For people seeking either routine or emergency healthcare, the extremes of winter weather present significant barriers. But, for individuals also facing the challenges of social determinants, these cold and wet months can be the toughest of the year. From coast to coast, healthcare providers and other organizations caring for vulnerable populations must not only prepare for weather, but also think of ways to ensure continued prevention and minimal disruption of care.
Keeping Coordination ‘Hot’
The obvious barrier to healthcare as a result of winter weather is access. A storm can disrupt a patient’s care plan as they may not be able to receive the necessary treatment or monitoring. While most health systems have emergency plans in the case of winter storms, the intricacies of providing complex care to patients can prove difficult.
To prevent interruptions in care, more healthcare providers are preparing in advance of bad weather. Providers are texting and calling patients to keep them connected and on track to positive healthcare outcomes. Additionally, they are making sure patients are in the best possible situation to continue their care despite the weather. If receiving outpatient care, many providers are now giving supplies—medication, oxygen or equipment—in advance of a storm to continue care without any interruption.
As an example, last winter, Boston experienced record snowfalls and weeks of below-average temperatures. Many residents were homebound with impassable roads and a public transportation system which ground to a halt. Making matters more challenging, amidst the storms, Massachusetts’ governor ordered all methadone clinics to close, a very rare occurrence due to their legal requirement to stay open 365 days a year. The clinicians at one of the larger behavioral health services centers helping patients fighting opiate addiction planned ahead by distributing “take-home” doses of the medication. While admitting the potential for abuse, the organization believed that the risk was outweighed by the benefit of not breaking the chain of this regular and vital care.
Preventing ‘Cold’ Consequences
In addition to better coordinating care in advance of bad weather, many organizations have tried to preemptively address health hazards associated with winter. One of the main concerns is the lack of shelter and resources, including, heat, food and proper clothing to remain safe during inclement weather.
In New Jersey, a number of urban safety-net hospitals are trying to reduce the wintertime spike in readmission rates among patients. To this end, the hospitals are combatting a host of social determinants from poverty and isolation to substance abuse and mental health issues. For instance, staff are trying to determine which patients may not have proper heating at home or no one close who can get through bad weather to aid them during the healing process, both major drivers for patient readmission.
Numerous nonprofit organizations also ramp up efforts during the cold months to assist those most vulnerable to the winter weather—homeless living on the streets. Philadelphia-based nonprofit Project Home, runs a program called Hub for Hope from early January through April in a subway station under City Hall. The program not only offers a place to stay, but also provides a hot drink, and social and mental health services. The nonprofit aims to lower the barrier to care. On a typical day, they see between 150 to 200 people. While they help homeless in the short-term offering shelter during winter storms, their primary goal is to help people get permanent housing, and connect them to ongoing primary healthcare.
Extreme weather can be tough on all of us, but its most severe impacts are felt by those who are already challenged by social determinants. With more planning and thoughtful innovation by those in healthcare, we can hopefully minimize the season’s effects on them.