Margot Kushel, MD
1001 Potrero Ave, SFGH 10
San Francisco, CA 94110
Margot Kushel, MD is a Professor of Medicine in the Division of General Internal Medicine at the Zuckerberg San Francisco General Hospital and Trauma Center and a core faculty member in UCSF's Center for Vulnerable Population. Margot's research interests include the health and health care utilization patterns of homeless adults and other vulnerable populations and the development and evaluation of novel interventions designed to improve outcomes in individuals who seek care in the safety net. She is the PI of a NIA funded R01 to study the causes and consequences of geriatric conditions in older homeless adults and the Co-PI (with Kelly Knight PhD) of a related study examining how families can be involved in efforts to rehouse older homeless adults. She is a co-investigator on an R-01 award from NIDA (Kelly Knight, PhD PI) to study how pain is experienced by patients and managed by clinicians in safety net settings. Dr. Kushel is the co-Director of the UCSF Primary Care Research Fellowship (for which she is the site director of SFGH-based DGIM fellows). She maintains an active clinical practice in SFGH General Medical Clinic and attends on the inpatient medicine service at SFGH.
Recent Articles (81)
- Whittle HJ, Palar K, Ranadive NA, Turan JM, Kushel M, Weiser SD. "The land of the sick and the land of the healthy": Disability, bureaucracy, and stigma among people living with poverty and chronic illness in the United States. Soc Sci Med. 2017 Aug 26; 190:181-189.
- Hurstak E, Johnson JK, Tieu L, Guzman D, Ponath C, Lee CT, Jamora CW, Kushel M. Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study. Drug Alcohol Depend. 2017 Jul 04; 178:562-570.
- Knight KR, Kushel M, Chang JS, Zamora K, Ceasar R, Hurstak E, Miaskowski C. Opioid pharmacovigilance: A clinical-social history of the changes in opioid prescribing for patients with co-occurring chronic non-cancer pain and substance use. Soc Sci Med. 2017 Aug; 186:87-95.
- Landefeld JC, Miaskowski C, Tieu L, Ponath C, Lee CT, Guzman D, Kushel M. Characteristics and Factors Associated with Pain in Older Homeless Individuals: Results from the HOPE HOME Study. J Pain. 2017 Apr 12.
- Hurstak EE, Kushel M, Chang J, Ceasar R, Zamora K, Miaskowski C, Knight K. The risks of opioid treatment: Perspectives of primary care practitioners and patients from safety-net clinics. Subst Abus. 2017 Apr 10; 1-9.
- Kertesz SG, Baggett TP, O'Connell JJ, Buck DS, Kushel MB. Permanent Supportive Housing for Homeless People - Reframing the Debate. N Engl J Med. 2016 Dec; 375(22):2115-2117.
- Spinelli MA, Ponath C, Tieu L, Hurstak EE, Guzman D, Kushel M. Factors associated with substance use in older homeless adults: Results from the HOPE HOME Study. Subst Abus. 2016 Nov 29; 0.
- Raven MC, Guzman D, Chen AH, Kornak J, Kushel M. Out-of-Network Emergency Department Use among Managed Medicaid Beneficiaries. Health Serv Res. 2016 Nov 11.
- Chang JS, Kushel M, Miaskowski C, Ceasar R, Zamora K, Hurstak E, Knight KR. Provider Experiences With the Identification, Management, and Treatment of Co-occurring Chronic Noncancer Pain and Substance Use in the Safety Net. Subst Use Misuse. 2016 Oct 18; 1-5.
- Vijayaraghavan M, Schroeder SA, Kushel M. The effectiveness of tobacco control policies on vulnerable populations in the USA: a review. Postgrad Med J. 2016 Sep 22.
- Lee CM, Mangurian C, Tieu L, Ponath C, Guzman D, Kushel M. Childhood Adversities Associated with Poor Adult Mental Health Outcomes in Older Homeless Adults: Results From the HOPE HOME Study. Am J Geriatr Psychiatry. 2016 Aug 17.
- Raven MC, Tieu L, Lee CT, Ponath C, Guzman D, Kushel M. Emergency Department Use in a Cohort of Older Homeless Adults: Results from the HOPE HOME Study. Acad Emerg Med. 2016 Aug 13.
- Raven MC, Kushel M, Ko MJ, Penko J, Bindman AB. The Effectiveness of Emergency Department Visit Reduction Programs: A Systematic Review. Ann Emerg Med. 2016 Jun 7.
- Kushel M. Things Fall Apart: Preventing High Readmission Rates Among Homeless Adults. J Gen Intern Med. 2016 May 16.
- Brown RT, Goodman L, Guzman D, Tieu L, Ponath C, Kushel MB. Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study. PLoS One. 2016; 11(5):e0155065.
- Brown RT, Hemati K, Riley ED, Lee CT, Ponath C, Tieu L, Guzman D, Kushel MB. Geriatric Conditions in a Population-Based Sample of Older Homeless Adults. Gerontologist. 2016 Feb 26.
- Vijayaraghavan M, Tieu L, Ponath C, Guzman D, Kushel M. Tobacco cessation behaviors among older homeless adults: Results from the HOPE HOME Study. Nicotine Tob Res. 2016 Feb 26.
- Lee CT, Guzman D, Ponath C, Tieu L, Riley E, Kushel M. Residential patterns in older homeless adults: Results of a cluster analysis. Soc Sci Med. 2016 Mar; 153:131-40.
- Ceasar R, Chang J, Zamora K, Hurstak E, Kushel M, Miaskowski C, Knight K. Primary care providers' experiences with urine toxicology tests to manage prescription opioid misuse and substance use among chronic noncancer pain patients in safety net health care settings. Subst Abus. 2016 Jan-Mar; 37(1):154-60.
- Chodos AH, Kushel MB, Greysen SR, Guzman D, Kessell ER, Sarkar U, Goldman LE, Critchfield JM, Pierluissi E. Hospitalization-Associated Disability in Adults Admitted to a Safety-Net Hospital. J Gen Intern Med. 2015 Dec; 30(12):1765-72.
- Chan B, Goldman LE, Sarkar U, Schneidermann M, Kessell E, Guzman D, Critchfield J, Kushel M. The Effect of a Care Transition Intervention on the Patient Experience of Older Multi-Lingual Adults in the Safety Net: Results of a Randomized Controlled Trial. J Gen Intern Med. 2015 Dec; 30(12):1788-94.
- Palar K, Kushel M, Frongillo EA, Riley ED, Grede N, Bangsberg D, Weiser SD. Food Insecurity is Longitudinally Associated with Depressive Symptoms Among Homeless and Marginally-Housed Individuals Living with HIV. AIDS Behav. 2015 Aug; 19(8):1527-34.
- Kushel M. The First Step is the Hardest: Overcoming Barriers to Primary Care. J Gen Intern Med. 2015 Jul; 30(7):868-9.
- Brown RT, Pierluissi E, Guzman D, Kessell ER, Goldman LE, Sarkar U, Schneidermann M, Critchfield JM, Kushel MB. Functional disability in late-middle-aged and older adults admitted to a safety-net hospital. J Am Geriatr Soc. 2014 Nov; 62(11):2056-63.
- Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet. 2014 Oct 25; 384(9953):1529-40.
- Goldman LE, Sarkar U, Kessell E, Guzman D, Schneidermann M, Pierluissi E, Walter B, Vittinghoff E, Critchfield J, Kushel M. Support from hospital to home for elders: a randomized trial. Ann Intern Med. 2014 Oct 7; 161(7):472-81.
- Kushel M. Improving care for hospitalized, opioid-dependent patients: a promising start. JAMA Intern Med. 2014 Aug; 174(8):1377-8.
- Vijayaraghavan M, Freitas D, Bangsberg DR, Miaskowski C, Kushel MB. Non-medical use of non-opioid psychotherapeutic medications in a community-based cohort of HIV-infected indigent adults. Drug Alcohol Depend. 2014 Oct 1; 143:263-7.
- Jeevanjee S, Penko J, Guzman D, Miaskowski C, Bangsberg DR, Kushel MB. Opioid analgesic misuse is associated with incomplete antiretroviral adherence in a cohort of HIV-infected indigent adults in San Francisco. AIDS Behav. 2014 Jul; 18(7):1352-8.
- Greysen SR, Hoi-Cheung D, Garcia V, Kessell E, Sarkar U, Goldman L, Schneidermann M, Critchfield J, Pierluissi E, Kushel M. "Missing pieces"--functional, social, and environmental barriers to recovery for vulnerable older adults transitioning from hospital to home. J Am Geriatr Soc. 2014 Aug; 62(8):1556-61.
- Vijayaraghavan M, Penko J, Vittinghoff E, Bangsberg DR, Miaskowski C, Kushel MB. Smoking behaviors in a community-based cohort of HIV-infected indigent adults. AIDS Behav. 2014 Mar; 18(3):535-43.
- Weiser SD, Yuan C, Guzman D, Frongillo EA, Riley ED, Bangsberg DR, Kushel MB. Food insecurity and HIV clinical outcomes in a longitudinal study of urban homeless and marginally housed HIV-infected individuals. AIDS. 2013 Nov 28; 27(18):2953-8.
- Vogenthaler NS, Kushel MB, Hadley C, Frongillo EA, Riley ED, Bangsberg DR, Weiser SD. Food insecurity and risky sexual behaviors among homeless and marginally housed HIV-infected individuals in San Francisco. AIDS Behav. 2013 Jun; 17(5):1688-93.
- Vijayaraghavan M, Kushel MB, Vittinghoff E, Kertesz S, Jacobs D, Lewis CE, Sidney S, Bibbins-Domingo K. Housing instability and incident hypertension in the CARDIA cohort. J Urban Health. 2013 Jun; 90(3):427-41.
- Wang EA, Hong CS, Shavat S, Kessell ER, Sanders R, Kushel MB. Wang et al. Respond. Am J Public Health. 2013 Jun; 103(6):e6-7.
- Vijayaraghavan M, Penko J, Bangsberg DR, Miaskowski C, Kushel MB. Opioid analgesic misuse in a community-based cohort of HIV-infected indigent adults. JAMA Intern Med. 2013 Feb 11; 173(3):235-7.
- Weiser SD, Hatcher A, Frongillo EA, Guzman D, Riley ED, Bangsberg DR, Kushel MB. Food insecurity is associated with greater acute care utilization among HIV-infected homeless and marginally housed individuals in San Francisco. J Gen Intern Med. 2013 Jan; 28(1):91-8.
- Vijayaraghavan M, Penko J, Guzman D, Miaskowski C, Kushel MB. Primary care providers' views on chronic pain management among high-risk patients in safety net settings. Pain Med. 2012 Sep; 13(9):1141-8.
- Wang EA, Hong CS, Shavit S, Sanders R, Kessell E, Kushel MB. Engaging individuals recently released from prison into primary care: a randomized trial. Am J Public Health. 2012 Sep; 102(9):e22-9.
- Penko J, Mattson J, Miaskowski C, Kushel M. Do patients know they are on pain medication agreements? Results from a sample of high-risk patients on chronic opioid therapy. Pain Med. 2012 Sep; 13(9):1174-80.
- Chartier M, Carrico AW, Weiser SD, Kushel MB, Riley ED. Specific psychiatric correlates of acute care utilization among unstably housed HIV-positive adults. AIDS Care. 2012; 24(12):1514-8.
- Kushel M. Older homeless adults: can we do more? J Gen Intern Med. 2012 Jan; 27(1):5-6.
- Weiser SD, Young SL, Cohen CR, Kushel MB, Tsai AC, Tien PC, Hatcher AM, Frongillo EA, Bangsberg DR. Conceptual framework for understanding the bidirectional links between food insecurity and HIV/AIDS. Am J Clin Nutr. 2011 Dec; 94(6):1729S-1739S.
- Straus SG, Chen AH, Yee H, Kushel MB, Bell DS. Implementation of an electronic referral system for outpatient specialty care. AMIA Annu Symp Proc. 2011; 2011:1337-46.
- Miaskowski C, Penko JM, Guzman D, Mattson JE, Bangsberg DR, Kushel MB. Occurrence and characteristics of chronic pain in a community-based cohort of indigent adults living with HIV infection. J Pain. 2011 Sep; 12(9):1004-16.
- Hansen L, Penko J, Guzman D, Bangsberg DR, Miaskowski C, Kushel MB. Aberrant behaviors with prescription opioids and problem drug use history in a community-based cohort of HIV-infected individuals. J Pain Symptom Manage. 2011 Dec; 42(6):893-902.
- Vijayaraghavan M, Penko J, Guzman D, Miaskowski C, Kushel MB. Primary care providers’ judgments of opioid analgesic misuse in a community-based cohort of HIV-infected indigent adults. J Gen Intern Med. 2011 Apr; 26(4):412-8.
- Moskowitz D, Thom DH, Guzman D, Penko J, Miaskowski C, Kushel M. Is primary care providers' trust in socially marginalized patients affected by race? J Gen Intern Med. 2011 Aug; 26(8):846-51.
- Thom DH, Wong ST, Guzman D, Wu A, Penko J, Miaskowski C, Kushel M. Physician trust in the patient: development and validation of a new measure. Ann Fam Med. 2011 Mar-Apr; 9(2):148-54.
- Tsai AC, Weiser SD, Petersen ML, Ragland K, Kushel MB, Bangsberg DR. A marginal structural model to estimate the causal effect of antidepressant medication treatment on viral suppression among homeless and marginally housed persons with HIV. Arch Gen Psychiatry. 2010 Dec; 67(12):1282-90.
- Brown RT, Kimes RV, Guzman D, Kushel M. Health care access and utilization in older versus younger homeless adults. J Health Care Poor Underserved. 2010 Aug; 21(3):1060-70.
- Williams BA, McGuire J, Lindsay RG, Baillargeon J, Cenzer IS, Lee SJ, Kushel M. Coming home: health status and homelessness risk of older pre-release prisoners. J Gen Intern Med. 2010 Oct; 25(10):1038-44.
- Althoff KN, Gange SJ, Klein MB, Brooks JT, Hogg RS, Bosch RJ, Horberg MA, Saag MS, Kitahata MM, Justice AC, Gebo KA, Eron JJ, Rourke SB, Gill MJ, Rodriguez B, Sterling TR, Calzavara LM, Deeks SG, Martin JN, Rachlis AR, Napravnik S, Jacobson LP, Kirk GD, Collier AC, Benson CA, Silverberg MJ, Kushel M, Goedert JJ, McKaig RG, Van Rompaey SE, Zhang J, Moore RD. Late presentation for human immunodeficiency virus care in the United States and Canada. Clin Infect Dis. 2010 Jun 1; 50(11):1512-20.
- Kim-Hwang JE, Chen AH, Bell DS, Guzman D, Yee HF, Kushel MB. Evaluating electronic referrals for specialty care at a public hospital. J Gen Intern Med. 2010 Oct; 25(10):1123-8.
- Chen AH, Kushel MB, Grumbach K, Yee HF. Practice profile. A safety-net system gains efficiencies through 'eReferrals' to specialists. Health Aff (Millwood). 2010 May; 29(5):969-71.
- Wang EA, Hong CS, Samuels L, Shavit S, Sanders R, Kushel M. Transitions clinic: creating a community-based model of health care for recently released California prisoners. Public Health Rep. 2010 Mar-Apr; 125(2):171-7.
- Seligman HK, Laraia BA, Kushel MB. Food insecurity is associated with chronic disease among low-income NHANES participants. J Nutr. 2010 Feb; 140(2):304-10.
- Deeks SG, Gange SJ, Kitahata MM, Saag MS, Justice AC, Hogg RS, Eron JJ, Brooks JT, Rourke SB, Gill MJ, Bosch RJ, Benson CA, Collier AC, Martin JN, Klein MB, Jacobson LP, Rodriguez B, Sterling TR, Kirk GD, Napravnik S, Rachlis AR, Calzavara LM, Horberg MA, Silverberg MJ, Gebo KA, Kushel MB, Goedert JJ, McKaig RG, Moore RD. Trends in multidrug treatment failure and subsequent mortality among antiretroviral therapy-experienced patients with HIV infection in North America. Clin Infect Dis. 2009 Nov 15; 49(10):1582-90.
- Sewell JL, Kushel MB, Inadomi JM, Yee HF. Non-English speakers attend gastroenterology clinic appointments at higher rates than English speakers in a vulnerable patient population. J Clin Gastroenterol. 2009 Aug; 43(7):652-60.
- Weiser SD, Bangsberg DR, Kegeles S, Ragland K, Kushel MB, Frongillo EA. Food insecurity among homeless and marginally housed individuals living with HIV/AIDS in San Francisco. AIDS Behav. 2009 Oct; 13(5):841-8.
- Kim Y, Chen AH, Keith E, Yee HF, Kushel MB. Not perfect, but better: primary care providers' experiences with electronic referrals in a safety net health system. J Gen Intern Med. 2009 May; 24(5):614-9.
- Yen IH, Hammond WP, Kushel MB. From homeless to hopeless and healthless?: the health impacts of housing challenges among former foster care youth transitioning to adulthood in California. Issues Compr Pediatr Nurs. 2009; 32(2):77-93.
- Reid KW, Vittinghoff E, Kushel MB. Association between the level of housing instability, economic standing and health care access: a meta-regression. J Health Care Poor Underserved. 2008 Nov; 19(4):1212-28.
- Das-Douglas M, Riley ED, Ragland K, Guzman D, Clark R, Kushel MB, Bangsberg DR. Implementation of the Medicare Part D prescription drug benefit is associated with antiretroviral therapy interruptions. AIDS Behav. 2009 Feb; 13(1):1-9.
- Ma CT, Gee L, Kushel MB. Associations between housing instability and food insecurity with health care access in low-income children. Ambul Pediatr. 2008 Jan-Feb; 8(1):50-7.
- Kushel MB, Yen IH, Gee L, Courtney ME. Homelessness and health care access after emancipation: results from the Midwest Evaluation of Adult Functioning of Former Foster Youth. Arch Pediatr Adolesc Med. 2007 Oct; 161(10):986-93.
- Seligman HK, Bindman AB, Vittinghoff E, Kanaya AM, Kushel MB. Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002. J Gen Intern Med. 2007 Jul; 22(7):1018-23.
- Adams J, Rosenheck R, Gee L, Seibyl CL, Kushel M. Hospitalized younger: a comparison of a national sample of homeless and housed inpatient veterans. J Health Care Poor Underserved. 2007 Feb; 18(1):173-84.
- Kushel MB, Miaskowski C. End-of-life care for homeless patients: "she says she is there to help me in any situation". JAMA. 2006 Dec 27; 296(24):2959-66.
- Kessell ER, Bhatia R, Bamberger JD, Kushel MB. Public health care utilization in a cohort of homeless adult applicants to a supportive housing program. J Urban Health. 2006 Sep; 83(5):860-73.
- Hahn JA, Kushel MB, Bangsberg DR, Riley E, Moss AR. BRIEF REPORT: the aging of the homeless population: fourteen-year trends in San Francisco. J Gen Intern Med. 2006 Jul; 21(7):775-8.
- Kushel MB, Colfax G, Ragland K, Heineman A, Palacio H, Bangsberg DR. Case management is associated with improved antiretroviral adherence and CD4+ cell counts in homeless and marginally housed individuals with HIV infection. Clin Infect Dis. 2006 Jul 15; 43(2):234-42.
- Kushel MB, Gupta R, Gee L, Haas JS. Housing instability and food insecurity as barriers to health care among low-income Americans. J Gen Intern Med. 2006 Jan; 21(1):71-7.
- Bhandari VK, Kushel M, Price L, Schillinger D. Racial disparities in outcomes of inpatient stroke rehabilitation. Arch Phys Med Rehabil. 2005 Nov; 86(11):2081-6.
- Kushel MB, Hahn JA, Evans JL, Bangsberg DR, Moss AR. Revolving doors: imprisonment among the homeless and marginally housed population. Am J Public Health. 2005 Oct; 95(10):1747-52.
- Tsai M, Weintraub R, Gee L, Kushel M. Identifying homelessness at an urban public hospital: a moving target? J Health Care Poor Underserved. 2005 May; 16(2):297-307.
- Walley AY, White MC, Kushel MB, Song YS, Tulsky JP. Knowledge of and interest in hepatitis C treatment at a methadone clinic. J Subst Abuse Treat. 2005 Mar; 28(2):181-7.
- Kushel M, Bindman AB. Health care lobbying: time to make patients the special interest. Am J Med. 2004 Apr 1; 116(7):496-7.
- Kushel MB, Evans JL, Perry S, Robertson MJ, Moss AR. No door to lock: victimization among homeless and marginally housed persons. Arch Intern Med. 2003 Nov 10; 163(20):2492-9.
- Kushel MB, Perry S, Bangsberg D, Clark R, Moss AR. Emergency department use among the homeless and marginally housed: results from a community-based study. Am J Public Health. 2002 May; 92(5):778-84.
- Kushel MB, Vittinghoff E, Haas JS. Factors associated with the health care utilization of homeless persons. JAMA. 2001 Jan 10; 285(2):200-6.