On steamy days in the Twin Cities, Seneca Krueger and her colleagues carry around lots of bottled water.
Krueger, a community impact manager at Community Medical Services, an opioid treatment facility, said a single bottle of water can help save someone experiencing homelessness a trip to the hospital. Identifying symptoms of heat exhaustion and dehydration is difficult enough, but then trying to convince them to seek treatment is even harder.
“My garage is full of people’s belongings because it was the only way to keep them safe and they would agree to go to the hospital,” she said.
The problem is only getting worse. “We’re seeing more and more folks outside who are new to homelessness, who don’t necessarily know where to go to get water, or where to get cool,” she said.
Krueger said she’s also seen more instances of heat exhaustion and heat stroke, a trend confirmed by statewide statistics. Health care facilities have seen about 800 heat-related emergencies each year in recent summers.
With Minnesota’s climate expected to continue to warm, and more very hot days coming before the end of the summer, Sahan Journal spoke with state health officials about what extreme heat can do to the body and how to stay cool.
Heat index
The heat index, also called the apparent temperature, is a figure developed through research that combines relative humidity and air temperature. The number — which doesn’t take into account other variables like wind or cloud cover — is meant to show what the temperature feels like to the human body.
“If you’re exposed to a certain heat index for a length of time, you could start seeing things like heat stress or heat stroke begin to take effect,” said Tyler Haserstein, a meteorologist with the National Weather Service (NWS) Twin Cities office. “Depending on how high that heat index is, it may happen sooner and it will take longer to recover.”
The National Weather Service issues advisories and warnings when the heat index climbs to those thresholds. But due to different climates and conditions nationwide, as well as how different populations can withstand the heat, that threshold can vary.
“Being in Minnesota, we acclimate to heat a bit differently than people that live in, say, Texas, so the thresholds do differ office to office,” he said.
For the seven-county Twin Cities metro area, the threshold for a heat advisory is 95, and 100 for an extreme heat warning. But another factor NWS officials take into account when issuing advisories and warnings is the population of people experiencing homelessness.
“The rest of our counties tend to have a smaller and more rural population, and tend not to have as large of a homeless footprint,” he said. “Those thresholds are five degrees higher, so that would be 100 for a heat advisory, and 105 heat index for a heat warning.
Health effects of extreme heat
Extreme heat causes more deaths annually nationwide than all other weather hazards combined, according to the NWS. Between 2000 and 2023, there were 77 deaths in Minnesota directly related to heat.
As the body heats up, it tries to cool itself down by sweating. But when exposed to hot conditions for a prolonged period of time, the body can’t cool itself fast enough, and symptoms of heat exhaustion can begin to develop, said Dr. Nick Lehnertz, a medical specialist at the Minnesota Department of Health.
Those symptoms include fatigue and weakness, headaches, excessive sweating and clammy skin.
“It is incredibly concerning, and we have to respond right away in order to reduce the risks of those symptoms that you’re experiencing,” Lehnertz said.
If an individual is unable to reduce their body temperature, their condition can turn into heat stroke. Symptoms of heat stroke may include a worsening headache, dizziness, confusion, agitation, loss of coordination or consciousness and even seizure.
“I can’t emphasize this enough: heat stroke is a medical emergency,” he said. “That is a 911 call, and you have to go be seen by a medical provider in an emergency care setting.”
The groups most vulnerable to these conditions include children and seniors, as well as people with conditions such as diabetes, obesity and heart or lung disease. Others who may be at relatively higher risk are people who take medications — like certain heart and psychiatric medications — that are diuretics. They can make people lose more fluid, or otherwise make it more difficult to regulate internal body temperature.
How to protect oneself
When treating heat exhaustion or heat stroke, Lehnertz said the goal is to cool the body down as rapidly as possible. In a medical facility, that could involve submerging the body in an ice bath, covering the body in ice packs and administering cool intravenous fluids.
Lehnertz said the three best ways to prevent reaching that point are staying hydrated, staying cool and staying informed.
Staying hydrated: drinking water or beverages with electrolytes like Gatorade, and avoiding beverages like coffee and alcohol, which are diuretics and make you lose more water than you retain.
Staying cool: spending time in air-conditioned facilities or in the shade if you’re outdoors; if your home doesn’t have air conditioning, going to public spaces like libraries or malls that do.
Staying informed: paying attention to the temperature and humidity through apps or websites, and considering altering plans to avoid midday heat if the heat index is high.
Krueger said July and August are the months when there is the greatest risk. More people are outdoors, but the number of places they can go to stay cool or get water seems to be dwindling.
“There is a lot more need, and a lot more people with bigger needs,” she said. “The spaces that they were able to access are becoming overwhelmed with that big need. Many are cutting hours or telling people they can’t come back.”
Krueger said she and her team try to help people find spaces they can use to stay cool, and urge them to move off of concrete and onto grassy areas. They look for symptoms of heat exhaustion and heat stroke, and get people to the hospital if they need treatment.
Hennepin and Ramsey counties offer several cooling locations across the Twin Cities metro listed on interactive maps that include libraries, recreation centers, wading pools and shopping malls. Some examples include:
- Minneapolis Central Library, 300 Nicollet Mall, Minneapolis
- Salvation Army Citadel, 401 W. 7th St., St. Paul
- Mount Olive Lutheran Church, 3045 Chicago Ave. S., Minneapolis
- Merriam Park Rec Center, 2000 St. Anthony Ave., St. Paul
