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

Gargano, Lisa M.; Caramanica, Kimberly; Sisco, Sarah; Brackbill, Robert M.; Stellman, Steven D.

doi:10.1017/dmp.2015.71

Cited by 17 publications

(22 citation statements)

References 49 publications

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“…While results are mixed, some studies on preparedness of disaster survivors have similarly shown that prior experience does not necessarily translate into current preparedness. In a recent study by Gargano et al, people who had been exposed to the World Trade Center (WTC) disaster had lower levels (18.8 %) of preparedness as compared to a national sample (25 %), although those with the greatest WTC exposure were most likely to have been prepared for Hurricane Sandy [43]. Motivation to prepare was also not influenced in our sample by the saliency of the disaster threat.…”

Section: Iscussioncontrasting

confidence: 52%

Psychosocial Influences on Disaster Preparedness in San Francisco Recipients of Home Care

et al. 2016

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Disasters disproportionately impact certain segments of the population, including children, pregnant women, people living with disabilities and chronic conditions and those who are underserved and under-resourced. One of the most vulnerable groups includes the community-dwelling elderly. Post-disaster analyses indicate that these individuals have higher risk of disaster-related morbidity and mortality. They also have suboptimal levels of disaster preparedness in terms of their ability to shelter-in-place or evacuate to a shelter. The reasons for this have not been well characterized, although impaired health, financial limitations, and social isolation are believed to act as barriers to preparedness as well as to adaptability to changes in the environment both during and in the immediate aftermath of disasters. In order to identify strategies that address barriers to preparedness, we recently conducted a qualitative study of 50 elderly home care recipients living in San Francisco. Data were collected during in-home, in-person interviews using a semi-structured interview guide that included psychosocial constructs based on the social cognitive preparedness model and a new 13-item preparedness checklist. The mean preparedness score was 4.74 (max 13, range 1-11, SD. 2.11). Over 60 % of the participants reported that they had not made back-up plans for caregiver assistance during times of crisis, 74 % had not made plans for transportation to a shelter, 56 % lacked a back-up plan for electrical equipment in case of power outages, and 44 % had not prepared an emergency contacts list-the most basic element of preparedness. Impairments, disabilities, and resource limitations served as barriers to preparedness. Cognitive processes that underlie motivation and intentions for preparedness behaviors were lacking. There were limitations with respect to critical awareness of hazards (saliency), self-efficacy, outcome expectancy, and perceived responsibility. There was also a lack of trust in response agencies and authorities and a limited sense of community. Participants wanted to be prepared and welcomed training, but physical limitations kept many of them home bound. Training of home care aides, the provision of needed resources, and improved community outreach may be helpful in improving disaster outcomes in this vulnerable segment of the population.

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Section: Iscussioncontrasting

confidence: 52%

Psychosocial Influences on Disaster Preparedness in San Francisco Recipients of Home Care

et al. 2016

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“…A study of New York residents affected by Hurricane Sandy in 2012 found that those who had experienced previous trauma related to the attacks on the World Trade Centre were significantly more likely to evacuate and become displaced. 30 As noted above, our control for confounding by reported pre-existing illness would have controlled for this to some extent.…”

Section: Discussionmentioning

confidence: 99%

Effect of evacuation and displacement on the association between flooding and mental health outcomes: a cross-sectional analysis of UK survey data

Munro

Waite

Beck³

et al. 2017

The Lancet Planetary Health

104

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SummaryBackgroundExtensive flooding occurred during the winter of 2013–14 in England. Previous studies have shown that flooding affects mental health. Using data from the 2013–14 Public Health England National Study of Flooding and Health, we compared the prevalence of symptoms of depression, anxiety, and post-traumatic stress disorder between participants displaced by flooding and those flooded, but not displaced, 1 year after flooding.MethodsIn this multivariable ordinal regression analysis, we collected data from a cross-sectional survey collected 1 year after the flooding event from flood-affected postcodes in five counties in England. The analysis was restricted to individuals whose homes were flooded (n=622) to analyse displacement due to flooding. The primary outcome measures were depression (measured by the PHQ-2 depression scale) and anxiety (measured by the two-item Generalised Anxiety Disorder [GAD]-2 anxiety scale), and post-traumatic stress disorder (measured by the Post-Traumatic Stress Disorder Checklist [PCL]-6 scale). We adjusted analyses for recorded potential confounders. We also analysed duration of displacement and amount of warning received.FindingsPeople who were displaced from their homes were significantly more likely to have higher scores on each scale; odds ratio (OR) for depression 1·95 (95% CI 1·30–2·93), for anxiety 1·66 (1·12–2·46), and for post-traumatic stress disorder 1·70 (1·17–2·48) than people who were not displaced. The increased risk of depression was significant even after adjustment for severity of flooding. Scores for depression and post-traumatic stress disorder were higher in people who were displaced and reported receiving no warning than those who had received a warning more than 12 h in advance of flooding (p=0·04 for depression, p=0·01 for post-traumatic stress disorder), although the difference in anxiety scores was not significant.InterpretationDisplacement after flooding was associated with higher reported symptoms of depression, anxiety, and post-traumatic stress disorder 1 year after flooding. The amount of warning received showed evidence of being protective against symptoms of the three mental illnesses studied, and the severity of flooding might be the reason for some, but not all, of the differences between the groups.FundingNational Institute for Health Research Health Protection Research Units (HPRU) in Emergency Preparedness and Response at King's College London, Environmental Change and Health at the London School of Hygiene and Tropical Medicine, and Evaluation of Interventions at the University of Bristol, Public Health England.

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“…Respondents who lost power during Superstorm Sandy were not more likely to perceive their households as prepared or actually be prepared. Findings on the relationship between prior disaster experience and preparedness have been mixed [ 47 – 49 ]. A wide variety of factors likely influence this relationship, including the frequency and severity of outages experienced.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there may be misclassification of prior outage experience because we only asked about Sandy. Respondents may have had a range of previous power outage experience, in addition to other disaster experiences, such as the September 2001 World Trade Center terrorism attack, which could have influenced preparedness [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Power Outage Preparedness and Concern among Vulnerable New York City Residents

et al. 2018

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Power outages can impact health, and certain populations may be more at risk. Personal preparedness may reduce impacts, but information on power outage preparedness and risk perception among vulnerable populations is limited. We examined power outage preparedness and concern among New York City residents, including vulnerable populations defined as older adults (≥ 65 years), and respondents with household members who require assistance with daily activities or depend on electric medical devices. A random sample telephone survey was conducted during November–December 2016. Preparedness was defined as having a three-day supply of drinking water, non-perishable food, and a working flashlight. Among all respondents (n = 887), 58% were prepared and 46% expressed concern about health. Respondents with electric-dependent household members (9% of all respondents) tended to have higher preparedness (70 vs. 56% of respondents without electric-dependent household members). Among this group, only 40% reported being registered with a utility company to receive early notification of outages. While the subgroup sample was small, respondents with registered electric-dependent household members had lower preparedness than those with non-registered users (59 vs. 76%). Respondents with household members who needed assistance had comparable levels of preparedness to respondents without someone who needed assistance (59 vs. 57%). Older adults had greater preparedness than younger adults (65 vs. 56%). Health concerns were greater among all vulnerable groups than the general population. Levels of preparedness varied among vulnerable respondents, and awareness of power outage notification programs was low. Our findings highlight the need to increase awareness and preparedness among at-risk people.

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

Cited by 17 publications

References 49 publications

Psychosocial Influences on Disaster Preparedness in San Francisco Recipients of Home Care

Psychosocial Influences on Disaster Preparedness in San Francisco Recipients of Home Care

Effect of evacuation and displacement on the association between flooding and mental health outcomes: a cross-sectional analysis of UK survey data

Power Outage Preparedness and Concern among Vulnerable New York City Residents

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