homelessness; however, research in homeless and unstably housed (HUH) women is sparse. Researchers found that the most common reason for tobacco use was to reduce stress and anxiety. The findings suggest that tailored counseling and healthcare interactions that include smoking cessation efforts and address food insecurity during treatment.

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 homeless population is aging and people experiencing homelessness are at a heightened risk of experiencing physical and sexual victimization. This study examined whether homelessness is independently associated with experiencing physical or sexual abuse. Researchers found that older homeless adults experience high rates of victimization.

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 reported the public health response to a COVID-19 outbreak in a San Francisco shelter where 67% of residents and 17% of staff tested positive for SARS-CoV-2. The researchers describe the limited utility of case investigation, person-based contact tracing and symptom screening, and the benefits of mass testing in outbreak response.

This commentary coauthored by BHHI faculty describes how a coalition of Bay Area community organizations, academic institutions, and public health departments collaborated to provide high-risk populations with Covid-19 testing and vaccination, and also took the opportunity to connect them with other essential services.

This UCSF study compared infection control strategies to reduce COVID-19 outbreaks in homeless shelters in the United States. In high-risk homeless shelter environments and locations with high community incidence of COVID-19, even intensive infection control strategies are unlikely to prevent outbreaks, suggesting a need for non-congregate housing arrangements for people experiencing homelessness.

A UCSF study found that during the COVID-19 pandemic in California, older adults, Black and Latino residents, and those without college degrees experienced the highest per capita excess mortality. The researchers suggest that this pattern reflects the risk of COVID-19 death faced by low-wage, essential workers and their social networks owing to occupational exposure, crowded housing, and inadequate access to testing or treatments.