A recent special report released by the UCSF Benioff Homelessness and Housing Initiative on older adult homelessness found that nearly half of California's homeless population is now 50 and older. These older adults are staying homeless for longer and are in poorer health than their younger peers. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "These are people living on fixed incomes, on disability, on really meager pensions, and they really need housing that they can afford."

A new report estimates California could end homelessness by 2035 if it spent at least $8.1 billion every year on the problem. Margot Kushel, MD, director of the UCSF Benioff Housing and Homelessness Initiative said, “The main way to solve homelessness is through housing.” She pointed out that research shows California is short by 1 million affordable and available housing units for extremely low-income renters—those making less than 30% of area median income. “By shrinking that deficit, we will reduce homelessness,” she said. “It will take a sustained investment by federal, state and local governments to do it.”

California invested $17.5 billion over four years to combat homelessness. However, despite the investment, there has been an increase in the number of people experiencing homelessness across the state. A recent report by the UCF Benioff Homelessness and Housing Initiative dispelled common myths about homelessness. Margot Kushel, MD, director of UCSF’s Benioff Homelessness and Housing Initiative and lead investigator said, "Nine out of 10 people lost their stable housing here. These are Californians. We have to create the housing for all Californians"

The latest point-in-time count reveals the number of Californians without a stable place to call home increased by 22,500 over the past three years. Homelessness experts attribute the rise to precipitous drops in earnings during the pandemic among Californians already teetering on the edge. They also point to a worsening housing affordability crisis decades in the making. “We have to solve this rotting core in the center of California—we are a million units short of housing for extremely low-income workers,” said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative.

On this podcast episode of Think Out Loud, Dave Miller speaks with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, about the new study on homelessness and how the findings could be relevant to Oregon. When talking about how the study's findings could provide insight to Oregon, Dr. Kushel said, "I'm afraid what we're seeing in California is definitely a model, in not a good way, up and down the west coast, and throughout other parts of the country."

California’s homeless population is predominantly made up of people who lived in the state before losing their housing, with nearly half older than 50 and a disproportionate number who are Black and indigenous, according to a new statewide study. “We have got to bring housing costs down, and we’ve got to bring incomes up,” said Margot Kushel, MD, the study’s principal investigator and director of UCSF’s Benioff Homelessness and Housing Initiative. “We need to solve the fundamental problem—the rent is just too high.”

The California Statewide Study on People Experiencing Homelessness is the largest representative study on homelessness since the 1990s. The study used a mixed methods approach, collecting data from more than 3,000 surveys and 365 in-depth interviews to uncover who is experiencing homelessness, what individual circumstances have led to them becoming homeless, and how their health issues have affected their life experiences. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative and principal investigator on the report, also delivered the annual John P. Dunlop Lecture at the Harvard Joint Center for Housing Studies (JCHS), presenting the findings and discussing policy recommendations.

Kara Young Ponder, PhD, director of community engagement and racial justice at the UCSF Benioff Homelessness and Housing Initiative, spoke with Jaden Jefferson about the need for affordable housing and the UCSF BHHI California Statewide Study of People Experiencing Homelessness. A major finding of the study was that homelessness doesn't affect everyone equally, communities of color are disproportionately vulnerable to being displaced into homelessness, especially Black, Latinx, and Indigenous Californians. One reason that is the case is "when we look at the history of housing in this country, what we see is that our neighborhoods were actually built through racial covenants between the government and realtors in the form of what we now call redlining", said Dr. Ponder.

More than 181,000 Californians were unhoused in 2023, with nearly 70% living on the streets. Cities provide resources for emergency solutions, but it is not really a solution. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "We’re at a place in California, unfortunately, where doing well is often running in place." This is the first installment of a 4 part series exploring solutions to homelessness in California.

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, highlights the lack accessibility of the most effective evidence-based treatment for opioid use disorder in California. She outlines the effectiveness of methadone treatment to help people with opioid use disorder, and how Californians restrictions regarding methadone create unnecessary barriers to care. "If having to go to a clinic every day for medication isn’t onerous enough, California tacks on additional state laws that make staying in methadone treatment even more challenging for patients" said Dr. Suen. 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, Dalma Diaz, MA, a health equity fellow at the California Health Care Foundation, highlights how housing supports other social determinants of health, providing a lifeline. She puts forward the idea of prescribing housing as a way to provide limited rental subsidies. Ms. Diaz writes, "Our housing was a lifeline. It meant that my family, which included two children under 12 — one with a developmental disability — had a stable place to live during one of the most frightening and precarious moments of our lives." 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 article about Project Homekey, Margot Kushel, MD, director of the University of California San Francisco's Benioff Homelessness and Housing Initiative, described how the goal is to make sure even the “hardest-to-house” people will come inside. To that end, Dr. Kushel said Homekey gets the most important part right: providing permanent supportive housing, not temporary shelter. “Some people need services that go along with that housing, and some people don’t. But the really essential thing is that without the housing, the services don’t work,” she said.

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) has released the largest representative study of homelessness in the United States since the mid-1990s, providing a comprehensive look at the causes and consequences of homelessness in California and recommending policy changes to shape programs in response. The California Statewide Study of People Experiencing Homelessness (CASPEH) used surveys and in-depth interviews to develop a clear portrait of homelessness in California, where 30% of the nation’s homeless population and half of the unsheltered population live.

The Benioff Homelessness and Housing Initiative at the University of California San Francisco, released a groundbreaking report on the characteristics and causes of homelessness in California. The study used a mixed methods approach, collecting data from more than 3,000 surveys and 365 in-depth interviews. In addition to reinforcing the existing—and alarming—trends around both an aging population and disproportionate representation of communities of color among those experiencing homelessness, there were several findings from the report that stand out.

California launched Project Roomkey during the pandemic to house thousands of homeless seniors and people with medical conditions in hotels. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, spoke on NPR about how critical it is that people in these hotels stay housed.

In the largest representative study of homelessness in California since the mid-1990s, the California Statewide Study of People Experiencing Homelessness provides policy recommendations and demystifies common misconceptions. On Inside with Vicki Gonzalez, Margot Kushel, MD, director of UCSF’s Benioff Homelessness and Housing Initiative and lead investigator spoke with the host about the study's findings. "90% of people lost their last stable housing in California. Of the 10% who did not lose their housing in California, 30% of them were born in California" said Dr. Kushel.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was quoted regarding the success of Project Roomkey, which could become a model for future efforts to aid the estimated 150,000 homeless people in California. “It’s been a tremendous success,” Dr. Kushel said. “I do think that at the end of the day, it will become clear that this is the main reason we had fewer horrendous outcomes of people who were homeless.”

In this op-ed, Margot Kushel, MD,  professor of medicine and director of the Benioff Homelessness and Housing Initiative at UCSF, calls attention for the need of federal investments in affordable housing. She outlines that the federal governments disinvestment in affordable housing has forced local governments to use general funds to provide assistance, further highlighting it will take a coordinated effort between agencies to solve the crisis. "Increased federal funding is necessary, but not sufficient. Yet without it, it will be difficult to end homelessness. This crisis is solvable. Ensuring that people have housing that they can afford – through higher income, lower rents and dedicated rental assistance, as well as access to appropriate services – is essential." Dr. Kushel 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.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, discussed how the Johnson & Johnson vaccine has been popular among homeless and low-income populations as it requires people to come in for only one shot. She said she understands the need to pause its use to probe the risks but hopes it will be cleared for use again soon. “We heard loud and clear from the community that only having to come in once is a big advantage,” she said. “But transparency and safety are important.”

California’s homeless crisis is reaching unprecedented levels. In this podcast episode of Invisible People, Margot Kushel, MD, Division Chief of the UCSF Action Research Center for Health Equity, and the UCSF Benioff Homelessness and Housing Initiative, breaks down the findings of the California Statewide Study of People Experiencing Homelessness (CASPEH). Dr. Kushel said, "We need to have a maniacal focus on creating more housing."

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, was quoted in this article about how California moved thousands of people experiencing homelessness into private hotel rooms during the COVID-19 pandemic—in an effort named “Project Roomkey”—which eventually provided temporary shelter to more than 48,000 people in hotel rooms leased by the state. Dr. Kushel said, “What you don’t see are that many, many of those folks who are out there are getting out of their tents and going to jobs.” 

In this podcast episode of In Clear Terms with AARP California, host Dr. Thyonne Gordon spoke with Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative. Dr. Gordon and Dr. Kushel talk about the state of older adult homelessness in California, and the complex interactions between health and homelessness, and potential solutions to prevent and address the issue. Dr Kushel said, "The reason so many people are homeless in California, is we do not have the housing. If you ask the question though, 'Why is this person homeless', then you can see how things like illness, including mental health or substance use, can leave you vulnerable."

California’s homelessness crisis is a homegrown problem that is deepening amid a shortage of affordable housing and emergency shelter, and it’s often the brutal conditions of living on the street that trigger behavioral health problems, such as depression and anxiety, researchers found in a comprehensive study on homelessness. The new findings show that at least 90% of adults who are experiencing homelessness in the state became homeless while living in California. “This idea that homeless people are rushing into California is just not true,” said Margot Kushel, a physician who treats homeless people, and the lead investigator of the study for the UCSF Benioff Homelessness and Housing Initiative. “There’s so much myth-making around this magnet theory that people who are homeless flock to California, but this is our own problem.”