Although the majority of San Francisco residents have been vaccinated against the coronavirus, people experiencing homelessness may still face barriers to vaccination. By walking the streets and offering immunizations on the spot, Code Tenderloin has collaborated with UCSF and Glide to try to overcome those barriers. Margot Kushel, MD, who directs the UCSF Benioff Homelessness and Housing Initiative, said UCSF health workers asked Code Tenderloin to take the lead in the outreach work, "I can’t emphasize enough how much our efforts were led by Code Tenderloin, who really in the Tenderloin is seen as a very trusted entity. They know the community. They’ve been there, they get it."

In this op-ed, Leslie Suen, MD, MAS, explains the value of Overdose Prevention Centers (OPC), and use of a harm reduction framework as a multi-prong strategy to combat the opioid ...

By providing safe indoor spaces and safe supplies, overdose prevention centers treat overdoses and limit infections, while offering access to primary care services and evidence-based treatment for drug addiction. Leslie Suen, MD, MAS, explains why evidence-based harm reduction strategies like OPCs keep people safe while making treatment readily available to anyone who wants it.

The lack of affordable housing, systemic racism, and weak safety nets are the leading causes of Silicon Valley’s homeless crisis. UCSF Benioff Homelessness and Housing Initiative Director, Margot Kushel, MD, was a featured speaker for this event that San José Spotlight and nonprofit Destination: Home hosted as part of a series on the root causes of homelessness and possible solutions. The panel also featured Dontae Lartigue, founder, and CEO of Raising The Bar and board chair of the Santa Clara County lived experience advisory board; Jeff Olivet, executive director of the U.S. Interagency Council on Homelessness; and Tomiquia Moss, founder, and CEO of All Home. Destination: Home CEO Jennifer Loving moderated the conversation.

Each year, older adults make up a greater proportion of America’s homeless population and these numbers are only expected to keep rising. In part one of this story, Viewpoints Radio host Gary Price spoke with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and Dennis Culhane, PhD, professor, social policy, University of Pennsylvania, about the main societal factors driving this increase and why this group is particularly vulnerable to homelessness.

American adults 50 and older are the fastest growing group falling into homelessness. In part 1 of this story, Viewpoints Radio covered the factors fueling this rise. In part  2 – host Gary Price talks with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and Dennis Culhane, PhD, professor, social policy, University of Pennsylvania about why this population is especially vulnerable out on the streets and why it’s so hard to find a way back once you’re in this position.

Little is known about pathways to homelessness among older adults. In this study, researchers interviewed 350 homeless adults, aged 50 and older, recruited via population-based sampling. Participants reported current health and functional status, including recent mental health and substance use problems. Researchers found that the life course experiences and current health and functional status of individuals with first homelessness before age 50 differed in key ways from those whose first homelessness occurred later.

Paul's Place, a four story building that will provide needed services, temporary housing, and permanent supportive housing to those experiencing homelessness, opens its doors in Davis, California. In regards to combining multiple types of housing under one roof, Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative said, "I don’t see it as a particularly big red flag, I think that that is true in any shelter or in any permanent supportive housing building: There are going to be people at different points on their journey."

In the first year of the pandemic, San Francisco and other communities in California offered private hotel rooms, three meals a day and on-site medical services to homeless people who were at risk of getting severe COVID-19. The aim was to stop the spread of the virus among a highly vulnerable group, but the policy had another important effect, according to new research by UC San Francisco, UC Berkeley, and the San Francisco Department of Public Health. It dramatically lowered the use of acute medical care by the hotel occupants who had used this type of care the most in the past.

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."

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.

Homeless adults in their 50s and 60s have a similar prevalence of geriatric conditions, including functional and cognitive impairment, as adults in their 70s and 80s in the general population. Researchers aimed to describe the prevalence of symptoms among older homeless-experienced adults, analyze factors associated with moderate–high physical symptom burden, and identify symptom clusters. They conducted a cross-sectional analysis within longitudinal cohort study. Researchers found a high prevalence of symptomatology across multiple domains. They found that symptom domains clustered together: those with higher physical symptomatology had a high prevalence of other symptom domains.

In this op-ed, Leslie W. Suen, MD, MAS, an assistant professor of medicine in the UCSF Division of General Internal Medicine at San Francisco General Hospital, calls upon physicians to oppose medical discrimination against methadone patients. She highlights how methadone patients are routinely denied the care they need, exacerbating health disparities. "It’s far past time for every stakeholder to recognize their responsibilities and provide equal access to all patients, regardless of their medical condition or treatment." Dr. Suen 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.

This JAMA Health Forum research letter estimates how ending federal support for Housing First programs could affect homelessness in the United States. Programs incorporating a Housing F...

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.

In this op-ed, Morgan Philbin, PhD, MHS, associate director at the Benioff Homelessness and Housing Initiative and director of the Educations Program, and Emilie Bruzelius, PhD, MPH, a post-doctoral fellow in substance use epidemiology at Columbia University, advocates for rolling back punitive policies and creating non-stigmatizing medical environments that can support pregnant people who use drugs. They outline the unique barriers that people who are pregnant face. They write, "All stakeholders—healthcare providers and policymakers—must bring compassion to innovative drug policies that are fueled by science instead of stigma." 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 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 third in a series, these materials describe important considerations in planning strategies for vaccinating unsheltered people, as all persons experiencing homelessness are now eligible for vaccination in California.