Impacts of extreme weather on the health and well-being of people who are homeless

Recently in Australian Journal of Primary Health, Cusack et al. (2013) published their research into the extreme weather-related health needs of the homeless population and responses by homelessness service providers in Adelaide. They highlighted the fact that exposure to extreme weather is a significant health issue for the homeless population there. Their work indicated that service providers were beginning to plan for extreme heat events but were less cognisant of issues relating to cold and wet weather.

Research on this subject has to date been extremely limited and yet the risks to vulnerable populations are expected to further increase as climate change drives an increase in the frequency and intensity of extreme weather events (McMichael et al. 2012), such as floods, heat waves and bushfires. The homeless population is highly vulnerable to the health impacts of extreme weather due to the high prevalence of mental and physical health problems, limited resources to take adaptive measures and disengagement from health services. Poor representation in disaster planning and chronic under-resourcing of the homelessness sector might also increase vulnerability (Yip et al. 2008; Ramin and Svoboda 2009; Wandel et al. 2010). Mallon et al. (2013) found that few community service organisations across Australia have undertaken significant action to prepare for climate change and worsening extreme weather events.

We recently undertook a qualitative study (C Pendrey, M Carey, J Stanley, unpubl. data) to investigate the impacts of extreme weather on the health and well being of people who are homeless in Victoria, as reported by service providers. Semi-structured interviews were conducted with seventeen different health and welfare service providers to the homeless in urban and rural Victoria.

All service providers interviewed indicated adverse impacts on homeless clients from extreme weather events, which were reported to exacerbate physical and mental health problems and substance abuse. The majority of providers indicated that extreme weather had affected their ability to care for their clients and felt that climate change was a relevant issue for the homelessness sector, but that there was a lack of preparedness.

Extreme heat and flooding were the most consistently reported health stressors in urban areas, with bushfires and floods more important in rural areas. The reported health impacts from extreme heat, cold and wet conditions were similar to those reported by Cusack et al. (2013). A prominent theme was that extreme weather has a ‘magnifying effect’, exacerbating already highly prevalent physical and mental health problems and substance use disorders.

Extreme weather events affected homeless clients’ ability to meet their basic needs of food, water and shelter. A lack of cool and sheltered spaces accessible to homeless persons in urban areas was a significant issue for those seeking refuge from hazardous heat or cold and wet conditions. Recent bushfires and floods destroyed a large number of homes resulting in increased demand for a reduced supply of housing and dramatic increases in the already lengthy waiting periods for public housing. Some made homeless by extreme weather remained so for prolonged periods.

Service providers reported increased demand for services during extreme weather events. Many also reported increased difficulty providing services to homeless clients and the need to improve surge capacity during extreme events.

The emerging evidence from Cusack et al. (2013), our own study (C Pendrey, M Carey, J Stanley, unpubl. data) and a limited number of other studies in this field supports the importance of extreme weather as an increasing risk to the health and well being of people experiencing homelessness in Australia. Community health and welfare organisations are likely to continue to be challenged, as extreme weather can both increase the rate of homelessness and worsen the plight of those already experiencing homelessness. This important issue requires greater attention from researchers and policy makers. Climate change needs to be included in research agendas for housing and homelessness, and the vulnerability and specific needs of the homeless should be better incorporated in climate change adaptation and disaster planning. A proactive policy approach must ensure sufficient resourcing of services supporting the homeless population, including resourcing for long-term service planning in the context of a new, more extreme climate.

None declared.