Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-21T23:11:56.452Z Has data issue: false hasContentIssue false

Exposure to the World Trade Center Disaster and 9/11-Related Post-Traumatic Stress Disorder and Household Disaster Preparedness

Published online by Cambridge University Press:  15 June 2015

Lisa M. Gargano*
Affiliation:
World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York
Kimberly Caramanica
Affiliation:
World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York
Sarah Sisco
Affiliation:
Office of Emergency Preparedness and Response, New York City Department of Health and Mental Hygiene, Long Island City, New York
Robert M. Brackbill
Affiliation:
World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York
Steven D. Stellman
Affiliation:
World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
*
Correspondence and reprint requests to Lisa M. Gargano, PhD, MPH, 42-09 28th Street, 7th Floor, Long Island City, NY 11101 (e-mail: lgargano1@health.nyc.gov).

Abstract

Objective

In a population with prior exposure to the World Trade Center disaster, this study sought to determine the subsequent level of preparedness for a new disaster and how preparedness varied with population characteristics that are both disaster-related and non-disaster-related.

Methods

The sample included 4496 World Trade Center Health Registry enrollees who completed the Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. Participants were considered prepared if they reported possessing at least 7 of 8 standard preparedness items. Logistic regression was used to determine associations between preparedness and demographic and medical factors, 9/11-related post-traumatic stress disorder (PTSD) assessed at Wave 3, 9/11 exposure, and social support.

Results

Over one-third (37.5%) of participants were prepared with 18.8% possessing all 8 items. The item most often missing was an evacuation plan (69.8%). Higher levels of social support were associated with being prepared. High levels of 9/11 exposure were associated with being prepared in both the PTSD and non-PTSD subgroups.

Conclusions

Our findings indicate that prior 9/11 exposure favorably impacted Hurricane Sandy preparedness. Future preparedness messaging should target people with low social support networks. Communications should include information on evacuation zones and where to find information about how to evacuate. (Disaster Med Public Health Preparedness. 2015;9:625–633)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Falkiner, L. Impact analysis of the Canadian Red Cross Expect the Unexpected Program. 2003. http://www.redcross.ca/cmslib/general/imact_analysis_full_version.pdf. Accessed March 10, 2015.Google Scholar
2. Keim, ME. Building human resilience: the role of public health preparedness and response as an adaptation to climate change. Am J Prev Med. 2008;35(5):508-516.CrossRefGoogle ScholarPubMed
3. DeBastiani, SD, Strine, TW. Household preparedness for public health emergencies - 14 states, 2006-2010. MMWR Morb Mortal Wkly Rep. 2012;61(36):713-719.Google Scholar
4. Ablah, E, Konda, K, Kelley, CL. Factors predicting individual emergency preparedness: a multi-state analysis of 2006 BRFSS data. Biosecur Bioterror. 2009;7(3):317-330.CrossRefGoogle ScholarPubMed
5. Aspinwall, LG, Sechrist, GB, Jones, PR. Expect the best and prepare for the worst: anticipatory coping and preparations for Y2K. Motiv Emot. 2005;29(4):357-388.Google Scholar
6. Edwards, ML. Social location and self-protective behaviors: implications for earthquake preparedness. Int J Mass Emerg Disasters. 1993;11(3):293-303.CrossRefGoogle Scholar
7. Eisenman, DP, Zhou, Q, Ong, M, et al. Variations in disaster preparedness by mental health, perceived general health, and disability status. Disaster Med Public Health Prep. 2009;3(1):33-41.Google Scholar
8. Mishra, S, Suar, D. Do lessons people learn determine disaster cognition and preparedness? Psychol Dev Soc J. 2007;19(2):143-159.Google Scholar
9. Murphy, ST, Cody, M, Frank, LB, et al. Predictors of emergency preparedness and compliance. Disaster Med Public Health Prep. 2009 Jul 8 [Epub ahead of print].Google Scholar
10. Norris, FH, Smith, T, Kaniasty, K. Revisiting the experience-behavior hypothesis: the effects of Hurricane Hugo on hazard preparedness and other self-protectiev acts. Basic Appl Soc Psych. 1999;21(1):37-47.Google Scholar
11. Smith, DL, Notaro, SJ. Personal emergency preparedness for people with disabilities from the 2006-2007 Behavioral Risk Factor Surveillance System. Disabil Health J. 2009;2(2):86-94.Google Scholar
12. Eisenman, DP, Wold, C, Fielding, J, et al. Differences in individual-level terrorism preparedness in Los Angeles County. Am J Prev Med. 2006;30(1):1-6.Google Scholar
13. Page, L, Rubin, J, Amlot, R, et al. Are Londoners prepared for an emergency? A longitudinal study following the London bombings. Biosecur Bioterror Dec 2008;6(4):309-319.Google Scholar
14. Bethel, JW, Foreman, AN, Burke, SC. Disaster preparedness among medically vulnerable populations. Am J Prev Med. 2011;40(2):139-143.Google Scholar
15. Edwards, FL. Effective disaster response in cross border events. Journal of Contingencies and Crisis Management. 2009;17(4):255-265.Google Scholar
16. Strine, TW, Neff, LJ, Crawford, S. Health-related quality of life domains and household preparedness for public health emergencies: behavioral risk factor surveillance system, 2006-2010. Disaster Med Public Health Prep. 2013;7(2):191-200.Google Scholar
17. Boscarino, JA, Adams, RE, Figley, CR, et al. Fear of terrorism and preparedness in New York City 2 years after the attacks: implications for disaster planning and research. J Public Health Manag Pract. 2006;12(6):505-513.CrossRefGoogle ScholarPubMed
18. Hausman, AJ, Hanlon, A, Seals, B. Social capital as a mediating factor in emergency preparedness and concerns about terrorism. J Community Psychol. 2007;35(8):1073-1083.Google Scholar
19. Mulilis, JP, Duval, TS, Rogers, R. The effect of a swarm of local tornados on tornado preparedness: a quasi-comparable cohort investigation. J Appl Soc Psychol. 2003;33(8):1716-1725.CrossRefGoogle Scholar
20. Sattler, DN, Kaiser, CF, Hittner, JB. Disaster preparedness: relationships among prior experience, personal characteristics, and distress. J Appl Soc Psychol. 2000;30(7):1396-1420.CrossRefGoogle Scholar
21. Chen, V, Banerjee, D, Liu, L. Do people become better prepared in the aftermath of a natural disaster? The hurricane Ike experience in Houston, Texas. J Public Health Manag Pract. 2012;18(3):241-249.Google Scholar
22. Morgan, C. Hurricane awareness poll results - May 2009. Miami Herald. 2009.Google Scholar
23. Rincon, E, Linares, MY, Greenberg, B. Effect of previous experience of a hurricane on preparedness for future hurricanes. Am J Emerg Med Jul 2001;19(4):276-279.CrossRefGoogle ScholarPubMed
24. Farley, JE. Down but not out: earthquake awareness and preparedness trends in the St. Louis metropolitan area, 1990-1997. Int J Mass Emerg Disasters. 1998;16(3):303-319.CrossRefGoogle Scholar
25. Greenberg, MR, Dyen, S, Elliott, S. The public’s preparedness: self-reliance, flashbulb memories, and conservative values. Am J Public Health. 2013;103(6):e85-e91.Google Scholar
26. Heller, K, Alexander, DB, Gatz, M, et al. Social and personal factors as predictors of earthquake preparation: the role of support provision, network discussion, negative affect, age, and education. J Appl Soc Psychol. 2005;35(2):399-422.Google Scholar
27. Meyer, RJ. Failing to learn from experience about catastrophes: the case of hurricane preparedness. J Risk Uncertain. 2012;45(1):25-50.Google Scholar
28. Centers for Disease Control and Prevention. Deaths associated with Hurricane Sandy - October-November 2012. MMWR Morb Mortal Wkly Rep. 2013;62(20):393-397.Google Scholar
29. Blake, ES, Kimberlain, TB, Berg, RJ, Cangialosi, JP, Beven, JL. Tropical Cyclone Report - Hurricane Sandy. Miami, FL: National Hurricane Center; 2013.Google Scholar
30. Brackbill, RM, Hadler, JL, DiGrande, L, et al. Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack. JAMA. 2009;302(5):502-516.Google Scholar
31. Centers for Disease Control and Prevention. Deaths in World Trade Center terrorist attacks--New York City, 2001. MMWR Morb Mortal Wkly Rep. 2002;51(Spec No):16-18.Google Scholar
32. Farfel, M, DiGrande, L, Brackbill, R, et al. An overview of 9/11 experiences and respiratory and mental health conditions among World Trade Center Health Registry enrollees. J Urban Health. 2008;85(6):880-909.Google Scholar
33. Brackbill, RM, Caramanica, K, Maliniak, M, et al. Nonfatal injuries 1 week after hurricane sandy--New York city metropolitan area, October 2012. MMWR Morb Mortal Wkly Rep. 2014;63(42):950-954.Google Scholar
34. Subbarao, I, Lyznicki, JM, Hsu, EB, et al. A consensus-based educational framework and competency set for the discipline of disaster medicine and public health preparedness. Disaster Med Public Health Prep. 2008;2(1):57-68.Google Scholar
35. Currier, M, King, DS, Wofford, MR, et al. A Katrina experience: lessons learned. Am J Med. 2006;119(11):986-992.Google Scholar
36. Jenkins, JL, McCarthy, M, Kelen, G, et al. Changes needed in the care for sheltered persons: a multistate analysis from Hurricane Katrina. Am J Disaster Med. 2009;4(2):101-106.CrossRefGoogle Scholar
37. Brodie, M, Weltzien, E, Altman, D, et al. Experiences of hurricane Katrina evacuees in Houston shelters: implications for future planning. Am J Public Health. 2006;96(8):1402-1408.Google Scholar
38. Torabi, MR, Seo, DC. National study of behavioral and life changes since September 11. Health Educ Behav. 2004;31(2):179-192.Google Scholar
39. Blanchard, EB, Jones-Alexander, J, Buckley, TC, et al. Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther. 1996;34(8):669-673.Google Scholar
40. Ruggiero, KJ, Del Ben, K, Scotti, JR, et al. Psychometric properties of the PTSD Checklist-Civilian Version. J Trauma Stress. 2003;16(5):495-502.Google Scholar
41. Ventureyra, VA, Yao, SN, Cottraux, J, et al. The validation of the Posttraumatic Stress Disorder Checklist Scale in posttraumatic stress disorder and nonclinical subjects. Psychother Psychosom. 2002;71(1):47-53.CrossRefGoogle ScholarPubMed
42. Debchoudhury, I, Welch, AE, Fairclough, MA, et al. Comparison of health outcomes among affiliated and lay disaster volunteers enrolled in the World Trade Center Health Registry. Prev Med. 2011;53(6):359-363.Google Scholar
43. Welch, AE, Caramanica, K, Maslow, CB, et al. Frequent binge drinking five to six years after exposure to 9/11: findings from the World Trade Center Health Registry. Drug Alcohol Depend. 2014;140:1-7.Google Scholar
44. Ghuman, SJ, Brackbill, RM, Stellman, SD, et al. Unmet mental health care need 10-11 years after the 9/11 terrorist attacks: 2011-2012 results from the World Trade Center Health Registry. BMC Public Health. 2014;14:491.Google Scholar
45. Brackbill, RM, Stellman, SD, Perlman, SE, et al. Mental health of those directly exposed to the World Trade Center disaster: unmet mental health care need, mental health treatment service use, and quality of life. Soc Sci Med. 2013;81:110-114.Google Scholar
46. Adams, RE, Boscarino, JA, Galea, S. Alcohol use, mental health status and psychological well-being 2 years after the World Trade Center attacks in New York City. Am J Drug Alcohol Abuse. 2006;32(2):203-224.Google Scholar
47. New York City Office of Emergency. NYC Hazards: Hurricane Evacuation Zones. 2014. http://www.nyc.gov/html/oem/html/hazards/storms_evaczones.shtml. Accessed August 21, 2014.Google Scholar
48. Caramanica, K, Brackbill, RM, Liao, T, et al. Comorbidity of 9/11-Related PTSD and Depression in the World Trade Center Health Registry 10-11 Years Postdisaster. J Trauma Stress. 2014;27(6):680-688.CrossRefGoogle Scholar
49. Li, J, Brackbill, RM, Stellman, SD, et al. Gastroesophageal reflux symptoms and comorbid asthma and posttraumatic stress disorder following the 9/11 terrorist attacks on World Trade Center in New York City. Am J Gastroenterol. 2011;106(11):1933-1941.Google Scholar
50. Nair, HP, Ekenga, CC, Cone, JE, et al. Co-occurring lower respiratory symptoms and posttraumatic stress disorder 5 to 6 years after the World Trade Center terrorist attack. Am J Public Health. 2012;102(10):1964-1973.Google Scholar
51. Faupel, CE, Styles, SP. Disaster education, household preapredness, and stress responses following Hurricane Hugo. Environ Behav. 1993;25(2):228-249.CrossRefGoogle Scholar
52. Lemyre, L, Clement, M, Corneil, W, et al. A psychosocial risk assessment and management framework to enhance response to CBRN terrorism threats and attacks. Biosecur Bioterror. 2005;3(4):316-330.Google Scholar
53. Rohrmann, B. A socio-psychological model for analyzing risk communication processess. Aust J Disaster Trauma Stud. 2000;2:150-166.Google Scholar
54. Cohen, S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychol. 1988;7(3):269-297.Google Scholar
55. Krause, N. Chronic financial strain, social support, and depressive symptoms among older adults. Psychol Aging. 1987;2(2):185-192.Google Scholar
56. Levac, J, Toal-Sullivan, D, O’Sullivan, TL. Household emergency preparedness: a literature review. J Community Health. 2012;37(3):725-733.CrossRefGoogle ScholarPubMed
57. Paek, HJ, Hilyard, K, Freimuth, V, et al. Theory-based approaches to understanding public emergency preparedness: implications for effective health and risk communication. J Health Commun. 2010;15(4):428-444.Google Scholar
58. Bandura, A. Health promotion from the perspective of social cognitive theory. Psychology and Health. 1998;13:623-649.Google Scholar
59. NYC Office of Emergency Management. Know Your Zone. 2014. http://www.nyc.gov/html/oem/html/get_prepared/know_your_zone/knowyourzone.html. Accessed October 24, 2014.Google Scholar