Studying Homelessness: Using Research to Impact Social Determinants of Health by Margot Kushel, MD

As I was starting my research fellowship, I was given the advice to consider studying the thing that drove me the most crazy. The thing that seemed most profoundly broken was the way we cared for homeless patients. An estimated 10% of Americans living in poverty experience homelessness every year. At SFGH we took care of many homeless people: and what we were doing wasn’t working. This decision led to an immensely satisfying career trying to understand how homelessness affects health and health care outcomes—and designing interventions to decrease homelessness and improve health related outcomes.

Margot Kushel presenting "Studying Homelessness: Using Research to Impact Social Determinants of Health".

To do policy relevant work it is important to be knowledgeable about policy discussions that are taking place in the public sphere. If we are going to contribute thoughtfully to the public dialogue, we need understand that dialogue and engage with it. I believe this is true in every academic setting—but it is more true here. Because we are a public institution, we have an extra responsibility to the public—to use our expertise to try to inform the public dialogue around key issues that affect health. There is a conversation in the blogosphere about whether readmission penalties should be decided by data that has been adjusted for SES. I agree—I agree that hospitals should not be penalized for taking care of the poorest and most vulnerable around us. But—I also believe that we can’t stop with adjusting. Because adjusting for SES will never be enough. We need to actually do something about it—to talk about the conditions that breed poverty and to try to find solutions: solutions that support health.

We have a responsibility to understand and help design solutions for those things that fall just outside of medicine, but influence health so directly. I have been so lucky to work at UCSF—to work at a place where so many people are trying to solve the puzzle of improving health. And I have been so lucky to have been allowed to follow my own passions, to work on what interests me.

[johng]

Thanks in a million! Very well explained. This is the nth time that I am watching this again. Great content. Awesome. I couldn't find this explanation--simply put anywhere else. “Great teachers are hard to find”. Grade: A++ 💥

[d-mt]

Wow, finally found one video of yours that will allow comment posting. Thanks for all your homework on the homeless. I am curious how many are import vs. natives. Or did the population that came from outside of CA? I been in CA for 55 years. The homeless went from none exist to everywhere. I also believe CA is making huge money in the name of "helping" homeless, where in reality, they were helping themself, enrich themself, gain political power, etc.

[HomelessEntrepreneur]

Great to listen to others working hard to help homeless people improve their lives. Andrew Funk #HomelessEntrepreneur

[tirth]

Hello, By any chance can I get the research link to the 1999 Study mentioned in the talk? I am currently writing one paper and It would be helpful to me. Thank you!