There’s an old joke in creative communities about dying from exposure. It’s a play on the idea that artists should be content to be paid in “exposure,” rather than money. But exposure — that is, being exposed to the elements — is no joke to people who don’t have shelter.
In the earliest days of the colonization of the United States, exposure was a real threat to newcomers who didn’t know how to shield themselves. European colonists and “explorers” who pushed westward could freeze or die of sunstroke if they were unable to build a fire at night or find shade in the afternoon.
Now, in spite of myriad feats of industrialization, there are still members of our community, right here in Seattle, who face a similar fate.
Though Seattle is known for its gray skies and stormy weather, skin cancer has long been one of our region’s biggest medical enemies. Washington state outpaces the rest of the nation in skin cancer rates.
Among unsheltered individuals, this is absolutely the case. One study out of Salt Lake City screened homeless individuals for skin cancer and found that more than one in five of the patients they saw were diagnosed — and that they were not adequately prepared or able to prevent sun exposure.
It’s likely that skin cancer among homeless individuals is radically underreported and treated; a survey of medical students found that co-occurring symptoms of skin cancers, like problems with hearing and vision, rarely prompted them to ask about skin conditions.
And yet dermatological screenings for unsheltered people — the ones who are at the greatest risk of skin cancer due to prolonged and regular exposure to UV rays — may be viewed as frivolous or secondary to other treatment interventions.
Skin cancer doesn’t impact all racial groups equally, and Seattle’s racial disparity among homeless populations means that it’s not the only ailment associated with exposure. A San Francisco clinic found that more than half the patients presented with some dermatological complaint — including wounds, blisters, fungal infections and scabies — frequently exacerbated by wet socks, inadequate places to bathe or sanitize wounds and a lack of supportive or protective clothing.
In short, being outside does more than just impact one’s state of mind — it can literally degrade one’s body.
The reason that we can no longer drag our feet when it comes to finding warm, dry, clean places for people to stay is not simply about doing what is convenient, but what is critical. Every day that a person spends walking the streets looking for a tree to sit under, or a place to rinse out their socks, stained with blood, is another day that their life is in peril.
Hanna Brooks Olsen is a writer and policy consultant. Her work has appeared in The Atlantic, The Nation, Salon, Fast Company and Vice. View previous Access Denied columns.
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