Margot B Kushel
Biographic Data
| ID | 5493587 |
|---|---|
| NAME | Margot B Kushel |
| GIVEN NAMES | Margot B |
| FAMILY NAME | Kushel |
| SIGNATURE | KUSHEL M B |
| AFFILIATIONS | Margot B. Kushel is with the Division of General Internal Medicine, University of California at San Francisco/San Francisco General Hospital, San Francisco, Calif. Sharon Perry, David Bangsberg, Richard Clark, and Andrew R. Moss are with the Department of Epidemiology and Biostatistics, University of California at San Francisco. David Bangsberg is also with the Division of Infectious Diseases, Department of Medicine, University of California at San Francisco/San Francisco General Hospital. |
| VERIFIED | No |
| TOTAL WORKS | 23 |
| TOTAL CITATIONS | 114 |
| AUTHOR COUNT | 23 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2001 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 4 |
Health Care Access and Use Among Adults Experiencing Homelessness
This cross-sectional study found that adults experiencing homelessness reported poor access to ambulatory care and a high prevalence of short-term care use, despite high rates of insurance. Changes in homelessness during the past 30 years were associated with worsened health care access and use
“We remember the pain”
Rates of homelessness among adults aged 50 and over are rising. Common strategies for exiting homelessness rely on social and family support. However, intergenerational trauma may disrupt these social support networks and contribute to homelessness. Understanding the impact of intergenerational trauma on living with family or friends may give insight into addressing homelessness among older adults. We purposefully sampled 46 adults who reported l…
Barriers and facilitators to resolving older adult homelessness through stays with family
Living with family and friends is a common strategy used to prevent or exit homelessness, but little is known about structural barriers that impede family and friends' ability to provide temporary or permanent housing for older homeless adults. We conducted semi-structured interviews with 46 homeless participants from the HOPE HOME study, a cohort of 350 community-recruited homeless adults age 50 or older in Oakland, CA, who reported having staye…
Racial discrimination in the life course of older adults experiencing homelessness
Over 2.5 million people experience homelessness yearly in the United States. Black persons are overrepresented by three-fold among those experiencing homelessness but little research has examined the relationship between race and homelessness. We aimed to understand the relationship between race and the experience of homelessness for older adults. We used grounded theory methodology to analyze in-depth qualitative interviews (n = 65) of persons e…
Food Insecurity is Associated with Poor HIV Outcomes Among Women in the United States
Smoking Behaviors in a Community-Based Cohort of HIV-Infected Indigent Adults
Opioid Analgesic Misuse is Associated with Incomplete Antiretroviral Adherence in a Cohort of HIV-Infected Indigent Adults in San Francisco
Wang et al. Respond
chronic disease; emergency health service; female; health promotion; human; male; methodology; note; primary health care; prisoner; utilization review, Chronic Disease; Emergency Service, Hospital; Female; Health Promotion; Humans; Male; Primary Health Care; Prisoners
Specific psychiatric correlates of acute care utilization among unstably housed HIV-positive adults
The role of specific psychiatric diagnoses in emergency department use and/or inpatient hospitalizations (acute care) has not been extensively examined among HIV-infected, unstably housed persons. A community-recruited sample of 284 HIV-infected, unstably housed adults completed the Diagnostic Interview Schedule for DSM-IV. One-third of participants screened positive for major depression and stimulant use disorders. Sleeping on the street [adjust…
Food Insecurity and Risky Sexual Behaviors Among Homeless and Marginally Housed HIV-Infected Individuals in San Francisco
Engaging Individuals Recently Released From Prison Into Primary Care
Objectives. Individuals released from prison have high rates of chronic conditions but minimal engagement in primary care. We compared 2 interventions designed to improve primary care engagement and reduce acute care utilization: Transitions Clinic, a primary care–based care management program with a community health worker, versus expedited primary care. Methods. We performed a randomized controlled trial from 2007 to 2009 among 200 recently rel…
Conceptual framework for understanding the bidirectional links between food insecurity and HIV/Aids
Food Insecurity Is Associated with Chronic Disease among Low-Income NHANES Participants
Food Insecurity Among Homeless and Marginally Housed Individuals Living with HIV/Aids in San Francisco
Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was m…
Association between the Level of Housing Instability, Economic Standing and Health Care Access
Introduction . To determine the relationship between housing instability, economic standing, and access to health care and use of acute care services. Methods . We performed a meta-regression using four nationally representative surveys. The independent variable was an ordered measure of economic and housing instability: 1) the general population, 2) low-income population, 3) never homeless users-of-subsistence-services, 4) unstably housed, 5) fo…
Implementation of the Medicare Part D Prescription Drug Benefit is Associated with Antiretroviral Therapy Interruptions
Food Insecurity is Associated with Diabetes Mellitus
Housing instability and food insecurity as barriers to health care among low-income americans
Public Health Care Utilization in a Cohort of Homeless Adult Applicants to a Supportive Housing Program
Revolving Doors
Objectives. We studied a sample of homeless and marginally housed adults to examine whether a history of imprisonment was associated with differences in health status, drug use, and sexual behaviors among the homeless. Methods. We interviewed 1426 community-based homeless and marginally housed adults. We used multivariate models to analyze factors associated with a history of imprisonment. Results. Almost one fourth of participants (23.1%) had a …
No Door to Lock
BACKGROUND: Homeless persons experience high rates of sexual and physical assault; homeless women are thought to be at highest risk. To determine the prevalence, distribution, and factors associated with sexual and physical assault, we surveyed homeless and marginally housed adults in San Francisco, Calif. METHODS: We interviewed 2577 respondents about their history of recent sexual and physical assault, housing history, sexual practices, substan…
Emergency Department Use Among the Homeless and Marginally Housed
Objectives. This study examined factors associated with emergency department use among homeless and marginally housed persons. Methods. Interviews were conducted with 2578 homeless and marginally housed persons, and factors associated with different patterns of emergency department use were assessed in multivariate models. Results. Findings showed that 40.4% of respondents had 1 or more emergency department encounters in the previous year; 7.9% e…
Factors Associated With the Health Care Utilization of Homeless Persons
CONTEXT: Homeless persons face numerous barriers to receiving health care and have high rates of illness and disability. Factors associated with health care utilization by homeless persons have not been explored from a national perspective. OBJECTIVE: To describe factors associated with use of and perceived barriers to receipt of health care among homeless persons. DESIGN AND SETTING: Secondary data analysis of the National Survey of Homeless Ass…
Emergency Department Use Among the Homeless and Marginally Housed
Objectives. This study examined factors associated with emergency department use among homeless and marginally housed persons. Methods. Interviews were conducted with 2578 homeless and marginally housed persons, and factors associated with different patterns of emergency department use were assessed in multivariate models. Results. Findings showed that 40.4% of respondents had 1 or more emergency department encounters in the previous year; 7.9% e…
Engaging Individuals Recently Released From Prison Into Primary Care
Objectives. Individuals released from prison have high rates of chronic conditions but minimal engagement in primary care. We compared 2 interventions designed to improve primary care engagement and reduce acute care utilization: Transitions Clinic, a primary care–based care management program with a community health worker, versus expedited primary care. Methods. We performed a randomized controlled trial from 2007 to 2009 among 200 recently rel…
Revolving Doors
Objectives. We studied a sample of homeless and marginally housed adults to examine whether a history of imprisonment was associated with differences in health status, drug use, and sexual behaviors among the homeless. Methods. We interviewed 1426 community-based homeless and marginally housed adults. We used multivariate models to analyze factors associated with a history of imprisonment. Results. Almost one fourth of participants (23.1%) had a …
Public Health Care Utilization in a Cohort of Homeless Adult Applicants to a Supportive Housing Program
Factors Associated With the Health Care Utilization of Homeless Persons
CONTEXT: Homeless persons face numerous barriers to receiving health care and have high rates of illness and disability. Factors associated with health care utilization by homeless persons have not been explored from a national perspective. OBJECTIVE: To describe factors associated with use of and perceived barriers to receipt of health care among homeless persons. DESIGN AND SETTING: Secondary data analysis of the National Survey of Homeless Ass…
Emergency Department Use Among the Homeless and Marginally Housed
Objectives. This study examined factors associated with emergency department use among homeless and marginally housed persons. Methods. Interviews were conducted with 2578 homeless and marginally housed persons, and factors associated with different patterns of emergency department use were assessed in multivariate models. Results. Findings showed that 40.4% of respondents had 1 or more emergency department encounters in the previous year; 7.9% e…
No Door to Lock
BACKGROUND: Homeless persons experience high rates of sexual and physical assault; homeless women are thought to be at highest risk. To determine the prevalence, distribution, and factors associated with sexual and physical assault, we surveyed homeless and marginally housed adults in San Francisco, Calif. METHODS: We interviewed 2577 respondents about their history of recent sexual and physical assault, housing history, sexual practices, substan…
Revolving Doors
Objectives. We studied a sample of homeless and marginally housed adults to examine whether a history of imprisonment was associated with differences in health status, drug use, and sexual behaviors among the homeless. Methods. We interviewed 1426 community-based homeless and marginally housed adults. We used multivariate models to analyze factors associated with a history of imprisonment. Results. Almost one fourth of participants (23.1%) had a …
Housing instability and food insecurity as barriers to health care among low-income americans
Public Health Care Utilization in a Cohort of Homeless Adult Applicants to a Supportive Housing Program
Food Insecurity is Associated with Diabetes Mellitus
Association between the Level of Housing Instability, Economic Standing and Health Care Access
Introduction . To determine the relationship between housing instability, economic standing, and access to health care and use of acute care services. Methods . We performed a meta-regression using four nationally representative surveys. The independent variable was an ordered measure of economic and housing instability: 1) the general population, 2) low-income population, 3) never homeless users-of-subsistence-services, 4) unstably housed, 5) fo…
Implementation of the Medicare Part D Prescription Drug Benefit is Associated with Antiretroviral Therapy Interruptions
Food Insecurity Among Homeless and Marginally Housed Individuals Living with HIV/Aids in San Francisco
Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was m…
Food Insecurity Is Associated with Chronic Disease among Low-Income NHANES Participants
Conceptual framework for understanding the bidirectional links between food insecurity and HIV/Aids
Specific psychiatric correlates of acute care utilization among unstably housed HIV-positive adults
The role of specific psychiatric diagnoses in emergency department use and/or inpatient hospitalizations (acute care) has not been extensively examined among HIV-infected, unstably housed persons. A community-recruited sample of 284 HIV-infected, unstably housed adults completed the Diagnostic Interview Schedule for DSM-IV. One-third of participants screened positive for major depression and stimulant use disorders. Sleeping on the street [adjust…
Food Insecurity and Risky Sexual Behaviors Among Homeless and Marginally Housed HIV-Infected Individuals in San Francisco
Engaging Individuals Recently Released From Prison Into Primary Care
Objectives. Individuals released from prison have high rates of chronic conditions but minimal engagement in primary care. We compared 2 interventions designed to improve primary care engagement and reduce acute care utilization: Transitions Clinic, a primary care–based care management program with a community health worker, versus expedited primary care. Methods. We performed a randomized controlled trial from 2007 to 2009 among 200 recently rel…
Smoking Behaviors in a Community-Based Cohort of HIV-Infected Indigent Adults
Opioid Analgesic Misuse is Associated with Incomplete Antiretroviral Adherence in a Cohort of HIV-Infected Indigent Adults in San Francisco
Wang et al. Respond
chronic disease; emergency health service; female; health promotion; human; male; methodology; note; primary health care; prisoner; utilization review, Chronic Disease; Emergency Service, Hospital; Female; Health Promotion; Humans; Male; Primary Health Care; Prisoners
Food Insecurity is Associated with Poor HIV Outcomes Among Women in the United States
Racial discrimination in the life course of older adults experiencing homelessness
Over 2.5 million people experience homelessness yearly in the United States. Black persons are overrepresented by three-fold among those experiencing homelessness but little research has examined the relationship between race and homelessness. We aimed to understand the relationship between race and the experience of homelessness for older adults. We used grounded theory methodology to analyze in-depth qualitative interviews (n = 65) of persons e…
Barriers and facilitators to resolving older adult homelessness through stays with family
Living with family and friends is a common strategy used to prevent or exit homelessness, but little is known about structural barriers that impede family and friends' ability to provide temporary or permanent housing for older homeless adults. We conducted semi-structured interviews with 46 homeless participants from the HOPE HOME study, a cohort of 350 community-recruited homeless adults age 50 or older in Oakland, CA, who reported having staye…
“We remember the pain”
Rates of homelessness among adults aged 50 and over are rising. Common strategies for exiting homelessness rely on social and family support. However, intergenerational trauma may disrupt these social support networks and contribute to homelessness. Understanding the impact of intergenerational trauma on living with family or friends may give insight into addressing homelessness among older adults. We purposefully sampled 46 adults who reported l…
Health Care Access and Use Among Adults Experiencing Homelessness
This cross-sectional study found that adults experiencing homelessness reported poor access to ambulatory care and a high prevalence of short-term care use, despite high rates of insurance. Changes in homelessness during the past 30 years were associated with worsened health care access and use
Medicine (23 works) · Environmental health (16 works) · Homelessness and Social Issues (16 works) · Psychiatry (14 works) · Food Security and Health in Diverse Populations (13 works) · Gerontology (11 works) · Demography (10 works) · Population (10 works) · Psychology (10 works) · Family medicine (7 works)