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Open AccessArticle

Cold Weather Conditions and Risk of Hypothermia Among People Experiencing Homelessness: Implications for Prevention Strategies

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MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, 30 Bond Street, Toronto, ON M5B 1W8, Canada
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Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, ON M5T 3M7, Canada
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Toronto Public Health, 277 Victoria St, Toronto, ON M5B 1W2, Canada
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Division of General Internal Medicine, Department of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Cir, Toronto, ON M5S 1A8, Canada
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(18), 3259; https://doi.org/10.3390/ijerph16183259
Received: 2 August 2019 / Revised: 26 August 2019 / Accepted: 29 August 2019 / Published: 5 September 2019
Hypothermia is a preventable condition that disproportionately affects individuals who experience homelessness, yet limited data exist to inform the response to cold weather. To fill this gap, we examined the association between meteorological conditions and the risk of hypothermia among homeless individuals. Hypothermic events were identified from emergency department charts and coroner’s records between 2004 and 2015 in Toronto, Canada. A time-stratified case-crossover design with conditional logistic regression was used to assess the relationship between the meteorological conditions (minimum temperature and precipitation) and the risk of hypothermia. There were 97 hypothermic events identified: 79 injuries and 18 deaths. The odds of experiencing a hypothermic event increased 1.64-fold (95% CI: 1.30–2.07) with every 5 °C decrease in the minimum daily temperature and 1.10-fold (95% CI: 1.03–1.17) with every 1 mm increase in precipitation. The risk of hypothermia among individuals experiencing homelessness increased with declining temperature; however, most cases occurred during periods of low and moderate cold stress. 72% occurred when the minimum daily temperatures were warmer than −15 °C. These findings highlight the importance of providing a seasonal cold weather response to prevent hypothermia, complemented by an alert-based response on extremely cold days. View Full-Text
Keywords: homelessness; meteorological conditions; hypothermia; cold weather policy homelessness; meteorological conditions; hypothermia; cold weather policy
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Zhang, P.; Wiens, K.; Wang, R.; Luong, L.; Ansara, D.; Gower, S.; Bassil, K.; Hwang, S.W. Cold Weather Conditions and Risk of Hypothermia Among People Experiencing Homelessness: Implications for Prevention Strategies. Int. J. Environ. Res. Public Health 2019, 16, 3259.

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