A study of heat related illness preparedness in homeless veterans

Rao

et al. 2021

Women's Health Reports

Background: Little is known about menopausal symptoms in underserved women. Aim: To better understand self-reported menopausal symptoms in underserved and homeless women living in extreme heat during different seasons. Methods: A cross-sectional study, including the Greene Climacteric Scale (GCS), climate-related questions, and demographics was administered June to August of 2017 and December to February 2018 to women 40–65 years of age. Results: In 104 predominantly Hispanic (56%), uninsured (53%), menopausal (56%), and mid-aged (50 ± 9.5) women, 57% reported any bother, while 20% of these women reported “quite a bit” or “extreme” bother from hot flushes. The total GCS score was a mean of 41 ± 15.0; out of 63 indicating significant symptoms, the psychological and somatic clusters were highest. Women did not think temperature outside influenced their menopausal symptoms at either time point (69% in winter vs. 57% in summer, p = 0.23). In multivariable analyses after adjusting for race, body mass index, and living situation neither season nor temperature was associated with self-reported hot flush bother. While one-third of women reported becoming ill from the heat, 90% of women reported not seeking care from a doctor for their illness. Conclusion: Menopausal, underserved, homeless women living in Arizona reported few vasomotor symptoms regardless of season, and endorsed psychological and somatic complaints. Socioeconomic factors may influence types of bothersome menopausal symptoms in this population of women.

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Menopausal Symptoms in Underserved and Homeless Women Living in Extreme Temperatures in the Southwest

Rao

et al. 2021

Women's Health Reports

“…This population’s vulnerability is increased by high rates of uncontrolled chronic illness, alcohol and substance abuse, and mental illness. [33, 34] Studies have found a higher risk of hypothermia, hyperthermia, and mortality among the homeless vs. non-homeless during periods of extreme heat or cold. [35–37] In Phoenix, 15% of hyperthermia deaths from 2000–2008 were among the homeless.…”

Section: Resultsmentioning

confidence: 99%

Climate change and temperature extremes: A review of heat- and cold-related morbidity and mortality concerns of municipalities

et al. 2018

Cold and hot weather are associated with mortality and morbidity. Although the burden of temperature-associated mortality may shift towards high temperatures in the future, cold temperatures may represent a greater current-day problem in temperate cities. Hot and cold temperature vulnerabilities may coincide across several personal and neighborhood characteristics, suggesting opportunities for increasing present and future resilience to extreme temperatures. We present a narrative literature review encompassing the epidemiology of cold- and heat-related mortality and morbidity, related physiologic and environmental mechanisms, and municipal responses to hot and cold weather, illustrated by Detroit, Michigan, USA, a financially burdened city in an economically diverse metropolitan area. The Detroit area experiences sharp increases in mortality and hospitalizations with extreme heat, while cold temperatures are associated with more gradual increases in mortality, with no clear threshold. Interventions such as heating and cooling centers may reduce but not eliminate temperature-associated health problems. Furthermore, direct hemodynamic responses to cold, sudden exertion, poor indoor air quality and respiratory epidemics likely contribute to cold-related mortality. Short- and long-term interventions to enhance energy and housing security and housing quality may reduce temperature-related health problems. Extreme temperatures can increase morbidity and mortality in municipalities like Detroit that experience both extreme heat and prolonged cold seasons amidst large socioeconomic disparities. The similarities in physiologic and built-environment vulnerabilities to both hot and cold weather suggest prioritization of strategies that address both present-day cold and near-future heat concerns.

“…“Sometimes You Cannot Even Sleep at Night:” social vulnerability to disasters among men experiencing homelessness in Central Florida. USA Nicolay et al [ 32 ]. A study of heat related illness preparedness in homeless veterans.…”

Section: Resultsmentioning

confidence: 99%

“…They wrote of a “heat island” effect in which higher temperatures are observed in places where a large majority of homeless people seek shelter [ 37 ]. Another US study in this area described homeless individuals’ experiences, noted minimal recognition of the symptoms of heat-related illness aside from dizziness [ 32 ]. In an Australian study of homeless service provider impressions about the impacts of extreme weather [ 13 ], providers saw extreme weather events as negatively affecting the physical health of 18% of their clients, the mental health of 37%, and the drug and alcohol consumption of 26%.…”

Section: Resultsmentioning

confidence: 99%

Global Climate Implications for Homelessness: A Scoping Review

2020

Homelessness is a persistent global challenge with significant health impacts on those affected. Homeless people are by definition the most exposed to weather conditions and the social and economic problems caused by extreme weather and climate change and variability. This systematic review was designed to synthesize the academic literature that addresses the health and social implications of global climate change for homelessness. The question examined in this systematic scoping review is the following: What is the current state of knowledge in the scientific literature on the health and social implications of global climate change for homelessness? A systematic scoping review method was used to identify and synthesize the peer-reviewed literature relevant to this question. The databases searched were PsycINFO, Medline, Scopus, and Google Scholar. Of the 26 papers identified in this review, 20 employed original data analyses with conclusions largely inferred from cross-sectional associations. Themes included the potential influence of climate change on homelessness prevalence, climate impacts that exacerbate specific vulnerabilities of homeless populations (e.g., chronic illness, exposure, stigmatization), and health and social outcomes. Service use and design implications were also addressed. Given the scale of the impacts of climate change on homelessness, the literature on this topic poses promising directions but is under-developed in its current state to adequately inform risk mitigation and response planning. A systems framework is proposed here to inform future research and service design.