Unsheltered in the?Heat

Strategies for supporting the?unhoused

When the temperature soars, the people who are most vulnerable are those who cannot escape the heat: people living unhoused.

Colin Maloney is the Department of Health’s Community Health Strategist for Homelessness. They talked to us about the increased challenges that people experiencing homelessness face from heat and how communities can provide support.

Edited for length and clarity.

What are the main ways heat impacts people experiencing homelessness?

Dehydration and heat stroke are right up there. It’s not different from anybody else, but there are different risks. The main distinction between folks who are homeless and folks who are not is the greater difficulty finding an indoor place.

Dehydration is a huge problem. In the heat, the need to drink water is higher, because sweating from the heat causes people to lose more water from their bodies. Many homeless people are living in places that don’t have running water. A lot of communities provide bottled water, but not large amounts, such as 5-gallon jugs. And people can’t just haul huge jugs of water around, even if they can get or fill them. People go through a lot of individual-size bottles of water during the summer. A lot of service providers do try to make water available for folks, though.

Most people experiencing homelessness do not suffer from a serious mental illness or have a substance use disorder, but substance use can have dehydrating effects. For mental health problems, the effects of medication can change in the heat. And some medications can increase risk for heat illness and dehydration.

If people are living outside and experiencing severe mental illness or having substance use issues, they may not be able to take the care necessary to limit access to the sun. So, you may end up with a lot more sun exposure.

We know that extreme heat impacts people’s sleep and mental health. Lack of sleep has a really negative impact on people’s mental health. Living unhoused can cause sleep deprivation, as can heat, so that has a double impact.

What other kinds of issues do people experiencing homelessness face during high?heat?

We hear a lot about seniors being particularly vulnerable to heat. Many do not have the income to be able to afford air conditioning, or they are unable to travel far to get to a cooling center. What a lot of people don’t know is that the fastest-growing group of people becoming homeless these days is older people.

Service providers are seeing more and more people who are more medically fragile. If you’re becoming homeless for the first time in your 60s or older because you’ve been priced out of your home, it is a more complicated circumstance than someone who is in their 30s or 40s. You have more advanced medical issues. You might be taking more medications, which adds another layer of complexity to all of that. That is important for people to understand.

For people who don’t have a cool home to stay safe in, what is the best solution?

Well-planned cooling centers are a key way to help people through the heat. And it’s not only people who are unhoused who have challenges with heat. Many people live in buildings that don’t have A/C. I think there’s a pretty broad swath of the community that uses cooling centers. People who are housed may have a less consistent need to go to cooling centers, but people who literally have nowhere to go need to use the centers for longer.

Besides being cool, what are the characteristics a cooling center needs to?have?

For starters, they need to be open. Communities don’t always have a lot of resources dedicated to providing cooling centers. There are lots of towns in the state that do not have cooling centers. And a lot of the towns that do, have limited hours or days of operation.

One of the big needs is overnight options. There are libraries, community centers, and other service providers that might expand their hours, but overnight shelter is sometimes hard to find.

And then actually making sure the cooling centers have what they need to provide refuge. What are their policies on animals? Belongings? People who are unhoused have to bring their stuff with them, wherever they go. Are they able to accommodate people’s belongings, or to what degree?

One thing that always concerns me is the ability to identify the signs of an overdose or a mental health crisis and being both equipped and competent enough to intervene. So, offer some basic de-escalation training if you’re staffing a cooling center. Have naloxone on hand and know how to use it, so you feel confident recognizing if someone is overdosing, or has overdosed, and knowing what that looks like and what to do. That’s something that many traditional service providers do train their staff on. But the person working at the library may not be trained on naloxone use.

Cooling centers should also be in places that people experiencing homelessness already feel comfortable in. It’s not a matter of outreach to try to get people experiencing homelessness to come to a place. It is recognizing where they are already, and how we support them in the spaces they’re in to be safer. The less travel you require someone to do the better. This is why libraries are kind of perfect. Many of them are kind of de facto day centers for folks who are homeless even during non-heat events. They are trusted institutions, relatively speaking. It’s not so much of a “if you build it, they will come,” but “go to them.”

You mentioned the increase in older adults facing housing insecurity and homelessness. Can you share more about the scope and demographics of who is experiencing homelessness?

The number of people experiencing homelessness that’s most frequently cited comes from the annual point in time count. The count is a U.S. Department of Housing and Urban Development (HUD) requirement that communities must follow It is an imperfect gauge of the problem. For example, the most recent point in time count for Washington was 20,000+. However, the Department of Commerce puts out a report twice a year on homelessness called the Snapshot of Homelessness Reports. That data says it’s more like 163,000 people! That’s a little bit more than the number of people living in Bellevue.

We have some good data about racial disparities and homelessness. A report from the Lieutenant Governor’s Office shows that Black people in Washington are five times as likely to be homeless than white folks. And Native Americans are 10 times as likely to be homeless. When it comes to the experience of homelessness, there are significant disparities.

There’s also a common narrative that homelessness is caused by mental illness and drug use. Those are certainly challenges that many people who are homeless face, but we see that housing affordability is actually the primary driver.

If people want to do something to help on these issues, what are some good?ideas?

You can look into whether your city has cooling centers that would meet these needs. And I recommend that people watch Gregg Coburn’s 8-minute video about root causes of homelessness, because there are a lot of misconceptions.

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