Exposed Nevada Public Radio

To see what the effects of extreme heat may be like on a large scale if things don’t change, look no further than the unhoused people in your own city
“You’ll see guys sleeping under blankets, and they won’t move for a few hours. So, you go to check on them and you realize ‘Oh, he’s dead,’” says Santiago, his face drawn, as he sits with a small group of other men on the sidewalk outside Catholic Charities of Southern Nevada’s main campus. He’s describing what being unhoused is like in Las Vegas — a city with increasingly extreme temperatures because of climate change and a growing homeless population, exacerbated by pandemic-related evictions and a rising cost of living. This combination of factors is leading to a startling increase of deaths among the unhoused: According to reporting done by the Review-Journal, Clark County saw an 80 percent increase in heat-related fatalities among the homeless community from 2020 to 2021.

Santiago’s story illustrates the dire consequences of the problem facing elected officials, public health leaders, community members, and the unhoused themselves. What does a changing climate mean for this growing population of vulnerable Southern Nevadans — and for all of us?

*****

Once you’re out on the streets, the chance of you ever being put back into a house again are so small. You have to come up with so many extra deposits … Once you’re homeless, you’ll probably never be housed again. – Lori, an unhoused woman who’s been living on the streets of Las Vegas for years

The COVID pandemic made situations like Lori’s a reality for thousands of Nevadans. The United Way found that the state ranked No. 2 in the nation for unemployment because of COVID and had the ninth-highest homelessness rate before the pandemic even began.

“What we’re seeing is more homeless individuals on the street due to COVID or new eviction,” says Louis Lacey, director of Homeless Response Teams for HELP of Southern Nevada, and himself a former unhoused individual. “Or then the rising rental costs, which are forcing some people to move out because they can’t afford it. And they end up homeless.” The data bear this out: The Las Vegas Justice Court typically processes about 30,000 evictions in any given year, but that has risen to 45,000 since the Nevada eviction moratorium expired in May. “There’s been a lot of people that are suffering because they’ve been evicted with no place to go,” says Deacon Tom Roberts, CEO of Catholic Charities of Southern Nevada. “They’re just being pushed out on the street.”

COVID is not the only contributing factor to the mounting rates of homelessness — the recent economic downturn and rising inflation have also played a role. “Inflation always hurts the people lowest on the economic ladder,” says Nicholas Barr, a UNLV assistant professor of social work who studies vulnerable populations. And when, as experts estimate, 81.5 percent of those low-income people pay more than half their income toward rent, any rise in costs or inflation can be the difference between remaining housed or not in a metropolitan area such as Las Vegas, which the National Low Income Housing Coalition pegged as first in the nation for severe housing shortages.

While most experts agree that homelessness has increased in recent years, there is little consensus on how many unhoused individuals there actually are in Southern Nevada. Those in the field say the best estimates are from the Point-in-Time (PIT) Count and Survey, which measures how many individuals were experiencing homelessness on a single day. The count this year was on February 23, when surveyors identified 5,645 unhoused people, the most recorded since 2014. Yet, because these numbers represent a snapshot in time on a single day, there are doubts as to whether these numbers are even meaningful.

“The PIT Count is understood to be a not great method of counting, and it’s understood to almost always be a pretty substantial undercount,” Barr says. “It doesn’t capture this group of people who are doubled up with friends or family, or maybe staying in weeklies, who are unstable in their homes, or who are homeless, but are not immediately visible to people just walking around trying to do a count over the course of 24 hours.”

Regardless of the PIT Count’s accuracy, it can be helpful in showing broader trends among the homeless population. And those trends, Lacey says, are troubling, especially as concerns the newly unhoused. “We’re seeing more individuals that are on the streets that are not people who have been on the street for a long time,” he notes. “So, we have a lot of families and a lot of individuals who just a few years ago were stably housed and working, and now due to the turn of events … are finding themselves homeless. And some of these folks, they don’t have the survival skills that maybe some of our other unhoused clients who have been homeless for a while have.”

This could spell disaster as the weather gets more extreme. Individuals who have been unhoused for years still struggle with the heat themselves, so the risk for newly unhoused individuals, who don’t have the survival strategies to cope with higher temperatures the way their more experienced counterparts do, is that much greater as summers get hotter and longer.

*****

I know one person who was walking down the street and had a medical episode. She fell down on the pavement and ended up in the hospital, where she eventually lost her leg (to amuptation). The street is so hot it will burn you. Severely, very quickly … So that is something that a lot of people don’t think about: the heat coming off of the sidewalks and the pavement. It can be an ambient 115 degrees, which is not unusual in Las Vegas in the summer. But what is the heat coming off of the pavement? It’s definitely far greater. – Lacey, HELP of Southern Nevada

Climate change is often blamed for Las Vegas’ rising summer temperatures, but it is only one of several factors making it the second-fastest warming metropolitan area in the nation. Another is the urban heat island effect, whereby buildings, roadways, and other manmade structures absorb daytime heat, then release it at night. “This prevents the temperature going below a certain threshold,” says Erick Bandala, a systems research professor at the Desert Research Institute who has been studying the phenomenon for years. Bandala says the urban heat island is worsened by the removal of trees and grass, yet there is a need to balance cooling vegetation with water conservation, another pressing issue facing the region: “It’s a very complex situation here,” he adds.

The urban environment, beyond causing hotter summers, is also leading to more heat-related illnesses among the unhoused. “When we think about climate impacts, people tend to think about drought … floods … wildfire,” says Kristen Averyt, UNLV faculty member and senior climate advisor to Governor Steve Sisolak. “But there are more fatalities associated with extreme heat than any other weather event in a given year.”

The data concur. Last year, the Clark County Coroner’s Office reported 245 heat-related deaths in Southern Nevada, 83 of which were unhoused individuals — an almost 100 percent increase since 2020, when 46 unhoused individuals died from the same causes. “That’s a disproportionate number that are folks experiencing homelessness,” Barr notes. “It’s a huge problem.” The Review-Journal underlined the troubling situation last summer, reporting that 2021 was the deadliest year for the unhoused in a decade. Heat-related fatalities soared to seven times what they were in 2010.

These numbers are so high partly due to just how many conditions fall under the umbrella of “heat-related illnesses.” “Most people just think of heat-related illnesses as, you get exposed to heat and you get heatstroke, but it’s a spectrum of disease,” says UMC’s vice chief of emergency medicine, Ketan Patel. “The higher temperature can trigger strokes, asthma, COPD (chronic obstructive pulmonary disease). People can go into kidney failure … We get a lot of patients transferred in for pavement burns … Also people who have psychiatric disorders, which are actually very common in our homeless population — those patients are also susceptible because of the medications they’re on that have decreased their ability to cope with the heat and regulate their body temperatures.”

The higher temperatures and lack of urban vegetation, beyond causing or exacerbating physical health conditions, can also play a role in the development of mental health issues among the unhoused. “When we start looking at homelessness in general, we look at the green spaces, because it’s really tied to their dehydration range,” says Dak Kopec, an architectural psychologist and UNLV architecture professor. “And we don’t want to cause chronic dehydration. What ends up happening is that when you have a higher salt-to-water concentration, it allows for greater conductivity of neural synaptic connections. This is why (dehydration is) highly tied to schizophrenia.”

Any heat-related conditions, whether chronic, physical, or mental, can turn deadly. This is especially true if there’s a delay in medical intervention, a situation that’s not uncommon for a population with historically limited access to healthcare services. “We try to treat them the best we can, but sometimes it’s hard to stop the train once it leaves the station,” Patel says. For those experiencing homelessness, the core problem is the trauma that high heat inflicts on bodies already stressed by starvation, chronic sleep deprivation, and health issues.

Patel explains, “If your body is already at the cusp of having an issue (such as) kidney failure, heart disease, you’re at risk of a stroke — any added stress on top of that can be the straw that breaks the camel’s back.”

That level of constant stress can take a toll on the body, Bandala says, drawing from his research on the long-term effects of heat-related illness. “After exposure to extreme heat, it takes a long period of time for full recovery, if they recover at all.” The initial illness can trigger a lifelong hamster wheel of conditions for an unhoused individual, which can compound upon one another and lead to worse health outcomes over time. “Folks who are unsheltered and experiencing homelessness are not people who have resources to manage complex chronic health conditions,” UNLV’s Barr notes. “And those conditions are always made worse by being poor and being unsheltered. So, it’s this vicious cycle where people are more susceptible to heat death, and they develop chronic illness that then worsens that susceptibility.”

Naturally, when summer temperatures regularly reach highs of more than 110 degrees or the monsoon humidity settles over the valley, the homeless community seeks shelter wherever they can find it. This comes with its own set of dangers, beyond the heat. “If you have nowhere to go, a lot of folks then choose to go underground in the tunnels, and that creates huge safety issues,” says Lacey with HELP of Southern Nevada. “With the way the rains are here in Southern Nevada, it can rain miles away, but the water is going to come to you. So, all of a sudden, a wall of water comes, and the thing is that everybody has all their stuff down there, and a lot of various items end up in the tunnels. What happens is when these rains come and the waters come crashing down, the items come crashing along with the water. People get knocked down, and then they drown and die.”

*****

At the shelter, you get up at five o’clock in the morning, and you’re told to go out, and you’re sitting on a cold cement sidewalk with no place to go. No resources, you don’t know where to go — you’re just stuck there … The other women and I snuggled up to one another just to have our body heat. And hopefully that day will pass by faster, so you can get back in (the shelter) and get cleaned up and just go to sleep. – Karri Finley, a six-decade Las Vegas resident, who was unhoused for five years

While exposure to Southern Nevada’s extreme summer heat is generally more deadly for unsheltered individuals, people tend to underestimate how risky the cold and wind are for that same population. “In Vegas we always just think about the extreme heat, but we do get a lot of people who have cold exposure,” says UMC’s Patel. “And that is just like heatstroke — a spectrum … Especially here, when it rains in the winter, (the unhoused) can’t get away from the exposures of the damp cold. It can result in hypothermia, trench foot, infections of the feet. And people oftentimes lose limbs because of exposure.”

The cold, like the heat, can also exacerbate underlying conditions or seasonal illnesses, such as COVID or influenza. Karri Finley, who recently found housing after five years without, became intimately familiar with the dangers of the cold when she caught pneumonia in 2018. “Three o’clock in the morning, I started getting really, really sick just out of nowhere, and I was running a fever,” she remembers. “I almost lost my life.” Yet the illness was the least harmful aspect of the ordeal for Finley. The most devastating part, she says, was the response from the EMT, when they arrived and told her that she must be lying to try to get a warm hospital bed and a meal for the night: “I’ll never forget that. It was a hard thing to hear from somebody that works in a job like that.”

*****

I just had a backpack stolen, and all my cold-weather gear was in that backpack … But someone came up to me — a friend, or acquaintance — and handed me a fleece pullover. That got me through the winter. So, we help each other, we really do. – Kelly, an unhoused Las Vegan and buddy of Santiago

Kelly’s story illustrates how the unhoused oftentimes cope with exposure to extreme weather — by turning to other members of the community for an extra blanket, a shared umbrella, a spare fleece pullover. Charitable organizations also make efforts to ease the burden of extreme weather on the homeless population. A few of these groups, such as HELP of Southern Nevada, meet the unhoused where they are, going out on the streets and distributing items to help people survive exposure to the elements. “In (summer) survival kits, we are able to put burn cream, first aid kits, cooling fans, cooling towels, a tarp, giant water containers so that they can carry water with them,” says HELP’s Lacey. “In the winter kit, there would be blankets, beanies, scarves, gloves, underwear, socks.”

Other organizations focus on alleviating the root cause of heat- and cold-related illnesses by trying to prevent prolonged exposure to the elements in the first place. Catholic Charities of Southern Nevada, which has a shelter with 400 beds for local men, reports that it spent $5 million last fiscal year sheltering and providing services for 114,086 unhoused men in their emergency shelter. Catholic Charities’ Roberts also advocates for greater resources to prevent weather-related illness for the unhoused: “My job, I think more than anything, is to educate and inform, to help people understand what the issues are and why they exist. And then what we can do to help, and then what they can do to help, public or private … Part of our mission is we collaborate with others, so we’re not duplicating services.”

That collaboration extends to local elected officials, as well as other community organizations, such as The Salvation Army of Southern Nevada, which served 62,575 unhoused individuals last year. The Salvation Army offers 288 beds in its overnight shelter, in addition to other spaces for veterans and LGBT individuals, as well as a day shelter for those looking to escape the elements. Unhoused people can come and cool off or warm up, hydrate, charge their phones, and rest.

The Shade Tree, a charity dedicated to helping women and children exclusively, provides clients with what it calls an “Inclement Weather Shelter,” where unhoused individuals can spend the night during the winter or the day during the summer months. These services are augmented by those of the Las Vegas Rescue Mission — the final of the big four charities clustered around Main Street — with space to shelter 284 unhoused individuals. These organizations are the first lifeline for people experiencing homelessness, and a crucial avenue for escaping the cold or extreme heat. “Just showing that compassion to be able to know where people are and meeting them where they’re at” is an important part of the process, says Juan Salinas, The Salvation Army of Southern Nevada’s director of social services.

These civilian-led charity organizations supplement the work being done by the City of Las Vegas and Clark County. The city’s Courtyard Homeless Resource Center provides 800 covered sleeping mats and a Recuperative Care Center, which treats medical issues not severe enough to justify keeping someone in the hospital — such as recovery from heat stroke. This 38-bed facility has helped 261 patients to date and is intended to be the middle ground between the hospital and the streets. This is in addition to what the county is doing to keep the unhoused from overheating or getting too cold. “Clark County opens up emergency cooling stations during the summer and emergency warming stations during the winter,” Lacey says. “If the temperature reaches a certain level, then these stations are activated.”

These emergency stations are located within senior and community centers, as well as nonprofit spaces, and offer water, air conditioning, and heat, depending on the weather. Clark County is also attempting to prevent homelessness before it begins by using its $1.25 million Eviction Diversion Initiative grant to stem new evictions. Announced October 12, these funds are aimed at reducing preventable evictions among Las Vegans at risk of homelessness.

On the broader state level, the Nevada ACLU plans on pushing for the implementation of a so-called “Right to Rest Act” during the 2023 legislative session. If passed, it would establish a legal right for the unhoused to rest in public spaces, making Nevada one of the few states in the nation with such a law. Experts say a Right to Rest Act would affect how medical issues are treated in the homeless community. Nevada ACLU Policy Manager Lilith Baran says, “The reason this is helpful is, advocates and care workers are able to know where people are and where to find them. And if we’re moving people around all the time or forcing people to literally hide under the sewers and in drainpipes, it’s really hard to access care and help people with things like frostbite or heat exhaustion.”

Governor Sisolak’s office is also working on prevention, in the form of attempting to tackle extreme heat itself. Earlier this year, he appointed both a State Environmental Justice Team and an Extreme Heat Planning Team to generate recommendations and a plan to reduce the effects of climate change, particularly for marginalized Nevadans. Though tangible impacts from these two teams are yet to be seen, Averyt, the governor’s senior climate advisor and one of three people appointed to the heat team, says she hopes to see changes in the design and planning of urban communities that would make sure “we’re doing the best that we can to create resilience in our communities, whether that’s how we build our buildings, where we build our buildings, (or) what kind of design features they might use, and integrating that in as we think about affordable housing as well.”

For many in the Las Vegas community, the prevailing attitude toward helping the unhoused escape the extreme heat and cold can be summed up in the words of HELP’s Lacey: “I just want to leave it better than I found it. And I believe that everyone in the community feels the same way.”

*****

I see these guys in wheelchairs, or a woman with her legs cut off because she might have had gangrene, but she’s manually trying to go uphill with the wheelchair by hand. I don’t know why this has to be. Why do these people have to fight so hard to get a mechanical wheelchair? Why? It shouldn’t be like that for them.– Karri Finley

While many people in Las Vegas are investing in solutions to extreme weather-related illnesses among the unhoused, forces are also working against progress — not all of them in our control. One such uncontrollable force is the climate. “The science is pretty clear, it’s getting hotter on average,” Averyt says. “And that’s going to continue to drive longer and more intense heat waves.”

Magnifying the issue is the valley’s continued population growth: The 2020 census showed that Nevada is the fifth-fastest-growing state in the country, with Clark County growing more than 16 percent over the last decade. UNLV’s Center for Business and Economic Research estimates Southern Nevada will welcome about 700,000 more residents by 2040, reaching a population of three million.

“More people are coming to live here, which means that we most likely will need to increase the infrastructure and housing and streets,” DRI’s Bandala says. “And the urban community will respond, which means that it’s very likely that we will see an increase of the urban heat island effect if we don’t do something about it.” Kopek, the architectural psychologist at UNLV, adds that the way the urban community is favoring dark, inorganic structures (which absorb and emit heat) is part of the problem. Kopec notes, “Las Vegas still seems to be doing what they were doing back in the ’80s, which is building freeways and strip malls that are fronted by giant parking lots … It’s a little sad, because it’s a city that is growing by leaps and bounds, and it has the opportunities to be able to make better decisions.”

Though this urban growth has come with more homeless shelters, the shelter space is not keeping up with demand. It’s hard to estimate how many shelter beds the valley has — estimates range from 1,300 to 2,000 — but it’s clear that the number of beds, even at the higher end of that range, falls far short when compared to the number of unhoused individuals estimated by the PIT Count: 2,000 available sleeping spaces for over 5,645 people. In other words, more than half of unhoused individuals have nowhere to sleep during extreme heat and cold.

Yet another force working against the unhoused coping with heat- and cold-related illnesses is the Las Vegas Encampment Ordinance, Bill No. , sponsored by Mayor Carolyn Goodman and passed by the City Council on a 5-2 vote in late 2019. Making it a misdemeanor to sleep on the streets in specific areas of the city when shelter beds are available, the law includes punishment of up to six months in jail or a $1,000 fine. “Those kinds of things are extremely detrimental for a lot of reasons,” says Baran of the ACLU, one of more than 300 organizations and individuals that opposed the ordinance. “One of them is that you can’t fine someone who already has no money. So, what ends up happening is you just do this cycle of predatory fines and fees, and then people end up in a lot worse place than they were in the first place.” These jail stays and fines go on a criminal record, making it even more difficult for the unhoused to regain housing and employment, thus exposing them to heat and cold for longer.

Las Vegas Metro’s aggressive booking tactics may also contribute to criminal records for the unhoused. The Nevada Current reported in 2020 that Metro’s booking data showed 204 people had been arrested and jailed for staying in a park after hours, and 53 were booked for misusing benches and shelters at bus stops. This has the effect of frightening the homeless population away from shady and rain-protected areas (bus shelters and parks) and forcing them into more dangerous locations, where they are vulnerable to the elements.

The cycle of arrest, incarceration, and release of the unhoused is costly in other ways, too. John Piro, the Clark County deputy public defender, speaking to the Review-Journal after the Encampment Ordinance passed in 2019, noted that it costs $170 per day to keep an inmate in detention at the county jail. UNLV’s Barr argues that this money, along with the taxpayer-provided funding for emergency room stays and ambulance rides because of heat- or cold-related illnesses, would be better spent providing permanent housing for the homeless community. “We’re already paying for this stuff, but we’re just paying for really poor outcomes,” he says. “It’s cheaper, actually, to guarantee and provide housing. There are just some things that are complicated and expensive, but that are social goods that over the long term vastly repay their initial investments. And the bottom line is that, until we treat housing as a social good, and something that people deserve to have, we’re going to keep on having a problem.”

*****

The homeless population is oftentimes the first category of people to face any kind of environmental suffering — they are exceptionally vulnerable to a changing climate. As such, Southern Nevada has a tough challenge in protecting this at-risk population. Reducing instances of extreme weather, treating and preventing the illnesses associated with extreme weather among the unhoused, and precluding the occurrence of homelessness in the first place are all strategies the local community has mounted. Though there is a long way to go, experts are mostly hopeful that the situation of the unhoused can and will get better. “I am very optimistic,” says Roberts of Catholic Charities. “We can’t do everything, but we can do something. Every one of us.”

Doing something about heat- and cold-related illnesses likely will involve stable housing as a first step, and that takes time, money, and political will. “We can put people on the moon, we can intervene to save whole economic sectors during COVID,” Barr says. “(Providing housing) is doable. It’s just a question of whether it’s important enough to people to do it. But it’s not going to be a problem that’s responsive to the dictates of a two-year political cycle; it’s going to require sustained effort over multiple administrations to get it done.”

Until then, the unhoused must continue to find ways to cope with hotter summers, longer heatwaves, and consistently cold and damp winters. They do what people have always done: turning to one another for support. Santiago, the unhoused man sitting outside of Catholic Charities, looks at his friend Kelly and smiles. “Some of us come prepared, and some of us scramble — but we don’t mind helping brothers out.” ✦

EDITOR’S NOTE: Kelly, Lori, and Santiago, unhoused Las Vegans whom the writer interviewed in person, declined to give their last name for this story, to protect their and their families’ privacy.