2022

New policy paper outlines strategies to help address the homelessness crisis in California


A policy report co-authored by Dr. Ninez Ponce and Dr. Michael Rodriguez outlines evidence-based strategies to help address the homelessness crisis.

Tablet and computer screen with policy paper title: "Opening Doors for All: Improving Health in Housing and Homelessness"

California’s homelessness crisis is unprecedented. In early 2020, more than 160,000 people experienced homelessness on any given day, representing a 40% increase since 2015. The health effects on individuals experiencing housing insecurity have been profound, including outbreaks of hepatitis A and typhus in communities experiencing homelessness, as well as the COVID-19 pandemic, which has further impacted our health system, broader community, and economy, and exposed how public health impacts housing and homelessness.

During fall 2021, the UCLA Center for Health Policy Research (CHPR) convened a virtual event to bring together key voices — state and local legislators, academics, nonprofit organizations, advocates, health leaders, and people with lived experience — for two days of thoughtful discussions on past successes, lessons learned, barriers, and potential solutions to create a healthier, more prosperous California for all.

Focused on the intersection of health and homelessness, the 2021 E.R. Brown Symposium, Opening Doors for All: Improving Health in Housing and Homelessness, highlighted evidence-based strategies to help wrestle with this crisis at a time when state lawmakers have a significant budget surplus available to potentially invest in addressing it.

As local and state leaders consider what investments and policy levers to pull, UCLA CHPR released a policy paper -  co-authored by Dr. Ninez Ponce, professor of health policy and management and director of the UCLA Fielding School of Public Health's UCLA Center for Health Policy Research, and Dr. Michael Rodriguez, UCLA Fielding School of Public Health professor of community health sciences  - from the symposium that synthesizes key findings, barriers, and potential solutions. The paper describes the need for a well-coordinated effort among policymakers, community-based organizations, people with lived experience, health systems, and government agencies at the federal, state, and local levels to adequately address this crisis.

Some of the key takeaways of the symposium include:

  • Good health is not possible without housing. Lack of housing leads to deterioration of mental and physical health due to high stress, exposure to the elements, inadequate sanitation, lack of access to hygiene supplies, and poor nutrition.
  • Homelessness is often the result of structural issues rather than individual characteristics. The primary driver of homelessness in California is a lack of affordable housing, especially for those earning an extremely low income. Other drivers of homelessness include historical discrimination and structural racism.
  • To address the effects of structural racism, any new project should begin with a racial equity analysis to assess the potential effect on different racial and ethnic groups. Such analyses can help reduce existing inequities and avoid unintended negative consequences that affect marginalized groups.
  • People experiencing homelessness need privacy, autonomy, and safety. Small single cabins (“tiny homes”) where individuals can secure their belongings; get sleep without interruption; bring a spouse, partner, children, or pets; and be linked with services and permanent housing is a better option than a traditional group shelter.
  • Permanent supportive housing should be the goal. This model provides long-term housing coupled with intensive case management services linking individuals with medical, psychological, and other important social services.
  • Policy and program development should always involve people with lived experience. Their historical exclusion from these discussions has resulted in missed opportunities and wasted resources.

The paper also suggests that privately funded initiatives, which have more flexibility than publicly funded programs, may result in more innovation and experimentation. An excellent example is the Keep Oakland Housed campaign, which in its first two years prevented nearly 5,000 households from becoming homeless.

Addressing health and homelessness requires engagement, healing, resources, social change, leadership, and commitment across our society, starting in every community and neighborhood. Most notably, the paper notes that short-term, medium-term, and long-term efforts must be pursued at the same time.

In the short term, confidence-building measures are necessary to get partners together, foster collaboration, and generate political and public support to move forward. People experiencing homelessness must be treated with dignity and respect; they must be given a non-token role in developing programs and policy. The urgent need for additional permanent supportive housing must not only be met, but to house the most people most quickly, current qualification requirements must be modified or even eliminated.

In the medium term, policies, programs, and their implementation must be evaluated in the most impartial and transparent manner possible. Findings must be disseminated widely and quickly to catalyze action. In addition, evidence development must be treated not just as cataloging what worked where, but as an ongoing process that needs constant refinement and adaptation.

In the long term, the systematic and structural obstacles responsible for homelessness must be dismantled. Only through permanent change will we ensure adequate health care and housing be created for all.

by Tiffany Lopez


The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 761 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.

Faculty Referenced by this Article

Dr. Ninez Ponce
Ninez Ponce
Health Policy and Management
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Dr. Michael Rodriguez
Michael Rodriguez
Community Health Sciences
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Ron Andersen

Dr. Ron Andersen is the Wasserman Professor Emeritus in the UCLA Departments of Health Policy and Management.

Health Policy and Management
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Dr. Jessica Gipson
Jessica Gipson
Community Health Sciences
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Galper, Michael
Michael Galper
Health Policy and Management
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Dr. Paul Fu, Jr.
Paul Fu, Jr.
Health Policy and Management
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Pamela Davidson
Health Policy and Management
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Susan Ettner
Health Policy and Management
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Dawn Upchurch
Community Health Sciences
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Mangione, C
Carol Mangione
Health Policy and Management
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Dr. Donald Morisky
Donald E. Morisky
Community Health Sciences
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Brennan Spiegel
Health Policy and Management
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Dr. Dylan Roby
Dylan Roby
Health Policy and Management
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Yusuke Tsugawa
Yusuke Tsugawa
Health Policy and Management
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Dr. Yvonne Flores
Yvonne Flores
Health Policy and Management
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Freund, Deborah
Deborah Anne Freund
Health Policy and Management
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Dr. Arturo Vargas Bustamante
Arturo Vargas Bustamante
Health Policy and Management
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Emily Abel
Emily Abel
Health Policy and Management
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Dr. Anne Pebley
Anne Pebley
Community Health Sciences
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Barbara Berman
Health Policy and Management
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Dena Herman
Dena Herman
Community Health Sciences
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Comanor, Bill
William Comanor
Health Policy and Management
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Dr. Michael Goldstein
Michael Goldstein
Community Health Sciences
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Jody Heymann
Jody Heymann
Epidemiology Health Policy and Management
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Dr. Alice Kuo
Alice Kuo
Health Policy and Management
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Isomi Miake-Lye
Isomi Miake-Lye
Health Policy and Management
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Alan Tomines
Health Policy and Management
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Warren Scott Comulada
Warren Scott Comulada
Health Policy and Management
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Dr. Kenneth Wells
Kenneth Wells
Health Policy and Management
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Julie A. Elginer

EMPH Academic Program Director with expertise in healthcare marketing, finance, and reproductive health policy, teaching in the EMPH, MPH, MHA program

Health Policy and Management
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Dr. Chandra Ford
Chandra Ford
Community Health Sciences
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Sheba George
Community Health Sciences
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Natalie Muth
Community Health Sciences
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Dr. Shira Shafir
Shira Shafir
Community Health Sciences Epidemiology
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Dr. Stephanie Taylor
Stephanie L. Taylor

Nationally recognized health services researcher and sociomedical scientist with 25+ years' experience in effectiveness and implementation research.

Health Policy and Management
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Ilan H. Meyer
Ilan H. Meyer
Community Health Sciences
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Dr. Randall Kuhn
Randall Kuhn
Community Health Sciences
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Dr. Beth Glenn
Beth Glenn
Health Policy and Management
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Jeanne Miranda
Jeanne Miranda
Health Policy and Management
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Sean Darling-Hammond
Sean Darling-Hammond
Biostatistics Community Health Sciences
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Jack Needleman
Jack Needleman
Health Policy and Management
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Vickie Mays
Vickie Mays
Health Policy and Management
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Dr. Risha Gidwani
Risha Gidwani
Health Policy and Management
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Virginia C. Li
Virginia C. Li
Community Health Sciences
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Dr. Hiram Beltrán-Sánchez
Hiram Beltrán-Sánchez
Community Health Sciences
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Dr. Elizabeth D'Amico
Elizabeth D’Amico
Community Health Sciences
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Jean Balgrosky
Health Policy and Management
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Dr. Aria Fallah
Aria Fallah
Health Policy and Management
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Burt Cowgill
Burt Cowgill
Health Policy and Management
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Dr. Samuel Stratton
Samuel Stratton
Community Health Sciences
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Ron D. Hays
Ron D. Hays

@UCLA since 1997

Health Policy and Management
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Annette Maxwell
Health Policy and Management
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Clifford Ko
Clifford Ko
Health Policy and Management
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Sarah Blenner
Sarah Blenner

Director of Field Studies and Applied Professional Training

Community Health Sciences
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Dr. May Sudhinaraset
May Sudhinaraset
Community Health Sciences
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Gerald Kominski
Gerald Kominski
Health Policy and Management
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Corrina Moucheraud
Corrina Moucheraud
Health Policy and Management
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Bo-Kyung Elizabeth Kim
Community Health Sciences
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Dr. Lillian Gelberg
Lillian Gelberg
Health Policy and Management
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Paula Tavrow
Paula Tavrow
Community Health Sciences
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Robert Brook
Health Policy and Management
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Lori Pelliccioni
Health Policy and Management
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Olivia Jung
Olivia Jung
Health Policy and Management
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Kimberley Shoaf
Community Health Sciences
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Robert Kim-Farley
Robert J. Kim-Farley

Robert J. Kim-Farley, MD, MPH, is a Professor-in-Residence with joint appointments in the Departments of Epidemiology and Community Health Sciences

Community Health Sciences Epidemiology
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Emmeline Chuang
Health Policy and Management
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halbert, ronald
Ronald Halbert
Community Health Sciences
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Dr. Samuel Sessions
Samuel Sessions
Health Policy and Management
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Charlotte Neumann
Charlotte G. Neumann
Community Health Sciences
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Aronberg, Sandra
Sandra Aronberg
Health Policy and Management
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Kimberly Gregory
Kimberly Gregory
Community Health Sciences
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Ondine S. von Ehrenstein
Community Health Sciences Epidemiology
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James Macinko
James Macinko

Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research

Community Health Sciences Health Policy and Management
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Dr. Alina Dorian
Alina Dorian
Community Health Sciences
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Moira Inkelas
Moira Inkelas
Health Policy and Management
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Dr. Frederick Zimmerman
Frederick Zimmerman
Health Policy and Management
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Steven Teutsch
Health Policy and Management
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Dr. Judith M. Siegel
Judith M. Siegel
Community Health Sciences
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David Hayes-Bautista
Health Policy and Management
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Dr. Gilbert Gee
Gilbert C. Gee
Community Health Sciences
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Nadereh Pourat
Nadereh Pourat
Health Policy and Management
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Michelle Keller
Michelle S. Keller

Dr. Michelle S. Keller is a health services researcher whose research focuses on the use and prescribing of high-risk medications.

Health Policy and Management
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Dr. Felicia Hodge
Felicia Hodge
Health Policy and Management
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Dr. Joann Elmore
Joann G. Elmore
Health Policy and Management
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Laura Erskine
Laura Erskine
Health Policy and Management
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Sangeeta Ahluwalia
Sangeeta Ahluwalia
Health Policy and Management
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Dr. Elizabeth Yzquierdo
Elizabeth Yzquierdo
Community Health Sciences
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Avram Kaplan
Avram Kaplan
Health Policy and Management
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Kadiyala, Srikanth
Srikanth Kadiyala
Health Policy and Management
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David Eisenman
David Eisenman
Community Health Sciences
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Robert Kaplan
Robert Kaplan
Health Policy and Management
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Rosenstock
Linda Rosenstock
Environmental Health Sciences Health Policy and Management
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Thomas Priselac
Health Policy and Management
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Courtney S. Thomas Tobin
Community Health Sciences
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Philip Massey headshot
Philip Massey
Community Health Sciences
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Arlene Fink
Health Policy and Management
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Dr. Elizabeth (Becky) Yano
Elizabeth (Becky) Yano
Health Policy and Management
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Patricia Ganz
Patricia Ganz
Health Policy and Management
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Dr. Jonathan Fielding
Jonathan Fielding
Health Policy and Management
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Michael Ong
Michael Ong
Health Policy and Management
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Wendelin Slusser
Community Health Sciences
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Dr. John Lu
Z. John Lu
Health Policy and Management
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Cathy Lang
Cathy Lang

Assistant Dean for Research & Adjunct Associate Professor of Community Health Sciences

Community Health Sciences
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Dr. William McCarthy
William J. McCarthy
Health Policy and Management
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Thomas D. Gordon
Health Policy and Management
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Dr. Naomi Zewde
Naomi Zewde
Health Policy and Management
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Dr. Thomas Rice
Thomas Rice
Health Policy and Management
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Marjorie Kagawa-Singer
Marjorie Kagawa-Singer
Community Health Sciences
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Dana Hunnes
Dana Hunnes
Community Health Sciences
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Jose J. Escarce
Health Policy and Management
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May C. Wang
Community Health Sciences
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Paul Chung
Paul Chung
Health Policy and Management
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Dr. Michael Prelip
Michael Prelip
Community Health Sciences
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glik, deborah
Deborah Glik
Community Health Sciences
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Neal Halfon
Health Policy and Management
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Mark Litwin
Health Policy and Management
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Dr. Anthony Schiff
Anthony Hunter Schiff
Health Policy and Management
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Jennifer A. Wagman
Jennifer A. Wagman
Community Health Sciences
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Diana Hilberman
Diana Hilberman
Health Policy and Management
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Dr. Daniel Eisenberg
Daniel Eisenberg
Health Policy and Management
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Dr. Xi Zhu
Xi Zhu
Health Policy and Management
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Roshan Bastani
Health Policy and Management
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Dr. Jennifer Wortham
Jennifer Wortham
Health Policy and Management
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Leah Vriesman
Leah Vriesman
Health Policy and Management
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Dr. Dana Rose Garfin
Dana Rose Garfin
Community Health Sciences
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silhoette
Ty Robbins
Health Policy and Management
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Dr. Kristen Choi
Kristen Choi
Health Policy and Management
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