A UCSF BHHI study that followed older homeless adults in Oakland for nearly a decade found that becoming homeless after the age of 50 ratchets up a person’s likelihood of dying early, underscoring the unmistakable role that housing has in extending life. Researchers determined that people in the study who remained unhoused—compared to those who regained their housing—were 80% more likely to die during the follow-up time period from mid-2013 to the end of 2021.

Graham Pruss, PhD, UCSF Benioff Homelessness and Housing Initiative postdoctoral scholar, was quoted in this editorial discussing the rise in vehicle residency and possible ways to address it. Pruss suggests three basic options: lots for people living in cars where the goal is to move to house as quickly as possible; a supportive parking model for people in RVs who want to house, but it may take time; and a mobile home park where people stay indefinitely.

Domestic violence is a major but often overlooked driver of homelessness in Los Angeles, with 44% of unhoused women citing it as the primary cause, according to a 2023 Urban Institute survey. Yet, LA’s survivor support system is severely underfunded—only 10% of those seeking shelter secure a bed. A UCSF BHHI study found that 60% of survivors who fled abuse end up sleeping in cars, tents, or the streets, where they remain vulnerable to further violence. Experts and advocates warn that without integrating domestic violence services into homeless support systems—and vice versa—thousands will continue to face impossible choices and unsafe conditions.

This radio news story reports how mayoral candidates in LA propose addressing homelessness in Los Angeles. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, discusses how solving homelessness requires a big systemic fix. "The underlying drivers of homelessness are the lack of deeply affordable housing, income inequality, and structural racism. It’s going to be hard to solve this problem without effort from the federal government."

With modern home prices out of reach for many California residents on fixed incomes, older adults have become the fastest-growing segment of the unhoused population across the state, according to new research from UCSF. California makes up 30% of the nation’s unhoused population and is home to half of all the country’s unsheltered population, according to the landmark study, which looks at how people in the Golden State become unhoused, experience homelessness, and exit homelessness. Nearly half of all unhoused adults in the study were age 50 or older, and Black and Native American residents were “dramatically overrepresented,” the study shows. “The results of the study confirm that far too many Californians experience homelessness because they cannot afford housing,” said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative and principal investigator of the landmark study.

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.”

Research has demonstrated that homelessness is associated with poor health outcomes. However, there are fewer studies that show that gaining housing is associated with improved health outcomes. In a recent study published in early February was hypothesis-generating and found an association between housing and improved survival. Hannah C. Decker, MD, of the University of California, San Francisco and lead author, said, "Unhoused veterans who gained housing in the year after diagnosis had better outcomes than people who remained unhoused."

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.

Oregon and California lawmakers are reconsidering their approaches to mental health and involuntary confinement. Parallel debates in both states reflect the ongoing homelessness crisis. Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, said, "If you try to fix homelessness by tinkering with the health care system, we're not going to get anywhere."

The UCSF Benioff Homelessness and Housing Initiative collaborated with the California Homeless Coordinating and Financing Council and the California Health Care Foundation to create resources to help homelessness response systems with COVID-19 vaccination planning. The second in a series, these materials detail key lessons learned from the early rollout of COVID-19 vaccination events for sheltered or service-connected people experiencing homelessness.

The scale of devastation wrought by the deadly wildfires in Pacific Palisades and Altadena has been unimaginable. Entire neighborhoods have been wiped out, homes reduced to smoldering ruins, and acres of hillside consumed by relentless flames. In this episode of Life Examined, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, joins authors George Bonanno, PhD and Carolyn Korsmeyer, PhD to talk with host Jonathan Bastian about trauma, resilience, and why our homes are integral to who we are . Dr. Kushel said, "You have that physical safety, hopefully, that acceptance for who you are, and you can just be you. And there are very few other places where that is true."

Loneliness is often more common in older adults and those who face structural vulnerabilities, including those who experience homelessness. In the United States, 48% of single homeless adults are 50 and older. There is a limited information about loneliness among older adults who have experienced homelessness. This study used qualitative data collected as part of a longitudinal mixed-methods study, Health Outcomes of People Experiencing Homelessness in Older Middle Age (HOPE HOME). The study aimed to examine the intersection between social isolation, functional and cognitive impairment, and use of supportive services among a cohort of older adults experiencing homelessness in Oakland, California. Researchers found that homeless-experienced older adults with cognitive or functional impairments exhibited diverse loneliness experiences.

For the first time in six years, the number of people experiencing homelessness in Los Angeles decreased from the year before, according to the most recent point-in-time count. However, there has been less success in finding people experiencing homelessness permanent homes. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "If the underlying economic conditions don't change, and if the money gets cut, you're going to see an increase again."