Injury is a leading cause of hospitalization in people experiencing homelessness, yet post-injury care use is unknown. This study examines care use patterns in the 12 months after injury in people experiencing homelessness versus housed low-income Medicaid beneficiaries.

Cancer is a leading cause of death in older unhoused adults. In this retrospective cohort study, researchers assessed whether being unhoused, gaining housing, or losing housing in the year after cancer diagnosis is associated with poorer survival compared with being continuously housed. Researchers used a national sample of veterans with lung, colorectal, and breast cancer during the period of 2011-2020. Findings showed veterans who were unhoused before and for the twelve months after their diagnosis had 10–20 percent greater risk for all-cause mortality than veterans who were consistently housed, even after adjustment for multiple factors.

Cancer is a leading cause of death among older people experiencing homelessness. In this retrospective cohort study, researchers sought to characterize the diagnosis, treatment, surgical outcomes, and mortality by housing status of patients who receive care from the US Department of Veterans Affairs (VA) health system for colorectal, breast, or lung cancer. Researchers found that homelessness was associated with later stages at diagnosis for colorectal cancer.

A panel at the CalMatters Ideas Festival debates how to reduce homelessness without punishing poverty. Panelists discussed the underlying causes and what California should be focusing on. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "We know how to treat people, you have to start, though, with the housing." 

KQED’s Sold Out housing podcast examined the interplay of Margot Kushel’s work within and beyond medicine as traditionally understood. “There is no medicine as powerful as housing,” Dr. Kushel said.

Programs in San Francisco that offer people living on the streets respite, shelter, and treatment often fall dismally short of the need. “There just isn’t enough of it,” Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, says. “Without the housing, it all falls apart.”

A groundbreaking UCSF BHHI study challenges common perceptions about drug use among people experiencing homelessness. Researchers found that less than half of this population regularly used drugs, with methamphetamine being the most common substance, not opioids. Many respondents wanted treatment but struggled to access it, highlighting barriers to care. The study emphasizes that homelessness and substance use are interconnected and advocates for reducing barriers to treatment and prioritizing housing solutions. "We need to reduce barriers to substance use treatment, and that includes prioritizing people’s ability to return to housing,” said BHHI faculty member Ryan Assaf, PhD, MPH, the study’s lead author.

The coronavirus pandemic is upending the Bay Area’s fight against homelessness. Many of the changes—good and bad—will outlast the pandemic, says Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, who studies the intersection of homelessness and health.

Ned Resnikoff, policy manager at the UCSF Benioff Homelessness and Housing Initiative, said the best long-term solution to homelessness is to build more low-income housing. In the interim, people who are currently homeless need to be moved into housing. Mr. Resnikoff said resources need to be strategically funneled into preventing homelessness, and permanent rental subsidies could be one solution to helping prevent homelessness.

Homelessness has surged in the United States. It is a devastating public health crisis with ruinous, often permanent, effects on people’s lives. Margot Kushel, MD, professor of medicine and director of the Benioff Homelessness and Housing Initiative at UC San Francisco, said, "We will not solve this problem by denying the enormous trauma that people who’ve experienced homelessness have been through.”

Hospital emergency departments (ED) are on the frontlines of serving people experiencing homelessness, and this report investigated what ED data can reveal about homelessness in California. Hospitals operated by counties and the University of California reported higher shares of ED visits by people experiencing homelessness. Linking discharge data with homeless services programs can offer insights into how people engage with programs and help provide better resources to evaluate the programs and investments aimed at improving the lives of Californians experiencing homelessness.

A comprehensive new study finds the vast majority of the California's unhoused residents lived in the state before losing their housing. The goal of the report was to take a systematic approach to understanding the causes of homelessness and potential solutions instead of relying on the emotional responses the crisis can trigger, said study author Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative. “What we were trying to do is take the rhetoric down a bit, and using really scientific best practices, to get a handle on not only who was experiencing homelessness but what was happening in their lives before they became homeless,” Dr. Kushel said.

This news article reports on varying methods quantifying homelessness in San Francisco. These metrics — the PIT count, city data, and others — are often mere snapshots of the whole picture, or require people to reach out for services, said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative. That means a lot of people are left unseen. People drift in and out of homelessness; a person who was homeless at some point in the year may not be any more, she said.

Hemal Kanzaria, MD, Associate Professor of Emergency Medicine and faculty advisor at UCSF Benioff Homelessness and Housing Initiative, discussed findings of a new UCSF study describing how the hotel isolation and quarantine strategy used for homeless residents of San Francisco during the COVID-19 pandemic benefitted the entire community.

In this op-ed, Kara Young Ponder, PhD, director of community engagement and racial justice at the UCSF Benioff Homelessness and Housing Initiative, explains how neighborhood design and homeownership are entrenched in Jim Crow-era segregation practices. She outlines how the discriminatory, race-based residential segregation, has contributed to Black households being disproportionately vulnerable to displacement. Dr. Ponder writes, "Structural, institutional and interpersonal racism in our housing, criminal justice and education systems mean that Black Americans disproportionately struggle to find consistent housing, are vulnerable to displacement into homelessness and face more barriers when trying to get rehoused." 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, Cheyenne Garcia, senior research analyst at the Benioff Homelessness and Housing Initiative, advocates for policymakers, elected officials, funders, and activists to update the definition of homelessness to include those temporarily staying with family and friends. She emphasizes that the current practice of classifying such people as at risk of, rather than as experiencing, homelessness, denies them access to necessary resources and the opportunity to exit homelessness. "It is vital to dedicate more resources to those who are staying in precarious housing situations that can leave them homeless on the streets or in shelters at any time." Ms. Garcia 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 Atlantic published an article on a new strain of crystal meth said to be “worsening America’s homelessness problem.” Policy manager Ned Resnikoff examines how the piece showcases common misconceptions about homelessness.

Maria Raven, MD, Chief of Emergency Medicine at UCSF and a faculty advisor at BHHI, was quoted in this piece describing how hotels leased during the pandemic to prevent the spread of coronavirus provided shelter for unhoused people at risk of severe COVID-19. Dr. Raven said, "When someone is sick and vulnerable, let's get them housed and keep them housed."

The UC Center Sacramento hosted a "Special Winter Symposium: Dimensions of Chronic Homelessness and the Search for Solutions." In session 4, Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, joined State Senator John Laird and Dr. Toby Ewing to discuss how California is addressing the issue of people who are chronically unsheltered and what barriers remain.

In an effort to understand the spread of the coronavirus among the large population of homeless people in San Francisco’s District 10, UCSF joined with the United Council of Human Services and other community organizations to put together the weekend event.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was interviewed about the COVID-19 testing event in San Francisco. UCSF partnered with the San Francisco Department of Public Health and several community-based organizations to bring testing and information to people in District 10. Unhoused people are high risk for COVID-19, so increasing awareness around the disease is extremely important.

Most people experiencing homelessness in California are not regular drug users — and for some, substance use begins or worsens after losing housing. Some use drugs to stay awake and safe, coping with the trauma and danger of life without shelter. At the same time, many who want treatment can’t get it. This paper uses data from the California Statewide Study of People Experiencing Homelessness to show a comprehensive, representative look at substance use, overdose risk, and unmet treatment needs among people experiencing homelessness in California.

Mobile crisis services for people experiencing distress related to mental health or substance use are expanding in the US. In this mixed method study protocol, researchers plan to conduct an interrupted time series analysis to quantitatively examine the impacts of the Street Crisis Response Team (SCRT) on people experiencing homelessness who utilize the services in San Francisco. Researchers also plan to analyze racial and ethnic disparities to understand the impact on health equity.

A study from UCSF Benioff Homelessness and Housing Initiative examined implementation of a rapid COVID-19 test and response model in congregate shelters in San Francisco. The pilot allowed for detection and isolation of cases among staff and residents. Researchers recommend frequent testing with rapid turnaround as an important public health intervention to improve accessibility and availability of testing, identification, and isolation of COVID-19 positive cases in shelters.