Homelessness and Housing Initiative Turning Research into Action

Margot Kushel, MD is passionate about ending homelessness. She found her calling in the 1990s as a medical resident at Zuckerberg San Francisco General Hospital, a safety-net hospital where many of her patients were homeless. She quickly noticed something disturbing about their health. “We’d patch them up, discharge them to the street, and a few days later, they’d be back even sicker than before,” Kushel says.

It was obvious to Kushel that to heal her patients, she needed to change the system responsible for their lack of housing. In 2019, a $30 million gift established the UCSF Benioff Homelessness and Housing Initiative, which Kushel directs, giving her the opportunity to expand on the science as well as the impact of her decades-long work to end homelessness.

“There is no medicine as powerful as housing,” Kushel says. “This will not be business as usual or research in the way that many people might think of it. This initiative gives us the opportunity to work collaboratively with our community, meaning the people who are or have been homeless and people and organizations who do the hard work every day of trying to end homelessness.”

Kushel speaks from experience. Her HOPE HOME (Health Outcomes in Populations Experiencing Homelessness in Older Middle Age) project in Oakland, Calif., is the only study in the country that has been collecting health information from hundreds of older, homeless adults since 2013. Kushel works closely with a community advisory board that includes people who are homeless, policy makers, community-based organizations, and homeless-assistance program leaders.

As director of the UCSF Center for Vulnerable Populations, Kushel regularly shares the science that informs her work, often testifying before legislative bodies and educating policy makers. Her research helped guide large investments toward ending senior homelessness in the San Francisco Bay Area, and her expertise informed several bills to address senior homelessness in California that have passed or are currently being considered.

“We’ll collaborate with policy makers and people who run health systems at the local, state, and federal level to answer the questions that they haven't had the resources or the time to answer and work to translate our findings into effective policies,” Kushel says.

The initiative is creating online resources on effective strategies and programs to end homelessness that health care providers, policy makers, community members, and others across the country can access anytime and anywhere. It is providing training to people who want to go into this line of work, translating research into policies and practice. It uses rigorous but rapid research to answer questions that people from government and community-based programs have about what is effective and why.

“We think our biggest value-add is in the interface between health and housing because that's our expertise,” Kushel says. “I really hope that by working with all members of the community, we can help people understand this crisis and the path to a solution.”