Hot weather and homelessness – preventing deaths in summer
As the weather heats up, health risks increase for vulnerable people. With a Public Health England Heat Health Alert issued this week, how can we help to keep people safe?
While for many people this week’s high temperatures are a cause for celebration, Public Health England (PHE) are raising awareness of the risks to health this weather brings. Temperatures around 25°C and over are associated with excess summer deaths, and the Heatwave Plan for England warns that: “in contrast to deaths associated with cold snaps in winter, the rise in mortality as a result of very warm weather follows very sharply – within one or two days of the temperature rising.” As a result, being prepared and acting early are key to protecting people’s health.
Deaths may be from underlying illnesses made worse by heat – primarily lung and heart diseases – or from heat specific conditions, such as heat exhaustion and heatstroke. Mental ill health may also worsen during hot weather.
The high risk factors and vulnerabilities associated with homelessness are set out in Making the Case: the impact of heat on heath – now and in the future: “homeless people (those who sleep in shelters as well as outdoors) may be at increased risk from heatwaves. Higher rates of chronic disease (often poorly controlled), smoking, respiratory conditions, substance dependencies and mental illness are more frequent in homeless populations than in the general population. These risk factors increase the risks of heat related morbidity and mortality, on top of social isolation, lack of air conditioning, cognitive impairment, living alone and being exposed to urban heat islands.” These risk factors vary significantly between people experiencing homelessness and between places, but they can all increase the risks to health from heat.
For people sleeping on the streets, it can be a challenge to find drinking water, cool showers and cool spaces. Without safe storage, people are often wearing extra layers or carrying heavy bags all day. It isn’t only people sleeping rough who are affected – in some shelter and hostel buildings, temperatures don’t drop to comfortable levels at night. And whether housed or not, people may be drinking more alcohol during longer daylight hours, increasing their risk of dehydration.
Heat and COVID-19
In addition to established risks, PHE warn that “COVID-19 amplifies the risk of hot weather… People at risk from high temperatures may also be vulnerable to COVID-19 infection, and vice versa.” The impact of coronavirus restrictions may also pose new problems. People are likely to be spending more time indoors in small, hot rooms and, when outside, access to drinking water and air-conditioned public buildings has been restricted. Patterns of begging and street giving have changed, while building-based services cannot welcome as many people indoors during the heat of the day. Social distancing and hygiene measures might be compromised if people share bottles of water or gather together to stay in the shade.
Taking action to save lives
Despite the complex issues at play, there are simple actions that we can take to help reduce deaths in hot weather.
Homelessness charities can:
- Sign up for Met Office heat health alerts
- Raise awareness of heat risks among staff and the people you support e.g. download PHE’s Beat the Heat poster
- Inform staff of the signs and symptoms of heat exhaustion and heatstroke, and what to do if someone is suffering from them
- Use this heatwave checklist for residential settings
- Speak to your local authority public health, housing and emergency planning teams about coordinating heatwave responses
- Review your local plan in light of COVID-19 restrictions, prioritising vulnerable people
- Increase access to cool or shady spaces, indoors and outdoors, and talk to the local authority and other organisations about how they can create more cool accessible spaces
- Provide drinking water, refillable water bottles, sunscreen and summer clothing, including hats and sunglasses – ask local businesses and supporters for donations
- Arrange for safe storage of winter coats and heavy bags
- Map drinking water, public toilets and air conditioned public buildings in your local area for people out during the day
Members of the public
If you want to help someone who is on the street:
- Check if they are happy to accept items such as water, sunscreen, food etc – there may be a risk of coronavirus transmission from direct giving.
- Ask a nearby café if they will let you ‘pay it forward’, purchasing items for the person to collect.
- Help the person to send a StreetLink alert or find a local support service if they are in need of essential provision.
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