Homeless Skewing 50+, Many Just Need A Safe Place In Order To Get Back On Their Feet

by Richard Kuehn on 05/10/23

Burbank, CA   Dr. Joshua Bamberger from UCSF Family Community Medicine appeared at the C4A Conference : Mapping the Future of Aging and Disability in California, held here May 9-1.  He described a fascinating study of the homeless that he did right during the height of the COVID-19 pandemic.

On a panel entitled Aging in Community: The Affordable Housing Crisis That No One is Talking About, he said “March 17, 2020 I left UCSF and started surveying people in the homeless shelters in San Francisco.”  3,500 homeless adults were moved into housing, mostly using tourist hotels.  “We can house everyone if we want to.  “We’ve proven that during the COVID crisis.”  Each of the 3,500 people were given a medical assessment.  He found that most people really didn’t need anything other than a safe place to live. 

“The vast majority need a decent, permanent housing with some on site services.  About 10% need more,” he said.  He noted that when they did the survey, most of those over 50 had a diagnosis of congestive heart failure.  About 90% of those with congestive heart failure used methamphetamines.

Dr. Bamberger said that by augmenting the existing permanent housing with support services, this helped the homeless dramatically.  Also speaking on the panel was Dr. Margot Kushel, Professor of Medicine at UCSF and Division Chief for the UCSF Center for Vulnerable Populations and Director of the UCSF Benioff Homelessness & Housing Initiatives.

She noted that homelessness is a function of structural assets and the presence of a safety net.  “In California, in 2023, you do not need many vulnerabilities to become homeless.”  She noted the lack of affordable housing, income inequality and structural racism. 

“In 2023 in California we have 24 affordable housing units available and affordable for every 100 extremely low-income households.  We have 1.3 million in this group.”  She said that in San Francisco less than 5% identify as black, yet 37-38% of the homeless population in S.F. is black.  In 1990, 11% of the homeless are 50 years or older, while today 50% of homeless are 50+ (data according to the HOPE HOME Study which has been done since 2013 and is funded by the National Institutes on Aging).

Of the people 50 and older who were homeless, 44% had never been homeless before.  This is unlike the larger pool of homeless, many of whom had drug addiction or mental health issues.  Of the 50+ group, 44% had never been homeless before.

She said that the late onset homelessness looked very different.  They led very typical lives but had low-wage jobs with no pension.  These people typically had a crisis, like a marital breakdown, they or their spouse had an illness, or they had suffered through the death of a spouse or parent.  Many had been caregivers for their parent, and then lost their job and their home.

She noted that more than a quarter meet the criteria for cognitive impairment, and nearly half had problems with Activities of Daily Living (ADLs).  “50 is the new 75 for the homeless,” she concluded.