‘It’s brutal’: Punishing summer heat can kill, maim when you live outdoors in Worcester

• Older people can get into serious danger, as heat and dehydration stress bodies already challenged by age and chronic medical conditions or made more vulnerable by certain medications.
• Most people in Worcester can expect eight times the number of days over 90 degrees heat index a year when they reach retirement, compared to the number of hot days when they were kids.

WORCESTER – Calvin Gray is unhoused, and one of his favorite spots to stay cool is under a tree that offer shade on Harding Street.

That’s where Gray was this week, lugging his personal possessions, and he wasn’t alone. Other unhoused adults joined him under the tree, with a jug of ice-cold water for the group to share.

“It’s hot,” said the 50-year-old Gray, who noted he’s lost a lot of weight in the heat, and that worries him because he suffers with diabetes and congenital heart disease. Gray is one of hundreds of unhoused people in Worcester, as 493 people in the city experienced homelessness in June, according to the Central Massachusetts Housing Alliance.  

It’s easy to forget that extreme heat tied to climate change is hard on theunhoused as headlines are dominated by wildfire smoke from Canada and heat domes in the South and West. But heat and its negative health impacts on the homeless are real, according to experts. 

Dr. Erik Garcia at UMass Memorial Health has spent the past 29 years on the front lines of caring for the homeless, and he’ll never forget an unhoused man he recently treated who suffered second-degree burns on his feet from prolonged sun exposure.

“I’ve never seen a sunburn that bad before,” said Garcia, who noted that dehydration, pulmonary effects and exacerbation of preexisting health conditions are big concerns for the homeless due to elevated heat.

‘A profound impact’

“Heat is having a profound impact on the homeless,” said Ashley Ward, director of the Heat Policy Innovation Hub at Duke University.

Beyond the high cost of housing that makes it difficult for many to afford an apartment, Ward described other worrisome negative impacts from rising heat on the unhoused: 

● Lack of access to refrigeration means food spoils, resulting in increased risk of infections.

● Burns arise from lying on surfaces that retain heat, especially in urban areas where there is a preponderance of concrete.

Out of work increases heat risk

Bouts of unemployment can put people on the street, where they’re exposed to dangerous health outcomes from the heat. As Ricky Lozeau pulled his suitcase on wheels through Worcester Common, he said he’s homeless and looking for work. 

“The humidity will kill you,” Lozeau said. “It’s brutal up here.”

To protect Lozeau and other unhoused people in Worcester, Garcia said some steps are easy and relatively inexpensive to do, like offering cooling centers. Worcester currently has two, one downtown at the public library at Salem Square, the other is at the senior center on Providence Street. Work is underway to expand the total number, said city officials.

More ambitious programs, said Garcia, include providing free public water dispensers to refill bottles, planting more trees and expanding green space. Mobile vans with cool spaces inside for the unhoused to beat the heat that have cropped up in Canada is an idea worth exploring, Ward said.

Other meaningful ideas cited by Garcia include expanding the supply of affordable housing, and emergency and seasonal shelters.

Some medications weaken sun protection

Drugs that reduce the body’s ability to protect itself against the sun’s powerful rays is a concern. 

One such drug is doxycycline, Garcia said. The medication treats MRSA (methicillin-resistant Staphylococcus aureus), an infection that is caused by a type of staph bacteria that’s become resistant to many of the antibiotics used to treat ordinary staph infections.

MRSA is a “huge risk,” said Garcia, for those suffering with substance-use disorder and those living in group settings, situations that are common in the unhoused community.

“(Doxycyline) would decrease tolerance to sun exposure, and patients may not be aware of the damage (to their skin),” said Garcia, who noted damage can be rashes to “horrendous sunburns.”

Fear that heat deaths in Arizona could repeat in Worcester

Garcia is keeping a close eye on this summer’s record-breaking heat wave in Arizona’s Maricopa County, where more than 20 heat-associated deaths are confirmed and more than 200 deaths under investigation. 

If Worcester experiences a similar heat wave, Garcia worries about the city’s general population to cope, especially its homeless community.

“If we see that level (of heat in Arizona), we will likely see the mortality level we see (in Maricopa County),” Garcia said. “We as a community have to make investments to keep people safe.” 

Ward echoed that sentiment. She thinks government agencies devote resources to preparing for weather-related disasters like tornadoes, hurricanes and flooding, but not to heat.

“We don’t have real action from Congress on this,” Ward said. “It needs to step up here and think of ways that legislation is used to funnel federal dollars to state and local levels, specifically for heat.”

How many unhoused people die from extreme heat?

It’s unknown how many people struggling with consistent shelter die from heat exposure.

However, Ward said a clearer picture could be determined if emergency departments used existing medical codes for weather-related exposure that could be linked to health emergencies like cardiac arrest and renal failure. The incentive is not there to use the codes, said Ward, because they don’t provide government reimbursements for the cost of care.

“This is a systemic issue,” Ward said. “Doctors are doing a great job, but the incentive to incorporate these codes does not exist in the current system.”

Emergency departments in Worcester don’t generally look at weather-related issues that could account for a patient’s admission beyond frostbite, said Garcia. He thinks systems to provide follow-up care to help the unhoused and other patients that suffered heat-related illnesses could be set up, like those for patients suffering with substance-use disorders after discharge from the emergency room.

“A similar effort for especially weather-related issues for hot and cold exposure would make a lot of sense,” Garcia said.

Humid as heck: What to know when exercising outside in a Worcester summer

Beat the heat: Here’s what a heat wave really is, plus how to keep yourself safe

The Telegram & Gazette is investigating the effects of a rapidly heating planet on people who live in our city. Follow along with “City on Fire” as we report the struggle with summer temperatures, even in New England. This is part of the USA TODAY project Perilous Course. Contact reporter Henry Schwan to be included in a story if you have been affected by heat: expense of air conditioning or lack of it, health risks, less access to green space, concern about pets and animals in the summer conditions, worry about an older loved one, etc.

Contact Henry Schwan at [email protected]. Follow him on Twitter: @henrytelegram.