RESUMEN
On 11 September 2001, attacks on the World Trade Center (WTC) killed nearly three thousand people and exposed hundreds of thousands of rescue and recovery workers, passersby, area workers, and residents to varying amounts of dust and smoke. Former New York City Mayor Rudy Giuliani ordered the emergency evacuation of Lower Manhattan below Canal Street, but not all residents evacuated. Previous studies showed that those who did not evacuate had a higher incidence of newly diagnosed asthma. Among the 71,424 who enrolled in the WTC Health Registry in 2003-2004, we evaluated the bivariate association of educational attainment, household income, and race or ethnicity with reported evacuation on or after 9/11/01. We used log binomial regression to assess the relative risks of not evacuating from their home following the 9/11 attacks, adjusting for age, gender, and marital status. Out of a total of 11,871 enrollee residents of Lower Manhattan, 7345 or 61.79% reported evacuating their home on or after 9/11. In a fully adjusted model, the estimated relative risk for not evacuating was elevated for those who identified as non-Hispanic Black, Asian/Pacific Islander, and Hispanic residents compared to non-Hispanic White residents. Residents with a high school diploma/GED had an elevated estimated risk compared to those with at least a bachelor's degree. Those with lower household incomes had an elevated estimated risk compared to those with the highest income category. These significant inequities will need to be prevented in future disasters.
Asunto(s)
Ataques Terroristas del 11 de Septiembre , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven , Etnicidad/estadística & datos numéricos , Ciudad de Nueva York , Clase Social , Grupos Raciales/estadística & datos numéricos , Refugio de EmergenciaRESUMEN
A recent study of World Trade Center Health Registry enrollees found that about one-third experienced post-traumatic growth (PTG) in the wake of the 9/11 attacks and that PTG was associated with social support and social integration. However, the implications of PTG for the enrollees' overall quality of life are unknown. The present study investigated the prevalence of PTG and its association with the SF-12 physical and mental functioning quality of life scales in a sample of 4760 enrollees from the Registry's Health and Quality of Life Study (HQoL) who completed the first four surveys, were older than 18 on 9/11, reported English as their primary spoken language, and provided consistent self-report of 9/11 physical injury at the Registry's baseline and HQoL surveys. We employed multivariable linear regression to evaluate the association between PTG and the SF-12 physical and mental scales, controlling for sociodemographic and other variables. We found that 31% of the sample enrollees experienced PTG and that PTG exhibited a clinically and statistically significant association with the SF-12 mental scale but not the physical scale (physical: b = 0.15 (-0.45, 0.75), mental: b = 3.61 (2.85, 4.37)). Those who were physically injured during 9/11 showed larger improvements in mental functioning than those who were not. PTG has implications for the overall mental quality of life that should be further investigated.
Asunto(s)
Crecimiento Psicológico Postraumático , Trastornos por Estrés Postraumático , Adaptación Psicológica , Humanos , Prevalencia , Calidad de Vida , Sistema de Registros , Trastornos por Estrés Postraumático/epidemiología , Encuestas y CuestionariosRESUMEN
This study evaluated the impact of pre-Hurricane Sandy (Sandy) post-traumatic stress disorder (PTSD) trajectories on the relationship between Sandy exposures and post-Sandy 9/11-related PTSD among World Trade Center Health Registry (Registry) enrollees. The study population included 3,199 adult Registry enrollees who completed three surveys prior to Sandy in 2003-4, 2006-7, and 2011-12; a post-Hurricane Sandy survey (2013); and a follow-up survey in 2015-16. PTSD was assessed using the PTSD Checklist (PCL). Latent class growth analysis was used to identify groups of enrollees who shared a similar trajectory of change in PCL score in the time period prior to Sandy. We compared enrollees in each trajectory group to assess the impact of Sandy-related PTSD, Sandy exposures, and optimism on 9/11-related PTSD status post-Sandy (2015-16) using bivariate analyses and multivariable log-binomial regression. Sandy-related PTSD was the strongest predictor of subsequent 9/11-related PTSD. Lower optimism and higher Sandy exposure significantly predicted 9/11-related PTSD only in some trajectory groups. Hurricane Sandy may have exacerbated previously resolved symptoms of 9/11-related PTSD. This indicates a need after a disaster to assess and address mental health sequelae from previous traumatic exposures.