in Madison's Quality-of-Life
Recommendations For the Homeless and
There are many different factors that
determine an individual’s vulnerability to hypothermia. The result
is that health experts cannot predict how long a person can safely
remain outdoors at various temperatures. According to Dr. James J.
O’Connell from the Boston Health Care for the Homeless Program
(BHCHP), the most dangerous cases of hypothermia do not occur when
the ambient [surrounding] temperature is far below freezing.
Instead, Dr. O’Connell says, the worst cases they see arise when the
days are warm (between 40o F and 50o F) and the nighttime
temperature drops to the mid-30s.
cases of hypothermia often occur when the ambient temperature is
between 32o F and 40o F. For example, the most drastic case
ever seen at the BHCHP, in which a homeless man was brought in with
a body temperature of 57 o F, occurred when the temperature was
greater than 50o F during the day and fell to 36o F at night.
In order to protect their homeless citizens from extreme
cold, cities must organize and fund a winter response plan that
provides enough extra beds to accommodate the increased need of the
season. Dr. O’Connell asserts that “all cities should have a plan
well in place” before the cold weather arrives. Temperature cut-offs
should be avoided, since the effectiveness of a shelter is decreased
when the population it serves does not know, from night to night,
whether the shelter will be open. If a temperature cut-off is
necessary, due to financial or other reasons, the cut-off should be
at least 40o F in order to prevent the most dangerous cases of
hypothermia, according to Dr. O’Connell. If it is possible to
keep services open every night during the winter, regardless of
temperature, the winter season should be defined as October through
April. This allows homeless people to find shelter during the
transitions from fall to winter and from winter to spring, which Dr.
O’Connell acknowledges is a very dangerous period for homeless
A comprehensive approach is necessary in order to
make city-funded winter response plans as effective as possible.
When a homeless population has nowhere to take refuge indoors, it is
threatened by low daytime temperatures as well as nighttime cold.
Winter services must be available throughout the day, and cities
must have adequate space in day centers to accommodate people who
would otherwise remain outside until nightfall. If there is no
day center in an area, shelters in that area must open during the
day, at least when the temperature falls below 40o F.
Additionally, winter services must be available to
all homeless persons, without restrictions. Naturally,
people who are violent, threatening, or exceedingly disruptive may
be excluded from shelters for the safety of others. However, past
bans and other restrictions should be waived on nights when the
temperature is lower than 40o F. Most importantly, every city must
make winter shelter space available for people who have been
consuming alcohol or other drugs. The risk of developing hypothermia
is greatly increased for those who have been using substances,
especially alcohol. People who are inebriated must be allowed to
spend the night indoors during cold weather. If needed, they may be
separated from those who are sober, as long as they can remain safe
Local governments should play a large role
in the improvement of winter homeless services. Every state
and every major city should have a winter plan in place detailing
options for shelters, day centers, and emergency transportation, as
well as increased outreach and distribution of blankets and warm
clothing. This plan should be revised yearly, before the start of
the winter season. Additionally, the government should allocate
funds to winter services if there is not enough shelter space to
meet the nightly demand.
It must be understood that we do
not write this report to criticize existing winter services that are
imperfect due to funding or other circumstances out of their
control. Limited services that cannot be open reliably or cannot
accommodate everyone whose needs are certainly better than no
services at all. However, all homeless service providers must be
constantly trying to improve.
The homeless population is at greatly
increased risk for hypothermia and other cold- related
conditions. This risk is even higher from those who suffer from
substance addictions, mental illness, or other physical illnesses.
Even if they do not die from these conditions, their risk of death
from future unrelated conditions is greatly increased.
Homeless service providers and governments have the responsibility
to protect their homeless citizens through state- and city-wide
winter plans and increased shelter availability. An
exemplary winter shelter would be open 24 hours each day between
October 1 and April 30, regardless of temperature, as well as any
other days during the year when the temperature falls below 40o
F. It would also admit all homeless people, regardless
of sobriety status or past bans, unless they are violent or causing
an extreme disturbance.
Though many of the providers we
interviewed had impressive winter services, many others were
inadequate in some way. In some cases, this is a challenge that must
be met by providers themselves; in others, it is the result of a
lack of funding. In such situations, both the state and federal
government must provide sufficient and lasting resources and
services to its homeless constituents.
32 is not the magic number. For some reason “ we here in Madison” have decided that you are not cold or in danger of serious injury or death until the outside temperatures drops to 32 degrees.
I guess the magic number makes warm people feel better. The sad thing is, a person exposed to prolonged cool or cold temperatures inside or out can die of Hypothermia.
Temperatures of 33, 40, 50 or even 60 degrees for an extend time will cause one’s body to lose heat faster than it can create it.
The moral of this story is you can get just as dead at 40 or 50 as opposed to 32 degrees.