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News
UCSF Panelists Argue Structural Changes Necessary for Post-COVID Pandemic Society
NBC Bay Area • March 27, 2021
Among a group of medical experts from UCSF and Berkeley who expressed optimism that the COVID-19 pandemic could soon recede, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, pointed to initiatives like Project Roomkey as successful efforts in keeping unhoused residents sheltered and safe during the pandemic, but argued that much more is needed to ensure that society's most vulnerable groups are protected during the next large-scale public health crisis.
News
UCSF Professor Presents Homelessness Research at Harvard Joint Center for Housing Studies
The Harvard Crimson • March 25, 2024
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. 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. The panelists shared there perspectives on policy and economic approaches to addressing the housing crisis, agreeing that providing dedicated, sustained support to unhoused individuals is necessary. “The first thing we need to do is to recognize that every single path to ending this crisis flows through housing,” Dr. Kushel said.
News
UCSF Releases Report on Black Californians’ Experiences of Homelessness
KALW News • February 21, 2024
Black Californians make up only 7% of the states population, but make up more than 25% of the state's population of people who experience homelessness. A recent special report released by the UCSF Benioff Homelessness and Housing Initiative on Black Californians' experiences homelessness highlights the systemic racism. Kara Young Ponder, PhD, director of community engagement and racial justice at the UCSF Benioff Homelessness and Housing Initiative, said, "California is one million units short of affordable and available housing for extremely low-income renters, of which Black Californians are over represented."
News
UCSF Researchers Focus on ‘Aging Into Homelessness’ in Bay Area
KPIX CBS SF Bay Area • November 4, 2019
Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was interviewed about Project Home and how more people than ever before are “aging into homelessness.” Right now, more than half of the Bay Area homeless population is over age 50.
Reports
Understanding CalAIM Implementation Across California
Terner Center, Abt Associates, and UCSF’s Benioff Homelessness and Housing Initiative (BHHI) • February 8, 2024
The first brief on creating and sustaining effective homelessness organizations and systems looks at challenges to and opportunities for the California Advancing and Innovating Medi-Cal...
News
Understanding Homelessness in SF: The Causes of Homelessness in San Francisco
Manny's • February 27, 2023
Manny's organized a four-part series on understanding homelessness in San Francisco. In part one, the host spoke with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, about the root causes of homelessness in San Francisco to demystify the realities and complex factors that keep people homeless. Dr Kushel said, "The difference in community level of homelessness is entirely trackable by the availability of housing for the lowest income households."
Our Research
Understanding the 100 Highest Users of Health and Social Services in San Francisco
Academic Emergency Medicine • September 1, 2021
The San Francisco Department of Public Health implemented the Coordinated Care Management System (CCMS) in 2007. The CCMS is used to develop High Users of Multiple Systems (HUMS) tp identify individuals with the highest use of emergency medical services. Researchers described the HUMS scoring system and the characteristics and service use of the highest scoring 100 individuals. Researchers found that nearly all of the individuals had a history of homelessness in SF, and over half were unsheltered at their last point of contact.
Our Research
Understanding the Association Between Frequent Emergency Department Use and Jail Incarceration: A Cross-Sectional Analysis
Academic Emergency Medicine • May 1, 2022
The number of individuals incarcerated in the United States has increased since the 1970s. Frequent emergency department (ED) use and incarceration can both be driven by underlying structural factors and social needs. Researchers conducted a retrospective, cross-sectional analysis to assess whether an increased frequency of ED use was associated with incarceration. They found that ED use is independently associated with incarceration.
Opinion
Unfair “Fair” Housing Act Requires Reform
Visible • January 9, 2024
In this op-ed, Jesica Giannola, one of the CASPEH Lived Expertise Advisory Board members, calls attention to the unfair polices in the "Fair Housing Act". She outlines the issues and the need for reform, calling for young-adult and high school students to also be included under the same protections of families with minor children. "While it’s absolutely fair to ensure tenants can reliably pay rent, it’s incomprehensible that the same screening conditions applied to adults are also required of their 18-year-old high school students." Ms. Giannola 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.
News
Unhoused Americans Have Few Places to Turn When Death Is Near
PBS Newshour • June 16, 2023
The United States has an aging population, and sufficient end-of-life care is a growing problem. For people adults who are unhoused, long-term medical care is often inaccessible. There are a few facilities across the country that provide end-of-life hospice care to people experiencing homelessness, but there is not much known about mortality figures among the unhoused. Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, said, "The truth of the matter is most of the country is entirely unprepared for this."
News
Unhoused Californians Are Getting Older, and They’re Staying Unhoused Longer
LAist • May 27, 2024
Californians experiencing homelessness are aging, presenting unique challenges. 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 older you are when you first become homeless, sort of the more stuck in homelessness you get."
News
Unhoused Californians Are Living on the 'Bleeding Edge' of Climate Change
KQED • October 23, 2023
Unhoused people made up almost half of heat-related deaths in Los Angeles County last year, though they represent less than 1% of the population. In Sacramento County, the death rate among people experiencing homelessness in 2021 from hypothermia was 215.5 times higher than the county rate overall. California's climate and housing crises are colliding. Margot Kushel, MD, director of UCSF’s Benioff Homelessness and Housing Initiative, said, "Folks experiencing homelessness are on the bleeding edge of the health crises that are happening with extremes of temperature."
News
Unhoused People Kicked Off Medicaid in Montana
Montana Public Radio • April 4, 2024
During the COVID-19 pandemic, the number of Americans who got their health coverage from Medicaid increased. States are now required to check that every person is still eligible for Medicaid. However, some people who do qualify have accidentally lost coverage. This is particularly harmful for people experiencing homelessness. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "It doesn't seem like such a big deal to fill out paperwork. Put yourself in the position of an elder who's experiencing homelessness and has lost their vision and has no access to computer, no access to car, doesn't have a cell phone."
Our Research
Uniting Academic and Lived Expertise to Promote Housing and Health Equity
October 10, 2025
People with lived experience hold insights and networks that academic researchers alone cannot access. Building trust-based partnerships between researchers and lived experts takes time, vulnerability, and institutional change. But it’s essential to producing knowledge that leads to equitable and effective solutions.
Our Research
Unmet Mental Health and Substance Use Treatment Needs Among Older Homeless Adults: Results From the HOPE HOME Study
Journal of Community Psychology • August 19, 2019
The homeless population has a higher prevalence of mental health and substance use problems than the general population. Researchers aimed to examine the prevalence of and factors associated with unmet needs for mental health and substance use treatment in older homeless adults. They used logistic regression to examine factors associated with unmet treatment needs. Researchers found that older homeless adults have a high prevalence of unmet behavioral health treatment needs and need targeted services.
News
Unraveling the Misinformation about Homelessness in California
KPFA Letters & Politics • August 12, 2024
In this episode of KPFA Letters and Politics, host Mitch Jeserich spoke with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, about the myths and misinformation about homelessness. Dr. Kushel said, "This idea of a max exodus is simply not true. "
Basic Page
Unsheltered Homelessness
Seventy-eight percent of Californians experiencing homelessness live unsheltered, forced to live their private lives in public. This group faces significant health and safety risks, including exposure to infectious diseases, adverse weather conditions, and violence. To better understand unsheltered homelessness, we examined data from the California Statewide Study of People Experiencing Homelessness. We released a topic brief that examines who experiences unsheltered homelessness, how they lost their housing, their experiences during homelessness, and barriers to regaining housing. We also released tools to support evidence-based encampment resolution. Our Encampment Resolution Guide and Encampment Prioritization Tool are designed to help communities balance competing
Topic Brief
Unsheltered Homelessness
September 12, 2024
This topic brief examines who experiences unsheltered homelessness, how they lost their housing, their experiences during homelessness, and barriers to regaining housing. The findings highlight the urgent need for the homelessness system to advance evidence-based strategies to meet the needs of unsheltered people.
Research Area
Unsheltered Homelessness
On any given night, more than half a million Americans are homeless; 58% of those experiencing homelessness are unsheltered.
Our Research
Unstable Housing and Kidney Disease: A Primer
Kidney Med • March 7, 2022
Unstable housing has been associated with a higher risk of kidney disease and kidney disease progression. In this review, researchers discussed the underlying mechanisms of housing and kidney disease. Several considerations should be taken into account when working with individuals experiencing unstable housing or at risk for kidney disease. This review sheds light on that housing interventions can improve outcomes.
Our Research
Using a "Big Events" Framework to Understand Emergency Department use Among Women Experiencing Homelessness or Housing Instability in San Francisco During the COVID-19 Pandemic
International Journal of Drug Policy • November 1, 2021
The COVID-19 pandemic disrupted economic systems, social networks, and individual behaviors, altering patterns in health care use. In this study, researchers compared homeless and unstably housed (HSH) women who did and did not use an emergency department during the first 10 months of the pandemic. The researchers found that the rate of emergency department use among HUH women during the pandemic was similar to prior research.
Our Research
Using Alone at Home: What’s Missing in Housing-Based Responses to the Overdose Crisis?
Harm Reduction Journal • January 29, 2024
Responses to the overdose crisis in North America are increasingly centered on harm reduction approaches. In this commentary researchers aim to highlight current housing-based overdose prevention interventions and to situate them within the broader environmental contexts of marginal housing. Housing interventions need to be expanded, but also attend to the contextual drivers of risks in these settings to best foster enabling environments for harm reduction and maximize impacts.