Abstracts
Abstract
This paper asks how people experiencing homelessness and who are unsheltered manage the risks posed by insect-borne illnesses. Concerns over such risks have increased with recognition that climate change is expanding the range of many insect vectors for serious illnesses. In response to this threat, many cities – including Cambridge, Massachusetts (MA), where this study was conducted – have started to take efforts to protect the public. Nonetheless, these have often paid limited attention to the unsheltered. Drawing on interviews with 85 unsheltered residents this paper examines how these individuals understand and respond to insect-borne illness risks. The results show interviewees hold diverse views, with many having some awareness of such risks and taking a variety of steps to manage their exposure. In the absence of regular access to insect repellent many interviewees opt for a variety of alternative approaches, likely varying in effectiveness, to prevent and respond to insect bites. Some interviewees, however, are either unaware of their risks or unable to take steps to protect themselves. The results provide insights for city officials, advocates for the unsheltered, and planners as they try to protect highly vulnerable groups in the face of increasing climate-driven risk from insect-borne illnesses.
Keywords:
- Homelessness,
- Shelter,
- Health,
- insect,
- disease,
- vector,
- mosquito
Appendices
Bibliography
- Armstrong, P. M., & Andreadis, T. G. (2013). Eastern equine encephalitis virus—old enemy, new threat. New England Journal of Medicine, 368(18), 1670-1673. https://doi.org/10.1056/NEJMp121369610.1056/NEJMp1213696 Google Scholar Search this bibliographic reference on Google Scholar
- Badiaga, S., Raoult, D., & Brouqui, P. (2008). Preventing and controlling emerging and reemerging transmissible diseases in the homeless. Emerging Infectious Diseases, 14(9), 1353–1359. https://doi.org/10.3201/eid1409.08020410.3201/eid1409.080204 Google Scholar Search this bibliographic reference on Google Scholar
- BBC. (2024). Protests in Seville as West Nile virus kills five. https://www.bbc.com/news/articles/c1ep24g99v3oGoogle Scholar Search this bibliographic reference on Google Scholar
- Biehler, D., Baker, J., Pitas, J.-H., Bode-George, Y., Jordan, R., Sorensen, A. E., & Wilson, S. (2018). Beyond “the mosquito people”: The challenges of engaging community for environmental justice in infested urban spaces. In R. Lave, C. Biermann, & S. N. Lane (Eds.), The Palgrave Handbook of Critical Physical Geography (pp. 295-318). Palgrave.10.1007/978-3-319-71461-5_14 Google Scholar Search this bibliographic reference on Google Scholar
- Cambridge Public Health Department. (2018). Eastern Equine Encephalitis. http://www.cambridgepublichealth.org/services/environmental-health/mosquito-borne-diseases/eastern_equine_encephalitis.phpGoogle Scholar Search this bibliographic reference on Google Scholar
- Cambridge Public Health Department. (2024a). State health officials announce season’s first human case of Eastern Equine Encephalitis in Massachusetts. https://www.cambridgepublichealth.org/state-health-officials-announce-seasons-first-human-case-of-eastern-equine-encephalitis-in-massachusetts/Google Scholar Search this bibliographic reference on Google Scholar
- Cambridge Public Health Department. (2024b). Mosquito-borne illnesses: What are the risks? https://www.cambridgepublichealth.org/mosquito-borne-illnesses-what-are-the-risks/Google Scholar Search this bibliographic reference on Google Scholar
- Canadian Centre for Occupational Health and Safety. (2024). Mosquito-borne diseases: Sources of exposure and assessing risk. https://www.ccohs.ca/zoonotic-diseases/Mosquito-borne-diseasesGoogle Scholar Search this bibliographic reference on Google Scholar
- CBC. (2024). Ottawa resident who died last month had rare mosquito-borne virus. https://www.cbc.ca/news/canada/ottawa/eeev-equine-encephalitis-mosquito-resident-death-ottawa-1.7321168Google Scholar Search this bibliographic reference on Google Scholar
- Centers for Disease Control. (2018). Illnesses on the rise. https://www.cdc.gov/vitalsigns/vector-borne/index.htmlGoogle Scholar Search this bibliographic reference on Google Scholar
- Centers for Disease Control. (2024a). Where mosquitos live. https://www.cdc.gov/mosquitoes/about/where-mosquitoes-live_1.htmlGoogle Scholar Search this bibliographic reference on Google Scholar
- Centers for Disease Control. (2024b). About Eastern Equine Encephalitis. https://www.cdc.gov/eastern-equine-encephalitis/about/index.htmlGoogle Scholar Search this bibliographic reference on Google Scholar
- Centers for Disease Control. (2025). West Nile Virus: Historic data (1999-2024). https://www.cdc.gov/west-nile-virus/data-maps/historic-data.htmlGoogle Scholar Search this bibliographic reference on Google Scholar
- Clifford, B., Wilson, A., & Harris, P. (2019). Homelessness, health and the policy process: A literature review. Health Policy, 123(11), 1125-1132. https://doi.org/10.1016/j.healthpol.2019.08.01110.1016/j.healthpol.2019.08.011 Google Scholar Search this bibliographic reference on Google Scholar
- Curtis, A., Curtis, J. W., Shook, E., Smith, S., Jefferis, E., Porter, L., Schuch, L., Felix, C., & Kerndt, P. R. (2015). Spatial video geonarratives and health: Case studies in post-disaster recovery, crime, mosquito control and tuberculosis in the homeless. International Journal of Health Geographics, 141(1), 1-15. https://doi.org/10.1186/s12942-015-0014-810.1186/s12942-015-0014-8 Google Scholar Search this bibliographic reference on Google Scholar
- De Sousa, T, Andrichik, A, Prestera, E., Rush, K., Tano, C., & Wheeler, M. (2023). The 2023 annual homelessness assessment report (AHAR) to congress: Part 1 - Point-in-time estimates of homelessness, December 2023. US Department of Housing and Urban Development. https://www.huduser.gov/portal/sites/default/files/pdf/2023-AHAR-Part-1.pdfGoogle Scholar Search this bibliographic reference on Google Scholar
- Donley, A. M., & Wright, J. D. (2012). Safer outside: A qualitative exploration of homeless people's resistance to homeless shelters. Journal of Forensic Psychology Practice, 12(4), 288-306. https://doi.org/10.1080/15228932.2012.69564510.1080/15228932.2012.695645 Google Scholar Search this bibliographic reference on Google Scholar
- Hale, A., Allen, J., & Caughlan, J. (2005). Bugs that bite: Helping homeless people and shelter staff cope. Healing Hands, 9(1), 1-4. https://homelesshub.ca/resource/bugs-bite-helping-homeless-people-and-shelter-staff-cope/Google Scholar Search this bibliographic reference on Google Scholar
- Hwang, S. W., Svoboda, T. J., De Jong, I. J., Kabasele, K. J., & Gogosis, E. (2005). Bed bug infestations in an urban environment. Emerging Infectious Diseases, 11(4), 533–538. https://doi.org/10.3201/eid1104.04112610.3201/eid1104.041126 Google Scholar Search this bibliographic reference on Google Scholar
- Leibler, J. H., Zakhour, C. M., Gadhoke, P., & Gaeta, J. M. (2016). Zoonotic and vector-borne infections among urban homeless and marginalized people in the United States and Europe, 1990–2014. Vector-Borne and Zoonotic Diseases, 16(7), 435-444. https://doi.org/10.1089/vbz.2015.186310.1089/vbz.2015.1863 Google Scholar Search this bibliographic reference on Google Scholar
- Massachusetts Department of Public Health. (2018). West Nile virus still active in Massachusetts. https://cdnsm5-hosted.civiclive.com/UserFiles/Servers/Server_15207780/File/Departments/Health/MOSQUITOES/West%20Nile%20Press%20Release.pdfGoogle Scholar Search this bibliographic reference on Google Scholar
- Mathisson, D. C., Kross, S. M., Palmer, M. I., & Diuk-Wasser, M. A. (2021). Effect of vegetation on the abundance of tick vectors in the Northeastern United States: A review of the literature. Journal of Medical Entomology, 58(6), 2030-2037. https://doi.org/10.1093/jme/tjab09810.1093/jme/tjab098 Google Scholar Search this bibliographic reference on Google Scholar
- Meyer, T. E., Bull, L. M., Holmes, K. C., Pascua, R. F., Travassos da Rosa, A., Gutierrez, C. R., & Murray, K. O. (2007). West Nile virus infection among the homeless, Houston, Texas. Emerging Infectious Diseases, 13(10), 1500–1503. https://doi.org/10.3201/eid1310.07044210.3201/eid1310.070442 Google Scholar Search this bibliographic reference on Google Scholar
- Moore, E. L., Scott, M. A., Rodriguez, S. D., Mitra, S., Vulcan, J., Cordova, J. J., Chung, H.-N., De Souza, D. L., Gonzales, K. K., & Hansen, I. A. (2018). An online survey of personal mosquito-repellent strategies. PeerJ, 6, e5151. https://doi.org/10.7717/peerj.515110.7717/peerj.5151 Google Scholar Search this bibliographic reference on Google Scholar
- Morton, M. H., Dworsky, A., Samuels, M., & Patel, S. (2018). Missed opportunities: Youth homelessness in rural America. Chapin Hall at the University of Chicago.Google Scholar Search this bibliographic reference on Google Scholar
- National Law Center on Homelessness and Poverty. (2018). Homelessness in America: Overview of data and causes. https://homelesslaw.org/wp-content/uploads/2018/10/Homeless_Stats_Fact_Sheet.pdfGoogle Scholar Search this bibliographic reference on Google Scholar
- New Hampshire Public Radio. (2024). Hampstead resident dies from mosquito-borne EEE virus. https://www.nhpr.org/nh-news/2024-08-27/hampstead-resident-dies-from-mosquito-borne-eee-virusGoogle Scholar Search this bibliographic reference on Google Scholar
- Norman, T., & Pauly, B. (2013). Including people who experience homelessness: A scoping review of the literature. International Journal of Sociology and Social Policy, 33(3/4), 136-151. https://doi.org/10.1108/0144333131130820310.1108/01443331311308203 Google Scholar Search this bibliographic reference on Google Scholar
- Zielinksi-Gutiérrez, E. (2004). West Nile virus and other mosquito-borne infections. In, J. J. O’Connell (Ed.), The Health Care of Homeless Persons: A Manual of Communicable Diseases and Common Problems in Shelters and on the Streets (pp. 181-188). Boston Health Care for the Homeless Program.Google Scholar Search this bibliographic reference on Google Scholar
- Ramin, B., & Svoboda, T. (2009). Health of the homeless and climate change. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 86(4), 654–664. https://doi.org/10.1007/s11524-009-9354-710.1007/s11524-009-9354-7 Google Scholar Search this bibliographic reference on Google Scholar
- Rodriguez, S. D., Drake, L. L., Price, D. P., Hammond, J. I., & Hansen, I. A. (2015). The efficacy of some commercially available insect repellents for Aedes aegypti (Diptera: Culicidae) and Aedes albopictus (Diptera: Culicidae). Journal of Insect Science, 15(1), 140-145. https://doi.org/10.1093/jisesa/iev12510.1093/jisesa/iev125 Google Scholar Search this bibliographic reference on Google Scholar
- Sakamoto, I., Khandor, E., Chapra, A., Hendrickson, T., Maher, J., Roche, B., & Chin, M. (2008). Homelessness-diverse experiences, common issues, shared solutions: The need for inclusion and Accountability. Factor-Inwentash Faculty of Social Work, University of Toronto.Google Scholar Search this bibliographic reference on Google Scholar
- Solari, C. D., Cortes, A., Henry, M., Matthews, N., & Morris, S. (2014). The 2013 annual homeless assessment report (AHAR) to congress. US Department of Housing and Urban Development.Google Scholar Search this bibliographic reference on Google Scholar
- Thorbecke, C. (2016). Miami police distribute bug spray to homeless around zika outbreak epicenter. http://abcnews.go.com/US/miami-police-distribute-bug-spray-homeless-zika-outbreak/story?id=41078311Google Scholar Search this bibliographic reference on Google Scholar
- US Food and Drug Administration. (2020). Do not use: Black salve is dangerous and called by many names. https://www.fda.gov/consumers/consumer-updates/do-not-use-black-salve-dangerous-and-called-many-namesGoogle Scholar Search this bibliographic reference on Google Scholar
- Virginia Department of Health. (2022). Insect-borne disease prevention and treatment. https://www.vdh.virginia.gov/roanoke/2022/08/29/community-update-week-of-august-29th-2022/Google Scholar Search this bibliographic reference on Google Scholar
- Willison, C., Unwala, N., Singer, P. M., Creedon, T. B., Mullin, B., & Cook, B. L. (2024). Persistent disparities: Trends in rates of sheltered homelessness across demographic subgroups in the USA. Journal of Racial and Ethnic Health Disparities, 11(1), 326-338. https://doi.org/10.1007/s40615-023-01521-910.1007/s40615-023-01521-9 Google Scholar Search this bibliographic reference on Google Scholar
- Wusinich, C., Bond, L., Nathanson, A., & Padgett, D.K. (2019). If you’re gonna help me, help me: Barriers to housing among unsheltered homeless adults. Evaluation and Program Planning, 76: 101673. https://doi.org/10.1016/j.evalprogplan.2019.10167310.1016/j.evalprogplan.2019.101673 Google Scholar Search this bibliographic reference on Google Scholar