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Margot B. Kushel ’89, a professor of medicine at the University of California San Francisco, gave the Harvard Joint Center for Housing Studies’ 23rd John T. Dunlop Lecture on Thursday.
A leader in housing research gives the Dunlop Lecture each year. Past speakers have included lecturers specializing in architecture, urban design, and policy.
Last June, Kushel led the largest representative study of homelessness in the United States since the mid-1990s, surveying 3,200 homeless adults in California.
In her lecture, Kushel dove into the impact that homelessness has on an individual’s quality of life, highlighting the lived experiences of unhoused Californians who participated in the study.
“While it is really easy to blame people impacted by homelessness, doing so not only is not fair or right, but it also isn’t going to get us any closer to a solution,” Kushel said.
Kushel’s research identified systemic factors contributing to homelessness, indicating an overrepresentation of Black and Native American Californians in the state’s unhoused population.
Kushel and her team also found that the median monthly household income in the six months before homelessness is $960, approximately eight times lower than California’s median monthly income.
“There is no way to talk about homelessness without talking about deep, deep poverty,” Kushel said.
Kushel also assessed substance use among unhoused individuals. She found that substance use was often “a response” to homelessness rather than the cause of it.
“In fact, a third of those who use regularly only started to do so after they became homeless,” she said.
During the lecture, Kushel also presented the effects of homelessness on mental health, saying that 27 percent of unhoused individuals have been admitted to a psychiatric hospital in their lifetime.
“Homeless Californians’ mental health was extremely poor,” Kushel said. “But 44 percent had their first psychiatric hospitalization after they had become homeless.”
Kushel emphasized that resolving the homelessness crisis was a complex issue but stressed that increasing access to affordable housing is central to the solution.
“The first thing we need to do is to recognize that every single path to ending this crisis flows through housing,” Kushel said.
“You can have all the case managers and housing navigators in the world. If you’ve got nothing to navigate people to, it only gets you so far,” Kushel said in a panel after her lecture.
The panel also featured Boston Healthcare for the Homeless founder and Harvard Medical School professor James J. O’Connell and Peggy Bailey, a leader of a housing policy research center. JCHS Managing Director Chris Herbert, the moderator, asked how the nation could solve the homelessness crisis.
Panelists shared their perspectives on policy and economic approaches to addressing the housing crisis, agreeing that providing dedicated, sustained support to unhoused individuals is necessary.
“It needs not only housing, but ongoing funding,” Kushel said, “Just think about your own house, right? You’ve got to keep the roof on and all of that, but it importantly needs the services.”
The panel acknowledged that providing support at the scale that today’s homelessness crisis requires also needs reforms to healthcare and legislation.
“It is really hard. It takes a lot of funding.” Kushel said. “But the price of not doing it is simply too high.”
—Staff writer Laurel M. Shugart can be reached at laurel.shugart@thecrimson.com. Follow them on X @laurelmshugart or on Threads @laurel.shugart.
—Staff writer Olivia W. Zheng can be reached at olivia.zheng@thecrimson.com. Follow her on X @oliviawzg.
