Hypothermia and Homelessness

Cold weather poses a threat to those experiencing homelessness even when temperatures seem mild. Hypothermia can set in when temperatures drop below 50 degrees Fahrenheit, but many shelters don’t open until it’s much colder.

Hypothermia is a medical emergency that occurs when your body loses heat faster than it can produce heat, causing a dangerously low body temperature. Normal body temperature is around 98.6 F (37 C). Hypothermia occurs as your body temperature falls below 95 F (35 C).

When your body temperature drops, your heart, nervous system and other organs can’t work normally. Left untreated, hypothermia can eventually lead to complete failure of your heart and respiratory system and eventually to death.

Hypothermia is often caused by exposure to cold weather or immersion in cold water. Primary treatments for hypothermia are methods to warm the body back to a normal temperature.


Shivering is likely the first thing you’ll notice as the temperature starts to drop because it’s your body’s automatic defense against cold temperature — an attempt to warm itself.

Signs and symptoms of hypothermia include:

  • Shivering
  • Slurred speech or mumbling
  • Slow, shallow breathing
  • Weak pulse
  • Clumsiness or lack of coordination
  • Drowsiness or very low energy
  • Confusion or memory loss
  • Loss of consciousness
  • Bright red, cold skin (in infants)

Someone with hypothermia usually isn’t aware of his or her condition because the symptoms often begin gradually. Also, the confused thinking associated with hypothermia prevents self-awareness. The confused thinking can also lead to risk-taking behavior.

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In response, NYC’s Department of Homeless Services has issued what it calls a “Code Blue,” a set of emergency procedures aimed at protecting those homeless people who are in danger due to the weather. The city, which by law must offer shelter to all those who need it, implements Code Blue during periods of sustained winds or precipitation and when the temperature drops below 32 degrees Fahrenheit for an extended period.

According to nyc.gov, the following help is made more available for the homeless:

Shelters: During a Code Blue, homeless adults can access any shelter location for single individuals.
Beds are available system-wide to accommodate anyone brought in by outreach teams or walk-ins.

Drop-in centers: All drop-in centers are open 24 hours a day when Code Blue procedures are in effect, taking in as many as people as possible for the duration of inclement weather. Drop-in staff also can make arrangements for homeless individuals at other citywide facilities.

Safe havens and stabilization beds: Chronically homeless individuals may be transported to these low-threshold housing options, where they may go directly from the street to a bed.

New Yorkers should call 911 if they see someone in need of medical assistance, and 311 to have a HOME-STAT outreach team engage a homeless individual about going to a shelter and receiving homelessness services.

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To help combat the freezing cold temperatures in New York, you can buy emergency mylar blankets that will be included in each backpack. They’re often advertised as reflecting up to 90% of your body heat.

1 Comment

  1. Steve

    Hypothermia is a potentially lethal but highly preventable condition. As such, it is essential for public health, shelter, and outreach organizations to take proactive steps through planning and response to mitigate the health impacts of cold weather on people experiencing homelessness. Since hypothermic events occur during periods of low and moderate cold stress in addition to high cold stress, a multifaceted cold weather response is required. This study provided a health-based rationale to inform the evolution of a local approach to cold weather response, and highlighted the critical importance of a seasonal cold weather response strategy comprised of low-barrier access to seasonal shelters and warming centers in addition to extreme cold weather alerts. Future work should examine the impact of this joint approach on reducing the risk of hypothermia among individuals experiencing homelessness. In the meantime, the ultimate public health goal must remain the elimination of homelessness through policy change and increased availability of affordable housing and appropriate supports.


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