Abstract
High and low 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 almost no direct evidence available. We examined the temperature-mortality association among PEH in 2 populous, urban counties in hot-climate regions of the United States, focusing on heat effects. Study setting was Los Angeles County, CA, and Clark County, NV, which encompass the cities of Los Angeles and Las Vegas, respectively. Outcomes were 2015-2022 deaths among decedents categorized as homeless in county administrative records. We used quasi-Poisson distributed lag nonlinear models to estimate the association of mortality with daily temperatures and with 7-day lagged temperatures, adjusting for day of week, seasonality, and long-term trends. We estimated the minimum mortality temperature and fraction of mortality attributable to temperatures above and below minimum mortality temperature. The association between daily temperature and PEH mortality was skewed towards greater risk at higher temperatures, especially in Clark County. Temperature-attributable mortality equaled 50.1% of deaths in Clark County (95% CI, 29.0-62.8) and 7.0% in Los Angeles County (95% CI, 1.4-12.1). In both counties, most temperature-attributable deaths were attributable to heat rather than cold. In these hot-climate urban counties, our estimates of heat-attributable mortality among PEH were orders of magnitude greater than those reported in prior research on the general population. These results indicate that temperature vulnerability, particularly heat vulnerability, requires stronger public health and policy responses.
Alright, let’s break this down: a study concludes that people lying out in the street—most of whom are drug addicts—are more likely to die on a hot day than those who are inside with air conditioning. Well, stop the presses! Who could have guessed that baking on asphalt like an egg on a skillet might not be conducive to longevity?
This kind of study is a prime example of the mind-bending banality that passes for scientific insight these days. Our elite academic institutions, seemingly incapable of grappling with real problems, give us these groundbreaking revelations. Next up, perhaps they’ll inform us that people are more likely to drown in water than on dry land.
What makes this situation truly absurd isn’t just the waste of time and money on such a blindingly obvious conclusion. No, it’s the fact that these “findings” will inevitably be spun into policy recommendations. Cue the sanctimonious cries for more taxpayer dollars to fund air-conditioned safe spaces for those suffering from addiction. Because that’s the real solution, right? Just give the government more control and money to fix the problem, as if bureaucrats are going to solve the complex, entrenched issues of homelessness, addiction, and mental illness with central air conditioning and sun hats.
There’s a more serious issue here, though, and it’s one the media won’t touch: why are people lying in the streets in the first place? Could it be that decades of permissive policies, under the guise of “compassion,” have only exacerbated the homelessness and addiction crises? We’ve effectively normalized drug use, failed to enforce laws, and allowed cities to deteriorate into open-air homeless encampments. But instead of addressing those uncomfortable truths, we get another ivory tower study reminding us that it’s hot outside.
Let’s be real here. The tragic deaths of people sweltering in the streets are a symptom of a much larger problem. These individuals aren’t victims of climate change—they’re victims of societal breakdown, enabled by politicians who refuse to enforce laws and by a culture that increasingly rejects personal responsibility. But instead of confronting that, we get a study that hand-wrings about the obvious: heat kills.
What’s next? Perhaps we’ll get a follow-up study: “Drug addicts lying in snow are more likely to freeze to death than those who are inside with central heating.” It would be funny if it weren’t so tragically stupid.
Here is the entire press release from EurekAlert!
Boston University School of Public Health
FOR IMMEDIATE RELEASE
Thursday, October 10, 2024
##
By nature of their living situation, people experiencing homelessness (PEH) are considered one of the most vulnerable populations to the health impacts of extreme weather.
PEH are particularly vulnerable to heat, and the impact of heat on mortality in this group is substantially greater than for the general population, according to a new study by Boston University School of Public Health (BUSPH).
Published in the American Journal of Epidemiology, the study examined mortality rates in two hot-climate US counties—Clark County in Nevada, which includes Las Vegas, and Los Angeles County in California—and found that daily heat played a significant role in mortality among PEH.
This association was especially notable in Clark County, where nearly 50 percent of deaths during the study period were attributable to higher daily temperatures. Although LA County observed a smaller percentage of heat-attributable deaths, at 5.2 percent, daily heat appeared to contribute to many more deaths than daily cold in both counties.
The study is the first to examine heat-attributable mortality among PEH, providing valuable public health insight as the West Coast reels from an unprecedented October heatwave that has prompted numerous heat alerts in parts of LA and Las Vegas, where temperatures soared to 111 degrees and 104 degrees, respectively, in recent days. Both cities also continue to grapple with persistently high homelessness rates that far exceed the national average. Quantifying the impacts of extreme heat on PEH can inform new interventions and policies that reduce illness and mortality rates among this largely unsheltered population.
“It wasn’t a surprise that our team found an association between heat and mortality for unhoused people, but the magnitude was staggering,” says study senior and corresponding author Dr. Jonathan Jay, assistant professor of community health sciences at BUSPH. “Our estimates are 10 to 100 times greater than the known associations between daily heat and mortality for the general population in LA and Las Vegas, and this finding highlights the moral imperative for our systems to do more.”
He says the new findings also show that heat exposure is an important factor amplifying the vast health inequities for PEH, and highlight the need to center the most marginalized populations in research on climate and health.
For the study, Dr. Jay and colleagues from BUSPH and the David Geffen School of Medicine at the University of California, Los Angeles utilized mortality and daily temperature data for Clark and Los Angeles counties from January 2015 to August 2022 (for Clark County) and November 2022 (for LA County). The team analyzed deaths from all causes, rather than just deaths that were acutely heat- or cold-related (such as fatal heat stroke or hyperthermia), to ensure that the analysis captured all external causes of death as a result of high temperatures. Hot weather was defined as daily temperatures above the minimum mortality temperature (MMT)—the temperature at which mortality risk is lowest in each area—which was 11.6 Celsius (52.8 degrees Fahrenheit) for Clark County and 19.3 Celsius for LA County (66.7 degrees Fahrenheit).
After accounting for long-term and seasonal trends, days of the week, and cumulative effects of consecutive days’ temperatures, the researchers found that mortality risk among PEH increased in both hotter and colder temperatures. The heat was especially harmful in Clark County, where 15 percent of deaths were due to acutely heat-related causes, compared to 0.2 percent in LA County. Extremely hot days accounted for nearly 25 percent of all deaths in Clark County and 2.2 percent of all deaths in LA County.
“It was important to see that deaths increased as daily temperatures increased, from cool days to warmer days, and they spiked on hotter days, starting around 90 degrees Fahrenheit and higher,” Dr. Jay says. “That’s hot, but it’s not even close to the hottest temperatures these cities experience,” he adds, which suggests that public health advocates should be extra vigilant in providing heat-related support beyond the summer season, as climate change continues to extend the number and length of heat waves each year.
Public health strategies that can mitigate heat impacts among PEH in communities include cooling centers, water stations, greening, and reflective painting, the researchers say. But, ultimately, these strategies should embrace a “Housing First” approach, as the primary cause of homelessness is a lack of affordable housing. California, in particular, is consistently ranked as one of the most expensive states to live in the US. Policies that promote stable housing and other financial support for PEH are even more critical following the Supreme Court’s ruling in June that permits cities to ban people from sleeping and camping in public places.
“Too much of our policy is driven by the impulse to hide homelessness from view, rather than to recognize people’s dignity, protect their health, and improve our systems,” says Dr. Jay. “The idea that policing is key to solving this problem is false, and it’s a miscalculation we make over and over again as a society.”
The lead author of the study is Dr. Zihan Lin, a BUSPH postdoctoral fellow at the time of the study and a current assistant professor of biological, geographical and environmental sciences at Cleveland State University.
**
About Boston University School of Public Health
Founded in 1976, Boston University School of Public Health is one of the top ten ranked schools of public health in the world. It offers master’s- and doctoral-level education in public health. The faculty in six departments conduct policy-changing public health research around the world, with the mission of improving the health of populations—especially the disadvantaged, underserved, and vulnerable—locally and globally.
Journal
American Journal of Epidemiology
DOI
Method of Research
Observational study
Subject of Research
People
Article Title
Daily heat and mortality among people experiencing homelessness in 2 urban US counties, 2015-2022 Get access Arrow
Article Publication Date
25-Sep-2024
COI Statement
G.A.W. serves as a consultant to the Health Effects Institute and recently served as a consultant for Google, LLC.
Heck, even in 1964 they knew that the sun makes things very hot. 🙂
https://youtu.be/yKmKezVBdOQ
I grew up near Cronulla Beach in Sydney’s south..
I can recall getting blistered feet from hot sand and asphalt even back then.
Aaaaand, what about the Increased Mortality from Extreme Cold when CO2 levels drop and the heat diminishes making winters colder?
The “homeless” are also a revenue source for NGOs, which seem to have very little interest in reducing their own income.
“The “homeless” are also a revenue source for NGOs,”
“Ending Welfare as We Know It” enacted during the clinton administration was the single most effective anti-poverty program since the enactment of social security. The democrats and the welfare administrators were vastly against the policy since any program reducing welfare dependence would eliminate the need for their jobs.
If the “Democrat” rulers of Los Angeles hadn’t created so many PEH, it would far less of a problem.
And Las Vegas, is in the middle of a desert !!!
That “PEH” surprised me the most. I had no idea “the homeless” wasn’t good enough. My experience is that abbreviations like that exist to refer to specific subsets. My bad!
Idiocies like this new acronym exist so that the NGO’s and other parts of the “systems” mentioned in these asinine texts can invent and feed off new rivers of money. It helps identify the chosen ones as well. They all speak the same stupid jargon.
I’m in favor of canceling wind, solar, Carbon capture, and electric vehicles and directing some of that money toward getting people off the sidewalks and out of tents. Just the phrase “people experiencing homelessness” is an unnecessary euphemism used to hide the failure of society.
Policies meant to “solve” this issue often incentivize “PEH” because leaders do not want to admit to the inadequacies of their understanding.
They’ve been “helping the homeless” for 50 years here. First, it was all blamed on Reagan for closing mental health hospitals. Then it was blamed on PTSD from Vietnam Vets. Then it was blamed on the Grateful Dead. After that it was blamed on George Bush invading Iraq. Later it was blamed on Donald Trump tax cuts. Then it was blamed on Covid 19. More and more resources have been budgeted each year to “Help the Homeless”.
One thing is certain over time. The more they help, the more homeless appear.
“First, it was all blamed on Reagan for closing mental health hospitals.” That a liberal lie all Reagan did was prevent the federalization of the mental health system. It was running fine on the state leftist until in the late 60 and early 70 the left decided that being mental ill and a drug addict was a right and said people had a right to live on the street.
By 1980 one of the few states that still had function mental health system was North Dakota and the Association for Retarded Citizens of North Dakota made sure the hospitals for those development disable were closed too. The other mental health system were well being shutdown by the activist through any means they could. The had a pie in the eye belief that community care was better.
Funny though they made certain that said mental ill people could just walk away from such community based system. Force someone to take meds nope. We are now just finding out that the pharmaceuticals for mental health don’t work! Those that do only work well for about a third of that population they are suppose to help. It is a cluster screwup of mega proportion’s, yet the people that spearhead the insanity blame Reagan.
I have heard that about Regan many times before. Did not know his was on the federal level. Interesting. Thanks
We call this sort of thing a “BFO”, or “Blinding Flash of the Obvious”. I can only hope that vast amounts of my tax dollars were spent on this instead of actually solving any problem.
I calls it a BFD.
Didn’t we used to call them bums?
ooooo- that’s very unwoke to say that! /s
Policy based evidence making has been a thing for a very long time.
With all the money they’ve thrown away building useless unreliables, they could have easily built facilities or housing for the homeless and we wouldn’t be talking about this so-called problem.
I imagine people in a similar situation in a UK town will suffer excess deaths in the colder months, September through to June in parts of the country.
Is this is the follow up study?
“ the primary cause of homelessness is a lack of affordable housing.”
With this premise, one can’t believe a single finding from the ‘study’. The primary cause is, of course, drug use. Almost every sober person seeking ‘affordable housing’ will work hard and eventually find a way to afford the available offerings or move somewhere that they can afford to live safely.
Mental health is a big factor too. A lot of homeless people just aren’t mentally equipped to maintain a residence.
And at lest a few people aren’t addicts, don’t have mental health problems, have money, and still live on the streets.
I’ve heard it broken down like this:
The CATO distribution.
40% Crazy (who are mentally ill)
30% Addicts (who abuse substances)
20% Tramps (who like the lifestyle)
10% Out-of-Luck (who are trying to improve their situations)
The last category is the only one you can really help with social safety-nets.
20% Tramps (who like the lifestyle)
When I worked night security in San Bernardino, there was an old homeless guy who was always in the general area. He wouldn’t accept handouts, never asked for anything. He was literally a millionaire, but he preferred living as he did. An unusual but good example of that 20%.
I must be a heartless, soul-less bastard because the ‘news release’ full headline just makes me laugh.
At the author of said headline, not the people the author uses to kill other people.
As a former PEH (Person Experiencing Homelessness), my views may be somewhat skewed. The problem of PEH in the USA is twofold.
1) There are or were virtually no safety nets for people who had housing and lose it due to loss of employment or other. Affordable or low income housing means absolutely nothing when you have no income.
I was injured at work to the point where after recovery, I was not able to work anymore. It took the Social Security over 5 years to agree after litigation that I was disabled. During this period, I had zero income.
2) The first few days of PEH are perhaps the roughest as you are learning. Crime is rampant with theft and brutality foremost and enduring until you learn what you can and cannot do. But after that period, a PEH can live quite well. Clothing, even designer labels, are usually free. Food can be found easily and is also free. Hygiene resources are available and also free. Shelter is available during inclement weather although often with a religious bent. Medical care is free.
Yes, drug use and mental illness can be a major factor among the homeless. Just imagine sitting around all day & night with nothing to do. Many turn to the drugs as a method to escape.
Derbrix,
from your personal experience and perspective any thoughts on what we/society should do to lesson the problem? Was it too easy to stay in PEH as you pointed to in point 2. Perhaps more institutions as mentioned in other comments.
Also as you mention there are different types of homeless so I assumed it is not just one answer.
congrats on being former PEH and thanks for sharing. I am sure we can learn from your “skewed” view:)
I’m waiting on the study showing why water is wet.
As far as the homeless situation, even though the population of the U.S. has increased since the ’60s, there are less people in mental health facilities now. That might be a clue.
I had to laugh because Trump recently said the biggest threat to democracy is stupid people….on this point he is right on.
Ending the climate change scare is actually easy – just stop funding stupid studies like these. It is incredible how the Scientific Method simply does not exist in science today.
I would (slightly) disagree with this. Stupid people can’t help being stupid. They can be humoured or ignored. The real threat is from smart people in decision-making positions being stupid.
Of course more people die from heat in hot counties, there’s no cold. How about another study of homeless people in Winnipeg in the winter, I’ll bet they discover that more people die from the cold in cold counties. What a waste of paper.
Whoever approved this study should be fired, whoever paid for this study should be fired, whoever reviewed this study should be fired, whoever published this study should be fired if for no other reason than for pissing my money away.
Were any partial differential equations solved to reach this conclusion?
If you’re unable to anything productive, get useless study $$. Who pays for this kind of useless drivel? (I may not want to know the answer)