In this commentary of the study "Housing Status, Cancer Care, and Associated Outcomes Among US Veterans", Maria C. Raven, MD, MPH, associate Professor and Chief of Emergency Medicine at UCSF, provides lessons from the Veterans Health Administration. In 2009, the VHA began a multipronged initiative designed to end and prevent homelessness among veterans, which led to a 45% reduction in veteran homelessness from 2009 to 2017. Dr. Raven writes, "The results of this study indicate that in addition to providing housing at comparatively high rates for unhoused veterans, the system’s initiative to prevent and end veteran homelessness has also likely helped reduce important disparities in oncologic care for this population."

KTVU's Heather Holmes and Frank Mallicoat talk to Marc Dones, Policy Director of the Benioff Homelessness and Housing Initiative, about the challenges unsheltered people face and what research says about barriers to resources.

The perception of people experiencing homelessness is often based on anecdote. In the first episode of WPLNs 9 part housing series, In My Place, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, joins host Khalil Ekulona to talk about the causes of homelessness, the misconceptions and myths of homelessness, and what cities can solve the problem. As the conversation moved to the misconceptions of people experiencing homelessness, Dr. Kushel said, "I think the single biggest misconception is that homelessness is synonymous with mental health and substance use problems." Dr. Kushel adds "At its heart, homelessness is a problem of housing cost."

 Traumatic injury is a major cause of morbidity for people experiencing homelessness (PEH), however, injury patterns and subsequent hospitalization among PEH have not been studied on a national scale. In this national retrospective observational cohort study, researchers evaluated whether differences in mechanisms of injury exist between PEH and housed trauma patients in North America and whether the lack of housing is associated with increased adjusted odds of hospital admission. Researchers found that injured PEH had a significantly adjusted greater odds of hospital admissions.

A landmark study by UCSF Benioff Homelessness and Housing Initiative (BHHI) paints a different picture on people experiencing homelessness in California. Researchers at BHHI sought to capture the experiences of all people aged 18 years and older who experience some form of homelessness in California. "It took a lot of time and was a lot of work, but we wanted to be able to show policymakers what this issue looks like instead of just giving them more numbers to look at," said Margot Kushel, MD, the study’s principal investigator and director of UCSF’s Benioff Homelessness and Housing Initiative.

More than 650,000 people experienced homelessness on one night in January 2024, up 12% from 2022. In this episode of On Point, host Meghna Chakrabarti speaks with Nicole Santa Cruz, ProPublica reporter, Mike Johnston, mayor of Denver, CO, and Marc Dones, policy director of the UCSF Benioff Homelessness and Housing Initiative, about the rise of homelessness and encampment sweeps.

People living with HIV/AIDS (PLWHA) have an increased risk of experiencing homelessness. The underlying drivers of homelessness are structural, however individual factors such as mental health and substance use problems are also common drivers. People living with HIV/AIDS who experience homelessness are more likely to have uncontrolled viral load. Researchers from BHHI suggest integrating HIV treatment with mental health and substance use treatment.

To address intergenerational homelessness and housing insecurity, protecting low-income families and mitigating the risk of their children experiencing homelessness is paramount.

LifeMoves Mountain View is an interim shelter program that provides supportive services to help people who experience homelessness find stable housing in 3 to 4 months. However, data has shown that many of those experiencing homelessness are unable to find stable housing within that timeframe. Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, said, "People are not homeless because they need services. People are homeless because there isn't any housing."

Populations experiencing homelessness have high rates of tobacco use and experience substantial barriers to cessation. Tobacco-caused conditions are among the leading causes of morbidit...

Hosted by the California Partnership to End Domestic Violence (the Partnership), lead researcher Anita Hargrave, MD, UCSF BHHI Policy Director Tiana Moore, PhD, and CPEDV staff dove deeper into policy recommendations and solutions that arose from the California Statewide Study of People Experiencing Homelessness (CASPEH) findings on the intersection of intimate partner violence and homelessness. The webinar featured an in-depth discussion of local and state opportunities, as well as funding and programmatic policy recommendations for advocates, policymakers, and other decision-makers.

A special report on the relationship between intimate partner violence and homelessness in California by the UCSF Benioff Homelessness and Housing Initiative, found that 1 in 5 women who become homeless in California flee their homes to escape violence. Participants described the need to plan their exit in advance and to accumulate resource; however, of those who experienced intimate partner violence in the 6 months prior to homelessness, only 12% sought help from a domestic violence organization. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "Some people honestly had no idea what is a domestic violence shelter. Other people told us when they had to run, they had to run. They didn’t have time to figure out where to find a shelter."

Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, wrote an editorial in JAMA about a recent study on the negative health consequences of involuntary displacements on the lives of people experiencing homelessness. Dr. Kushel writes, "The question is not whether living in unsheltered settings is dangerous, but rather what is the role of forced displacements in addressing the harm caused by them."

The complex care evidence base continues to grow, but meaningful involvement of people with complex needs in the research process is lacking. Hemal Kanzaria, MD, Associate Professor of Emergency Medicine at University of California San Francisco spoke with The Better Care Playbook to learn more about how involving people with lived experience in research can help strengthen the complex care evidence base. Dr. Kanzaria said, "The partners are working together in every one of those steps and recognizing the skill set that everyone's bringing to it. That makes the work better than anyone could do by themselves."

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.

At least 19 states are directing funds from Medicaid programs to help patients who are experiencing homelessness find housing and avoid eviction. Evidence supporting redirecting Medicaid funding to housing is mixed. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "It’s much better than nothing, but it’s far from providing the long-term housing and stability that people really need."

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was interviewed for a New York Times article about how rates of COVID-19 among unhoused people remained lower than feared in 2020, as mitigation measures such as providing hotel rooms for the most vulnerable people and closing crowded shelters helped suppress infection rates.

"Homelessness is solvable. Its primary driver is housing unaffordability... so the solution has always been more housing, particularly for those who don’t currently have it," writes Ned...

The mortality rate for people experiencing homelessness in America has increased in recent years. People are dying at increased rates because of overdoses, but also of things that may have been avoided if the individual had a home or regular access to preventative medical care. Furthermore, the population of people experiencing homelessness are getting older. In California, the number of people 55 and older who sought homelessness services increased 84%  between 2017 and 2021. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "As the homeless population continues to age, you’re just going to see death rates keep going up and up and up."

In this op-ed, Maya Vijayaraghavan, MD, MAS, director of the UCSF Smoking Cessation Leadership Center, highlights the need for affordable housing to be free of secondhand smoke. She emphasizes the threat of secondhand smoke exposure disproportionately affects Black Americans and the effectiveness of smoke-free policies. However, barriers still remain to implement smoke-free policies. "The implementation of smoke-free policies in public housing was a step in the right direction and should be expanded to all affordable multi-unit housing." Dr. Vijayaraghavan 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.