A new UCSF BHHI study challenges misconceptions about drug use among people experiencing homelessness in California. While only 37% of homeless individuals regularly use illicit drugs, lifetime use is high, and 27% began using after losing housing. The study highlights the difficulty of accessing treatment, with only 7% receiving care and 1 in 5 actively seeking help but unable to get it. Margot Kushel, MD, emphasized the complex relationship between drug use and homelessness, stating, “People are telling us that it helps them survive,” she said. “It keeps them awake and alert. They are using it either because they are traumatized, they have been assaulted, they are afraid or depressed, using it as coping to make it all go away.”

The California Statewide Study on People Experiencing Homelessness is the largest representative study on homelessness since the 1990s. The research highlighted crucial aspects of homelessness and debunked several myths. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative and principal investigator of the landmark study emphasized the urgent need for a national effort to combat homelessness, building upon the insights gained from the California study.

The number of Latino/a people experiencing homelessness in the United States is increasing due to increased housing costs, economic disruption from the COVID-19 pandemic, and increased homelessness among migrants. There is little known about the lived experiences of Latino/a individuals experiencing homelessness. We conducted qualitative interviews in English and Spanish with 84 participants who self-identified as Latino/a as part of a large mixed methods representative study of homelessness. We analyzed qualitative interview transcripts from the California Statewide Study of People Experiencing Homelessness (CASPEH) to elucidate factors contributing to increased risk of homelessness for the Latino/a population, the vulnerabilities Latino/a individuals face while navigating homelessness, and how these vulnerabilities influence access to housing and services.

Everyday 171,000 people experience homelessness in California; in rural areas, in urban areas, throughout California. Margot Kushel, MD, director of UCSF’s Benioff Homelessness and Housing Initiative and lead investigator spoke with the host of the California Sun podcast, Jeff Schechtman, about the recent study released by the UCSF Benioff Homelessness and Housing Initiative. When speaking about root causes, Dr. Kushel said, "The root cause comes back to just housing. It is right there in the name, to be homeless is to not have a home". 

Among people experiencing homelessness in California, the group rising the fastest by proportion is older adults. A recent special report released by the UCSF Benioff Homelessness and Housing Initiative on older adult homelessness highlights their experiences during homelessness, and what impacted their return to permanent housing. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "The dramatic rise in homelessness among older adults has severe consequences for the health and safety of those who experience it and for our society at large. Now is the time for investments in real solutions to prevent and end homelessness among this vulnerable population."

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.

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.

Among people experiencing homelessness in California, nearly half of the population is now over the age of 50. By 50, a homeless person’s health more closely resembles that of someone in their 70s, with a higher chance of chronic disease, mobility issues, and cognitive decline, according to a recent special report released by the UCSF Benioff Homelessness and Housing Initiative on older adult homelessness. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "We could meaningfully reduce the number of people experiencing homelessness if we focused on this group."

A landmark study by UCSF Benioff Homelessness and Housing Initiative (BHHI) paints a different picture on people experiencing homelessness in California. The report released in June 2023, examines the demographics of people experiencing homelessness in California, how people enter and experience homelessness, factors that block or enable a person’s return to housing, and policy recommendations.

Homeless people in California are already a vulnerable group, often struggling with poor health, trauma and deep poverty before they lose their housing, according to a new study on adult homelessness. The study attempts to capture a comprehensive picture of how people become homeless in California, and what impeded their efforts at finding permanent housing. Researchers at the UCSF Benioff Homelessness and Housing Initiative hope that the study will strengthen public support for policies that focus on offering housing and emergency rental assistance—rather than policies emphasizing punishment or stigma. “People are homeless because their rent is too high. And their options are too few. And they have no cushion,” said Margot Kushel, MD, UCSF's BHHI director and lead investigator. “And it really makes you wonder how different things would look if we could solve that underlying problem.”

Homeless people in California are already a vulnerable group, often struggling with poor health, trauma and deep poverty before they lose their housing. Lead investigator of the new study, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, spoke with KTLA's the reports findings. Dr. Kushel said, "the main drivers of homelessness are deep poverty."

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a report that examines Latine Californians' experiences of homelessness and makes recommendations for policymakers and practitioners.

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a report that examines the issues of homelessness and behavioral health (substance use and mental health) and makes recommendations for policymakers and practitioners.

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.

Existing literature on people experiencing homelessness (PEH) draws on non-representative samples from service providers, populations with comorbidities, or areas with disproportionately high sheltered homelessness, leading to bias. Nearly a third of PEH in the US and over half of unsheltered PEH live in California. Researchers from the UCSF Benioff Homelessness and Housing Initiative designed a rigorous state-representative survey of PEH to investigate the antecedents of homelessness, understand health, and inform policy solutions. This is the first large representative study of PEH, beyond a single county, to draw inference on a large population that did not depend on service utilization.

The California Statewide Study on People Experiencing Homelessness researchers included people who were formerly or are currently experiencing homelessness. In this op-ed, Claudine Sipili, one of the Lived Expertise Advisory Board co-chairs, writes about the landmark study and her experience participating with the project. She writes, "Throughout the study, the board members’ guidance helped create a safe and dignified space for survey participants to share their experiences openly. By involving individuals with lived experience, we gained deeper insights into the complexities of homelessness."

A growing number of people with lived experience of homelessness are finding opportunities in California to influence academic projects. More entities are beginning to create entire boards or councils of people who know what it is like to lose their housing. With regards to including a lived expertise advisory board in UCSF BHHI's California Statewide Study of People Experiencing Homelessness, Kara Young Ponder, PhD, director of community engagement and racial justice at the UCSF Benioff Homelessness and Housing Initiative, said, "The researchers had missed an entire world of economic insecurity, and the survey was much richer because the board members could see things the researchers could not."

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

People with multiple, complex health and housing needs frequently receive fragmented care because the providing systems operate independently. The California Policy Lab at UC Berkeley and the UCSF Benioff Homelessness and Housing Initiative worked with partners in San Francisco’s public health and criminal legal systems to link together ten years of data from the physical health, behavioral health, housing, and criminal legal sectors.

A new UCSF BHHI study challenges common perceptions about homelessness and drug use in California, revealing that only 37% of surveyed unhoused Californians use drugs regularly, while 25% have never used them at all. Methamphetamine, not opioids, is the most commonly used drug, often as a means to stay alert while living on the streets. The study also highlights the complex relationship between addiction and homelessness—while drug use can increase the risk of losing housing, “Homelessness itself increases drug use because people use it as a coping strategy,” said Margot Kushel, MD. With homelessness on the rise and only 7% of respondents in treatment, experts stress that expanding affordable housing and accessible treatment options is crucial to addressing both crises.

Research from UCSF Benioff Homelessness and Housing Initiative reveals that most people experiencing homelessness in California are not illegal drug users—contrary to widespread public perception. These findings challenge common stereotypes and underscore the urgent need for better treatment options and housing solutions across the state. KCBS Radio news anchor Eric Thomas spoke with Margot Kushel, MD, Professor of Medicine and Chief of UCSF’s Division for Health Equity and Society, to dive deeper into the issue.

Loss of income is considered the number one factor for why Californians experience homelessness, according to new research from UCSF. The new findings highlight the idea that money is not only the main cause of the homelessness, but also a potential solution. "I think it’s really important to note how desperately poor people are, and how much it is their poverty and the high housing costs that are leading to this crisis" said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative and principal investigator of the landmark study.

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.

Researchers at UCSF Benioff Homelessness and Housing Initiative have released the largest representative survey of homeless people in more than 25 years. Researchers surveyed over 3200 people experiencing homelessness in California, and conducted over 300 in-depth interviews. The California Statewide Study on People Experiencing Homelessness paints a different picture, debunking common myths and providing evidence-based solutions.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, delivered the Harvard Joint Center for Housing Studies’ 23rd John T. Dunlop Lecture. Dr. Kushel spoke about the impact that homelessness has on an individual’s quality of life, highlighting the lived experiences of unhoused Californians who participated in the California Statewide Study of People Experiencing Homelessness. After the lecture there was a panel, featuring, Boston Healthcare for the Homeless founder, Harvard Medical School professor James J. O’Connell, and Peggy Bailey, a leader of a housing policy research center. JCHS Managing Director Chris Herbert, the moderated the panel. Dr. Kushel said, "While it is really easy to blame people impacted by homelessness, doing so not only is not fair or right, but it also isn’t going to get us any closer to a solution."