Shakoor Hajat is with the London School of Hygiene & Tropical Medicine, London, UK. Christophe E. Sarran is with the Met Office, Exeter, UK. Mariya Bezgrebelna is with the Department of Psychology, York University, Toronto, Ontario, Canada. Sean A. Kidd is with the Centre for Addiction and Mental Health and the University of Toronto Department of Psychiatry, Toronto.
Am J Public Health. 2023 Sep;113(9):981-984. doi: 10.2105/AJPH.2023.307351. Epub 2023 Jun 29.
To assess the impacts of ambient temperature on hospitalizations of people experiencing homelessness. We used daily time-series regression analysis employing distributed lag nonlinear models of 148 177 emergency inpatient admissions with "no fixed abode" and 20 804 admissions with a diagnosis of homelessness in London, United Kingdom, in 2011 through 2019. There was a significantly increased risk of hospitalization associated with high temperature; at 25°C versus the minimum morbidity temperature (MMT), relative risks were 1.359 (95% confidence interval [CI] = 1.216, 1.580) and 1.351 (95% CI = 1.039, 1.757) for admissions with "no fixed abode" and admissions with a homelessness diagnosis, respectively. Between 14.5% and 18.9% of admissions were attributable to temperatures above the MMT. No significant associations were observed with cold. There is an elevated risk of hospitalization associated with even moderately high temperatures in individuals experiencing homelessness. Risks are larger than those reported in the general population. Greater emphasis should be placed on addressing homeless vulnerabilities during hot weather rather than cold. Activation thresholds for interventions such as the Severe Weather Emergency Protocol (SWEP) could be better aligned with health risks. Given elevated risks at even moderate temperatures, our findings support prioritization of prevention-oriented measures, rather than crisis response, to address homelessness. ( 2023;113(9):981-984. https://doi.org/10.2105/AJPH.2023.307351).
评估环境温度对无家可归者住院的影响。我们使用每日时间序列回归分析,采用英国伦敦 2011 年至 2019 年 148177 例无固定住所和 20804 例诊断为无家可归的急诊住院患者的分布式滞后非线性模型。高温与住院风险显著增加相关;与最低发病温度(MMT)相比,25°C 时,无固定住所的住院患者的相对风险为 1.359(95%置信区间 [CI] = 1.216, 1.580),有 homelessness 诊断的住院患者为 1.351(95% CI = 1.039, 1.757)。14.5%至 18.9%的住院患者归因于高于 MMT 的温度。与寒冷天气没有观察到显著关联。无家可归者的住院风险与环境温度升高相关,即使是中度高温也会导致风险升高。风险比一般人群报告的更高。在炎热天气中,应更加重视解决无家可归者的脆弱性问题,而不是寒冷天气。干预措施(如恶劣天气应急协议[SWEP])的激活阈值可以更好地与健康风险保持一致。鉴于即使在中度温度下也存在较高风险,我们的研究结果支持优先采取以预防为导向的措施,而不是危机应对措施,以解决无家可归问题。(2023;113(9):981-984. https://doi.org/10.2105/AJPH.2023.307351)。