Phoenix homelessness exacerbates health problems caused by heat: NPR


Alicia Williams checks Paul Jaeger’s vital signs at the mobile medical unit parked outside St. Vincent de Paul, a soup kitchen charity in Phoenix’s Sunnyslope neighborhood on August 9. Jager, 64, is homeless, living with pre-existing conditions and has been waiting for housing assistance for two years.

Caitlin O’Hara for NPR


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Alicia Williams checks Paul Jaeger’s vital signs at the mobile medical unit parked outside St. Vincent de Paul, a soup kitchen charity in Phoenix’s Sunnyslope neighborhood on August 9. Jager, 64, is homeless, living with pre-existing conditions and has been waiting for housing assistance for two years.

Caitlin O’Hara for NPR

PHOENIX — It’s a hot morning in Phoenix, and Paul Yager is checking his vitals at a mobile clinic providing care to homeless patients. He is 64, HIV positive and sleeps most nights in a nearby park. He believes this team has kept him alive.

“I have a lot of life to live, and with God’s help, maybe I can live another 10 years,” Jaeger said.

But surviving a Phoenix summer without shelter is tough. In July, when temperatures here hovered above 110 for more than a week, Jaeger said he collapsed and couldn’t get up for hours.

“I’m not well anyway, so it’s just not good — it’s not healthy for me to be out in this weather,” Jaeger said.

No major US city gets more triple-digit days than Phoenix. But that famous desert heat harms more Arizonans every year. The Phoenix metro area averaged 78 heat-related deaths per year from 2005 to 2015, according to county records. But the number of deaths has hit a record high every summer since 2016. An unprecedented 339 heat deaths were recorded in the region last year. This year is on track to be the deadliest yet. Advocates say the real concern isn’t that Arizona has too hot weather, but that there aren’t enough homes.

“This is a really bad summer for us,” Dr. Kevin Foster, director of the Arizona Burn Center, told reporters in July.


Nina Gomez is a psychiatric nurse at Circle the City, a nonprofit organization that provides health care to homeless people. Dehydration and exhaustion can be detrimental to mental health, says Gomez: “The stress of the heat really exacerbates the psychosis, and then it becomes much harder to get people to commit to any services.”

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Nina Gomez is a psychiatric nurse at Circle the City, a nonprofit organization that provides health care to homeless people. Dehydration and exhaustion can be detrimental to mental health, says Gomez: “The stress of the heat really exacerbates the psychosis, and then it becomes much harder to get people to commit to any services.”

Caitlin O’Hara for NPR

Pavements can heat up to more than 150 degrees in the Phoenix sun. Every summer, Foster treats patients who fall, can’t get up, and develop severe burns.

The Arizona Burn Center has treated a large number of patients this year. And Foster said patient demographics are changing. In the past, patients were usually elderly people who struggled with balance. Recently, Foster’s patients are younger. He said they are now increasingly homeless and that more of their falls are related to substance abuse.

“They go down and stay down for a long time. They end up not only getting really bad burns, but suffering from heat prostration and heat stroke. Often their temperatures that come in are 108 or 109 degrees Fahrenheit.”

County records show similar demographic changes. Heat-related deaths in the open are increasingly common among homeless people. About 60% of cases involve substance use.


Dennis “Rooster” Williams, 69, and German shepherd Shadow sit outside St. Vincent de Paul in Phoenix’s Sunnyslope neighborhood.

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Dennis “Rooster” Williams, 69, and German shepherd Shadow sit outside St. Vincent de Paul in Phoenix’s Sunnyslope neighborhood.

Caitlin O’Hara for NPR

“Every single one of these deaths is preventable,” said David Hondula, director of the newly formed Phoenix Office of Heat Response and Mitigation. “My interpretation is the increase [in heat fatalities] it’s much more to do with what’s happening to social services than the climate.”

Hondula is concerned that already hot temperatures in the region are rising. The National Weather Service predicts that by the end of this decade, Phoenix will average more than 120 days a year of triple-digit heat.

But Hondula is more concerned about another trend. The unsheltered homeless population in Maricopa County, where Phoenix is ​​located, has tripled since 2016.

A shortage of construction dating back to the Great Recession of 2008, combined with explosive population growth, has caused home prices to skyrocket. This contributes to Arizona’s growing homeless population. Hondula said this makes heat a more critical threat to public health.

“Our unprotected neighbors are absolutely at the highest risk of heat-related death,” Hondula said. “Our best estimate is that the unprotected community is at about 200 to 300 times the risk of the rest of the population.”


Dr. Mark Bueno, Medical Director of the Street Medicine Program at Circle the City.

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Dr. Mark Bueno, Medical Director of the Street Medicine Program at Circle the City.

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It’s not just about the long hours spent outdoors. Hondula said homeless people also have limited access to medical care, an increased likelihood of chronic health problems and high rates of addiction, all of which can increase risk.

Dehydration and exhaustion can also be detrimental to mental health, said psychiatric nurse practitioner Nina Gomez at the mobile medical clinic run by the nonprofit Circle the City.

“The stress of the heat really exacerbates the psychosis, and then it becomes much more difficult to get people to commit to any services,” Gomez said.

The city of Phoenix is ​​making major investments to address the housing crisis, announcing in June that it was committing $70.5 million to affordable housing and homeless programs. But these problems cannot be solved overnight. So for now, organizations like Circle the City are trying to provide short-term solutions.


Nina Gomez, a psychiatric nurse practitioner with Circle the City, stands with the nonprofit’s mobile medical unit.

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Nina Gomez, a psychiatric nurse practitioner with Circle the City, stands with the nonprofit’s mobile medical unit.

Caitlin O’Hara for NPR

“We’re trying to intervene early, so hydrate people, give them food, see if they need anything before it’s a full-blown crisis,” Gomez said.

And as summer drags on, Yager and other homeless people at the clinic say they’ll be drinking water, wearing a hat and just trying to keep cool.

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