Our Encampment Prioritization Tool is designed to help communities navigate the complex landscape of homelessness. By balancing the urgent need to address encampments with the chronic shortage of housing and shelter resources, along with health and safety considerations, this tool guides stakeholders in making informed decisions. It ensures that actions prioritize housing and shelter placements over displacement, aligning with broader systemic reforms to effectively manage and resolve encampments.

Encampment resolution is a strategic approach focused on connecting unsheltered individuals to stable housing rather than displacing them through sweeps. This method employs evidence-based practices to connect people with housing solutions and prevent re-encampment, involving a wide range of stakeholders to address both the needs of the encampment residents and the community’s broader concerns.

This piece was originally published in Newsweek and is reprinted with permission. Over 7,000 people were displaced by the wildfires in Maui one month ago. So far, nearly 80 families ...

In this op-ed, Cheyenne Garcia, senior research analyst at the Benioff Homelessness and Housing Initiative, calls for action to end generational homelessness. She characterizes the dire need for expanded funding for necessary resources, like an increase in housing choice vouchers, to end family homelessness. "As a society, it is imperative to assume an obligation to protect children." Ms. Garcia 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.

The Home Safe program is a statewide effort to prevent and end homelessness among older adults and adults with disabilities served through Adult Protective Services (APS). Administered ...

A UCSF study found that during the COVID-19 pandemic in California, older adults, Black and Latino residents, and those without college degrees experienced the highest per capita excess mortality. The researchers suggest that this pattern reflects the risk of COVID-19 death faced by low-wage, essential workers and their social networks owing to occupational exposure, crowded housing, and inadequate access to testing or treatments.

This research letter discusses the experience of violence during homelessness, its impact on health, and recommendations for intervention. In the California Statewide Study of People Experiencing Homelessness, 38% of participants experienced violence during their current homelessness episode, and 74% of participants reported experiencing violence at some point in their lives. These results highlight the need to address violence against people experiencing homelessness through safer housing options, trauma-informed care, and long-term violence prevention strategies.

On the anniversary of the pandemic, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and other public health and infectious disease experts recall when they realized that COVID-19 was going to be trouble. Dr. Kushel said, "Pandemics thrive on inequality, on structural racism, on all the divisions that we have."

During an expert panel discussion examining COVID-19’s impact on our society and looking ahead to how we rebuild and prepare for future pandemics, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said that inequality wasn’t only exposed by the pandemic, it was a driver of it. More housing is critical to staving off future health and economic crises, said Dr. Kushel. “There’s no medicine as powerful as housing. We can't have a healthy economy with a million housing units short that we have in California for extremely low income households.”

Researchers evaluated cognitive function and factors associated with cognitive impairment in a cohort of older homeless adults. They conducted structured interviews and neuropsychological testing with participants. Older homeless adults displayed a prevalence of cognitive impairment 3–4 times higher than has been observed in general population adults aged 70 and older. Future research will be helpful in clarifying whether treatment of alcohol misuse leads to improvements in cognitive function and whether specific treatment strategies are more effective in this population.

Homelessness is dynamic; some individuals cycle between homelessness and housing. BHHI examined the prevalence of and factors associated with exits from and returns to homelessness among adults aged 50 and older. With a median 4 years of follow-up, 80% of participants exited homelessness into housing. Having a permanent rental subsidy was associated with retaining housing.

The US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity. Researchers conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. They found older homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups.

This UCSF study found that adults experiencing homelessness have a high risk of incarceration. The authors emphasize the need for targeted interventions addressing substance use, homele...

Older homeless-experienced adults are at higher risk of loneliness than general older adults, yet less is known about the factors contributing to loneliness for this group. Loneliness is associated with multiple adverse health and mental health outcomes. This study examines this gap in our knowledge.

In this long-term study of 450 homeless adults age 50 and older, BHHI researchers examined how factors like regaining housing, using drugs, and having various chronic conditions, such as diabetes, affected participants' risk of dying. They found that 26% of the participants died within a few years of being enrolled, and people who first became homeless at age 50 or older were about 60% more likely to die than those who had become homeless earlier in life, and those who remained homeless were about 80% more likely to die than those who were able to return to housing. These findings illustrate an urgent need for policy approaches to prevent and end homelessness among older adults in the United States and suggest that addressing older adults’ barriers to health care and high rates of institutionalization may prevent premature mortality.

The prevalence of substance use decreases as individuals age, but older adults now have a higher prevalence of substance use than older adults did 10 years ago. People experiencing homelessness have a higher prevalence of substance use disorders compared to the general population. In this cohort study, researchers examined the prevalence of and factors associated with substance use in a population of homeless individuals aged 50 and older. They found a high prevalence of substance use and an association between psychiatric hospitalization and depression with substance use. Researchers also recommend targeted treatment programs and geriatric substance use workforce development.

California's Project Homekey is a big step in creating needed new subsidized housing for the state’s more than 161,000 homeless residents, but homelessness policy experts, service providers, and others are only cautiously optimistic about it. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, explained that in the rush to house people quickly, there's also the risk of leaving out people who need housing the most. People who have been homeless for years will need the most help transitioning into housing. In addition, Dr. Kushel said, “It has been so hard to separate the homelessness crisis from all of the impacts of structural racism.”

Long-acting injectable antiretroviral therapy (LAI-ART) is approved for treatment-naive or experienced people with human immunodeficiency virus (HIV; PWH). The researchers performed the first LAI-ART demonstration project to include PWH unable to achieve or maintain viral suppression due to challenges adhering to oral ART at San Francisco's Ward 86. Researchers found preliminary short-term effectiveness of the treatment. More data on LAI-ART in hard-to-reach populations are needed.

People experiencing homelessness are at an increased danger of dying. A recent study by the National Bureau of Economic Research showed a 40-year-old person experiencing homelessness has a similar risk of death as a 60-year-old person with housing. Previous studies have also found that people who experience homelessness have a greater mortality risk. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "We’re letting people die because we’re not fixing the underlying crisis."

The aging of the homeless population is a stark demographic shift. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, found that unhoused people have the health profiles of patients two decades older, with similar rates of incontinence, dementia, and falls. Respite care, a temporary, short-term, 24-hour supervised care for seniors, is rapidly growing for people experiencing homelessness, reflecting the aging of the unhoused population.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, spoke about how homelessness is incompatible with health. The conditions of homelessness would leave a healthy person vulnerable to catching a disease like Covid-19. Unhoused people are already among the most sick in society, and they’re physically incapable of following the Centers for Disease Control and Prevention’s most basic virus-fighting directive: stay home. “It’s an enormous crisis superimposed on an existing crisis,” Dr. Kushel said.

There are over 1 million emergency department visits for non-life-threatening alcohol intoxication each year, many of which are people experiencing homelessness. In this op-ed, Shannon Smith-Bernardin, PhD, MSN, RN, assistant professor of nursing, answers questions about sobering centers, the utilization of sobering centers, and the health impact of sobering centers. Dr. Smith-Bernardin writes, "Sobering centers provide an opportunity for patients to build a consistent relationship with a health care professional who is specifically trained in addiction and trauma-informed care."