Weather Exposure and Health Impacts

One of the most immediate and life-threatening challenges of homelessness is exposure to weather conditions. Without the protection of stable housing, people experiencing homelessness face direct exposure to extreme heat, freezing cold, rain, snow, and other environmental conditions that can have severe—and sometimes fatal—health consequences.

Cold Weather Exposure

Cold weather presents particularly acute risks for people without adequate shelter:

Hypothermia

• Hypothermia can occur at temperatures well above freezing, especially with wind, rain, or wet clothing
• Core body temperature below 95°F (35°C) can lead to organ failure and death
• Early symptoms include shivering, confusion, and loss of coordination
• People with certain health conditions, those who are malnourished, or those using substances face heightened risk

Frostbite

• Freezing of skin and underlying tissues, particularly in extremities (fingers, toes, nose, ears)
• Can occur within minutes in extreme cold, especially with wind exposure
• May lead to permanent tissue damage, infection, and in severe cases, amputation
• Often affects feet due to wet footwear and limited ability to change socks

Trench Foot

• Non-freezing cold injury caused by prolonged exposure to cold, wet conditions
• Feet become red, swollen, and painful, potentially leading to tissue death
• Common among people who cannot keep feet dry or change into dry socks
• Can lead to long-term nerve damage and chronic pain

Protective Strategies Against Cold

People experiencing homelessness develop various strategies to protect against cold:

• Layering: Wearing multiple layers of clothing, often all possessions at once
• Improvised insulation: Using newspapers, cardboard, or plastic bags for additional warmth
• Seeking heat sources: Staying near building exhaust vents, steam grates, or other heat sources
• Creating windbreaks: Using tarps, cardboard, or other materials to block wind
• Burning materials: Sometimes resorting to dangerous warming fires

These strategies, while necessary for survival, often provide inadequate protection and can create additional risks, such as burns or carbon monoxide poisoning from improvised heating methods.

Heat Exposure

While cold weather risks often receive more attention, extreme heat can be equally or more dangerous:

Heat-Related Illnesses

• Heat exhaustion: Characterized by heavy sweating, weakness, dizziness, and nausea
• Heat stroke: A life-threatening condition where body temperature rises above 103°F (39.4°C), potentially causing brain damage or death
• Heat cramps: Painful muscle spasms, often in legs and abdomen
• Heat rash: Skin irritation from excessive sweating in hot, humid weather

Dehydration

• Limited access to clean drinking water
• Increased fluid needs during hot weather
• Reluctance to drink due to limited bathroom access
• Can lead to kidney problems, seizures, and life-threatening complications

Sunburn and Sun Damage

• Prolonged sun exposure without adequate protection
• Limited access to sunscreen
• Increased risk of skin cancer and premature aging
• Sunburn can exacerbate dehydration and heat-related illnesses

Protective Strategies Against Heat

People experiencing homelessness employ various strategies to cope with extreme heat:

• Seeking shade: Finding trees, awnings, or other shaded areas
• Accessing air conditioning: Using libraries, malls, or other public buildings during open hours
• Water sources: Staying near public fountains, parks with water features, or other water sources
• Limiting activity: Reducing physical exertion during the hottest parts of the day
• Improvised cooling: Using wet cloths or found items to create cooling methods

These strategies are often limited by restricted access to public spaces, limited operating hours of cooling centers, and the need to carry belongings throughout the day.

Rain and Moisture Exposure

Prolonged exposure to rain and moisture creates numerous health challenges:

Immediate Impacts

• Wet clothing and belongings: Difficulty drying possessions
• Increased cold risk: Wet conditions dramatically increase hypothermia risk, even in moderate temperatures
• Displacement: Rain often forces people to leave relatively safe sleeping locations
• Loss of belongings: Important documents, medications, and other items can be damaged or destroyed

Skin and Foot Conditions

• Maceration: Softening and breakdown of skin from prolonged moisture exposure
• Fungal infections: Athlete's foot, ringworm, and other fungal conditions
• Bacterial infections: Cellulitis and other skin infections from compromised skin barriers
• Immersion foot syndromes: Various conditions caused by prolonged exposure to wet conditions

Protective Strategies Against Rain

• Improvised shelters: Using tarps, plastic sheeting, or found materials
• Seeking overhangs: Bridges, building awnings, or other structures that provide cover
• Plastic protection: Using plastic bags to protect feet, important documents, or medications
• Public buildings: Seeking refuge in transit stations, 24-hour businesses, or other indoor spaces

These strategies provide limited protection and often lead to displacement from familiar areas, increasing vulnerability to other risks.

Air Quality and Environmental Hazards

Beyond temperature and precipitation, people experiencing homelessness face exposure to various environmental hazards:

Air Pollution

• Constant exposure to vehicle emissions, particularly in urban areas
• Proximity to highways, industrial areas, or other pollution sources
• Limited ability to escape poor air quality days
• Increased risk of respiratory conditions, cardiovascular disease, and other health impacts

Wildfire Smoke

• Increasingly common in many regions due to climate change
• Contains particulate matter and toxic compounds
• Limited access to filtered air environments
• Can exacerbate existing respiratory conditions

Environmental Contaminants

• Encampments often located in areas with environmental contamination
• Exposure to lead, industrial chemicals, or other toxins
• Contact with contaminated soil or water
• Limited ability to wash after exposure

Chronic Health Impacts of Weather Exposure

Beyond acute conditions, prolonged weather exposure contributes to numerous chronic health issues:

Respiratory Conditions

• Higher rates of asthma, chronic obstructive pulmonary disease (COPD), and other respiratory conditions
• Increased susceptibility to respiratory infections
• Exacerbation of existing conditions due to weather extremes and pollution exposure

Cardiovascular Strain

• Increased blood pressure from cold exposure
• Heat stress on the cardiovascular system
• Increased risk of heart attack and stroke during temperature extremes

Musculoskeletal Issues

• Joint pain exacerbated by cold and damp conditions
• Muscle tension from constant cold stress
• Limited treatment options for chronic pain

Compromised Immune Function

• Chronic stress from weather exposure weakens immune response
• Increased susceptibility to communicable diseases
• Slower healing from injuries and infections

Barriers to Weather Protection

Several factors limit the ability of people experiencing homelessness to protect themselves from weather exposure:

Shelter System Limitations

• Insufficient capacity: Many communities have far fewer shelter beds than people experiencing homelessness
• Weather-triggered systems: Some shelters only open during extreme weather events, leaving people exposed during merely "bad" weather
• Restrictive policies: Sobriety requirements, gender segregation, pet restrictions, or other rules that prevent access
• Geographic barriers: Shelters may be located far from where people typically stay

Anti-Homeless Infrastructure

• Benches designed to prevent lying down
• Spikes or barriers in sheltered areas
• Removal of public structures that could provide weather protection
• Fencing off of bridges, underpasses, or other potential shelter locations

Criminalization of Survival Strategies

• Laws against camping, sleeping in vehicles, or erecting temporary shelters
• Enforcement that destroys weather protection materials during encampment sweeps
• Restrictions on fires or other heating methods, even during dangerous cold
• Limited legal options for self-protection against elements

Effective Interventions

Several approaches can help mitigate weather-related health risks for people experiencing homelessness:

Emergency Weather Responses

• Low-barrier warming centers: Accessible spaces during cold weather without restrictive entry requirements
• Cooling centers: Air-conditioned spaces during extreme heat
• Expanded transportation: Free transportation to weather relief centers
• Outreach during extreme weather: Proactive engagement to connect people with resources

Practical Support

• Weather-appropriate supplies: Distribution of sleeping bags, tarps, sunscreen, water bottles, and other protective items
• Hygiene access: Facilities to dry clothing and shower after weather exposure
• Medical care: Street medicine and mobile clinics to address weather-related health conditions
• Storage options: Safe places to store belongings during extreme weather

Policy Changes

• Right to shelter: Guaranteeing shelter access during extreme weather
• Sanctioned camping: Designated areas where people can legally set up weather protection
• Suspension of enforcement: Halting anti-camping enforcement during extreme weather
• Climate adaptation planning: Including homeless populations in climate resilience strategies

Conclusion

Weather exposure represents one of the most immediate and life-threatening aspects of homelessness. Without the protection of stable housing, people experiencing homelessness face direct exposure to extreme temperatures, precipitation, and other environmental conditions that can have severe health consequences.

The health impacts of weather exposure range from acute emergencies like hypothermia and heat stroke to chronic conditions that develop over time. These impacts are exacerbated by limited access to healthcare, inadequate shelter options, and policies that criminalize survival strategies.

Addressing weather-related health risks requires both immediate interventions to protect people during extreme weather events and longer-term solutions that provide stable housing. By understanding the serious health implications of weather exposure, communities can develop more effective responses that save lives and reduce suffering among people experiencing homelessness.

References & Further Reading

1. Centers for Disease Control and Prevention. "Extreme Heat and Your Health." CDC, 2023. https://www.cdc.gov/extreme-heat/index.html
2. Centers for Disease Control and Prevention. "Hypothermia-Related Deaths — United States, 2003–2018." Morbidity and Mortality Weekly Report, vol. 69, no. 51-52, 2021. https://www.cdc.gov/mmwr/volumes/69/wr/mm6951a6.htm
3. National Health Care for the Homeless Council. "Homelessness & Health: What's the Connection?" NHCHC, 2019. https://nhchc.org/understanding-homelessness/faq/
4. Ramin, B. and Svoboda, T. "Health of the Homeless and Climate Change." Journal of Urban Health, vol. 86, no. 4, 2009, pp. 654-664. https://doi.org/10.1007/s11524-009-9354-7
5. Environmental Protection Agency. "Heat Island Effect." EPA, 2023. https://www.epa.gov/heatislands
6. National Weather Service. "Weather Related Fatality and Injury Statistics." NWS, 2023. https://www.weather.gov/hazstat/
7. Romaszko, J. et al. "Mortality Among the Homeless: Causes and Meteorological Relationships." PLoS ONE, vol. 12, no. 12, 2017. https://doi.org/10.1371/journal.pone.0189938
8. National Coalition for the Homeless. "Homeless Populations Are Among the Most Vulnerable to Climate Change." NCH, 2019. https://nationalhomeless.org/category/climate/