Response to Homelessness: Hot or Cold?

In January, NCH released a report on Winter Services that detailed extended shelter hours and other services that work to decrease the risk of hypothermia deaths among people who are homeless. Hypothermia refers to the life-threatening conditions that can occur when a person’s core temperature drops below 95 degrees Fahrenheit.

HypERthermia is just the opposite referring to a myriad of conditions that can occur as a result of a person absorbing or producing more heat that the body can dissipate. Just as with hypothermia, people most at risk of hyperthermia are the young and elderly, those who have persistent medical conditions, and those exposed to extreme environmental conditions.

NCH’s Winter Services report found that 700 people experiencing or at-risk of homelessness are killed from hypothermia annually in the United States. A similar report from the Center for Disease Control (CDC) that looked at data from 1999 to 2003 found that on average 688 deaths each year were due to hyperthermia. While the CDC report does not mention the housing status of those who passed away due to heat-related illnesses, we can relate the risks to people who are homeless (my comments in italics) to the CDC’s recommendations for preventing hyperthermia:

Suggestion #1: Drink more fluids, regardless of your activity level.

Many people who are homeless do not have ready access to water. Restaurants will charge, soup kitchens may only be open at certain times during the day, there are fewer and fewer publicly accessible water fountains, can you imagine not having a refrigerator full of cold water or even a sink for tap water?

Suggestion #2: Don’t drink liquids that contain alcohol or large amounts of sugar.

Sodas can be cheaper than bottled water! People who are suffering from alcohol dependence are at particular risk for temperature-related illness.

Suggestion #3: Stay indoors and, if at all possible, stay in an air-conditioned place. If your home does not have air conditioning, go to the shopping mall or public library.

There are few day centers available for people experiencing homelessness, and often, people who “look” homeless (have lots of bags or who have not been able to shower or do laundry) are turned away from establishments like libraries and restaurants.

Suggestion #4: Electric fans may provide comfort, but when the temperature is in the high 90s, taking a cool shower or bath, or moving to an air-conditioned place is a much better way to cool off.

Electric fans (anything other than a small battery-operating or hand fan), taking a shower or air-conditioning are simply not options when you have no home.

Suggestion #5: Wear lightweight, light-colored, loose-fitting clothing.

Type of clothing is often not an option when you cannot pay for appropriate pieces or do not have somewhere secure to store clothing.

Some communities have stepped up efforts to prevent the risk of hyperthermia among people experiencing homelessness: the Arizona Department of Health Services published a guide on where to find cooling centers; a Columbia, South Carolina shelter has extended weekend hours to provide a cool refuge during the hot summer months; and DC opens cooling centers and emergency shower locations (though I’ve only heard from a couple of people who know about these).

But it seems that the level of response to heat emergencies is not matched even to the number of cold-weather emergency services available to people who are experiencing homelessness. Are we wrong about this? Does your community (homeless services or health departments) have cooling centers or make other extra efforts to ensure the homeless population has refuge from the summer heat? Let us know!

Other resources:
Change.org Post May 30, 2010 – How to Help the Homeless Beat the Heat
Health Care for the Homeless Council Hyperthermia factsheet

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