abstract
Higher and lower daily ambient temperatures are associated with higher mortality in the general population. People experiencing homelessness (PEH) are thought to be particularly vulnerable, but there is little direct evidence. We examined the relationship between temperature and mortality from PEH in two densely populated urban counties in a hot climate region of the United States, focusing on thermal effects. The study locations are Los Angeles County, California, and Clark County, Nevada, which include the cities of Los Angeles and Las Vegas respectively. The results were the deaths of decedents classified as homeless from 2015 to 2022 in county administrative records. We used quasi-Poisson distributed lagged nonlinear models to estimate the association of mortality with daily temperature and 7-day lagged temperature, adjusting for day of the week, seasonality, and long-term trends. We estimated the minimum mortality temperature and the proportion of deaths due to temperatures above and below the minimum mortality temperature. The association between daily temperature and PEH mortality favored greater risk at higher temperatures, particularly in Clark County. Temperature-attributable mortality was 50.1% (95% CI, 29.0-62.8) in Clark County and 7.0% (95% CI, 1.4-12.1) in Los Angeles County. In both counties, most temperature-related deaths were due to heat rather than cold. In these urban counties with hot climates, our estimates of heat-induced mortality from PEH are orders of magnitude higher than those reported in previous studies of the general population. These results suggest that temperature vulnerability, particularly heat vulnerability, requires stronger public health and policy responses.
https://academic.oup.com/aje/advance-article-abstract/doi/10.1093/aje/kwae084/7689061?redirectedFrom=fulltext
Well, let's break it down: One study concluded that people lying on the street (most of them drug addicts) were more likely to die on a hot day than those in air-conditioned rooms. Well, stop the media! Who would have thought that baking on asphalt like frying eggs on a frying pan might not be conducive to longevity?
This kind of research is a prime example of the baffling banality of what is now regarded as scientific insight. Our elite academic institutions, seemingly unable to solve practical problems, have given us these groundbreaking revelations. Next, maybe they'll tell us that people are more likely to drown in water than on dry land.
What makes this situation truly ridiculous is not just a waste of time and money on such an obvious conclusion. No, the fact is that these “findings” will inevitably be translated into policy recommendations. Note the sanctimonious call for more taxpayer dollars to provide air-conditioned safe spaces for those suffering from drug addiction. Because that’s the real solution, right? Just give the government more control and money to solve problems, as if bureaucrats were trying to solve complex and deep-seated problems like homelessness, addiction, and mental illness with central air conditioning and visors.
But there's a more serious question here, one that the media won't touch on: Why are people lying on the streets in the first place? Have decades of lax policies under the guise of “compassion” only worsened the homelessness and addiction crisis? We have effectively normalized drug use, failed to enforce the law, and allowed cities to deteriorate into open-air homeless encampments. but not solution Those ones Discomforting truth, we get another ivory tower study to remind us that it's hot out there.
Let's be honest. The tragic deaths of people sweltering in the streets are symptoms of a larger problem. These people are not victims of climate change but of social collapse caused by politicians who refuse to enforce the law and a culture that increasingly rejects personal responsibility. But instead of confronting the issue head-on, we get a study that unsettles the obvious: Heat kills.
What to do next? Maybe we'll get a follow-up study: “June addicts lying in the snow are more likely to freeze to death than those inside a centrally heated room.” That would be interesting if it weren't so tragically stupid.
Below is the full press release from EurekAlert!
Boston University School of Public Health
Publish immediately
Thursday, October 10, 2024
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Due to the nature of their living situation, people experiencing homelessness (PEH) are considered to be among the most vulnerable to the health impacts of extreme weather.
A new study from the Boston University School of Public Health (BUSPH) shows that PEH are particularly susceptible to the effects of high temperatures, which have a much greater impact on mortality in this group than in the general population.
Published in the American Journal of EpidemiologyThe study examined mortality in two hot-climate U.S. counties—Clark County, Nevada (which includes Las Vegas) and Los Angeles County, California—and found that daily high temperatures play a significant role in mortality from PEH.
The association was particularly striking in Clark County, where nearly 50% of deaths during the study period were attributed to rising daily temperatures. Although Los Angeles County had a smaller share of deaths attributable to heat at 5.2%, in both counties daily heat appears to cause far more deaths than daily cold.
This study is the first to examine heat-related mortality in PEH, providing valuable public health insights into the impact of an unprecedented October heat wave on the West Coast that prompted multiple emergency declarations in parts of Los Angeles and Las Vegas. A heat alert was issued, with temperatures there soaring to 111 degrees and 104 degrees in recent days. Both cities also continue to deal with persistently high homelessness rates that far exceed the national average. Quantifying the impact of extreme heat on PEH can inform new interventions and policies to reduce illness and mortality in this largely unsheltered population.
“Our team's finding of an association between heat and mortality among homeless people was not surprising, but the magnitude of the association is striking,” said the study's senior author and corresponding author, Boston School of Public Health Community said Dr. Jonathan Jay, assistant professor of health sciences. “Our estimate is 10 to 100 times higher than the known association between daily heat and mortality in the general population of Los Angeles and Las Vegas, a finding that highlights the ethical imperative that our systems do more action.
He said the new findings also show that heat exposure is an important factor exacerbating the huge health inequalities in PEH and highlight the need to focus climate and health research on the most marginalized populations.
For the study, Dr. Jay and colleagues from BUSPH and the David Geffen School of Medicine at UCLA used mortality and daily temperatures in Clark and Los Angeles counties from January 2015 to August 2022 (Clark County) Data, and November 2022 (Los Angeles County). The team analyzed deaths from all causes, not just those related to severe heat or cold (such as fatal heat stroke or hyperthermia), to ensure the analysis captured all external causes of death from high temperatures. Hot days are defined as daily temperatures above the Minimum Mortality Temperature (MMT) (the temperature with the lowest mortality risk in each region), which is 11.6 degrees Celsius (52.8 degrees Fahrenheit) in Clark County and 19.3 degrees Celsius (66.7 degrees Fahrenheit) in Los Angeles County.
After accounting for long-term and seasonal trends, days of the week, and the cumulative effects of temperatures over consecutive days, the researchers found that the risk of death from PEH increased in both hotter and colder temperatures. Heat hazards are particularly severe in Clark County, where 15% of deaths are from severe heat-related causes, compared with 0.2% in Los Angeles County. Extreme hot weather causes nearly 25% of all deaths in Clark County and 2.2% of all deaths in Los Angeles County.
“It's important to see that as daily temperatures rise, from cooler to warmer days, the number of deaths increases, and that on hot days, the number of deaths spikes from around 90 degrees Fahrenheit or higher. Start high,” Dr. Jay said. “It's hot, but not anywhere near the hottest temperatures these cities have experienced,” he added. This suggests that as climate change continues to prolong the number of people exposed to heat, public health advocates are putting pressure on providing heat-related support after the summer. Be extra vigilant.
Public health strategies that can mitigate the heat impacts of PEH in communities include cooling centers, water stations, landscaping and reflective paint, the researchers said. But ultimately, these strategies should take a “housing first” approach, as the leading cause of homelessness is a lack of affordable housing. California, in particular, is consistently ranked as one of the most expensive states in the United States. Policies that promote stable housing and other financial support for PEH have become even more important following a Supreme Court ruling in June that allowed cities to ban people from sleeping and camping in public spaces.
“Too many of our policies are driven by the impulse to hide homelessness, rather than recognizing people's dignity, protecting their health and improving our systems,” Dr. Jay said. “The idea that policing is the key to solving this problem is misguided, and it's a miscalculation we make over and over again as a society.”
The study's lead author is Zihan Lin, Ph.D., then a BUSPH postdoctoral fellow and now an assistant professor of biological, geographical and environmental sciences at Cleveland State University.
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About Boston University School of Public Health
The Boston University School of Public Health was established in 1976 and is one of the top ten schools of public health in the world. It offers master's and doctoral degree education in the field of public health. Faculty in six departments conduct policy-changing public health research around the world with the mission of improving the health of local and global populations, especially the health of disadvantaged, underserved, and vulnerable populations.
Magazine
American Journal of Epidemiology
DOI
10.1093/economy/kwae084
research methods
observational study
research topic
people
Article title
Daily heat and death rates among homeless people in 2 U.S. urban counties, 2015-2022 Access Arrow
Article publication date
September 25, 2024
Conflict of Interest Statement
GAW serves as a consultant to the Health Effects Institute and most recently to Google, LLC.
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