A qualitative examination of health and health care utilization after the September 11th terror attacks among World Trade Center Health Registry enrollees.
BACKGROUND: Many individuals who have 9/11-related physical and mental health symptoms do not use or are unaware of 9/11-related health care services despite extensive education and outreach efforts by the World Trade Center (WTC) Health Registry (the Registry) and various other organizations. This study sought to evaluate Registry enrollees' perceptions of the relationship between physical and mental health outcomes and 9/11, as well as utilization of and barriers to 9/11-related health care services. METHODS: Six focus groups were conducted in January 2010 with diverse subgroups of enrollees, who were likely eligible for 9/11-related treatment services. The 48 participants were of differing race/ethnicities, ages, and boroughs of residence. Qualitative analysis of focus group transcripts was conducted using open coding and the identification of recurring themes. RESULTS: Participants described a variety of physical and mental symptoms and conditions, yet their knowledge and utilization of 9/11 health care services were low. Participants highlighted numerous barriers to accessing 9/11 services, including programmatic barriers (lack of program visibility and accessibility), personal barriers such as stigmatization and unfamiliarity with 9/11-related health problems and services, and a lack of referrals from their primary care providers. Moreover, many participants were reluctant to connect their symptoms to the events of 9/11 due to lack of knowledge, the amount of time that had elapsed since 9/11, and the attribution of current health symptoms to the aging process. CONCLUSIONS: Knowledge of the barriers to 9/11-related health care has led to improvements in the Registry's ability to refer eligible enrollees to appropriate treatment programs. These findings highlight areas for consideration in the implementation of the new federal WTC Health Program, now funded under the James Zadroga 9/11 Health and Compensation Act (PL 111-347), which includes provisions for outreach and education.
Keywords
Public-health; Emergency-response; Mental-health; Physiological-effects; Education; Health-care; Health-programs; Group-behavior; Group-dynamics; Medical-treatment; Health-surveys; Health-services; Qualitative-analysis; Humans; Psychological-responses; Surveillance-programs; Behavior; Decision-making; Attitude; Health-hazards; Hazardous-materials;
Author Keywords: September 11, 2001; 9/11; World Trade Center Health Registry; Health care utilization; Barriers to care; Focus groups
Contact
Alice E Welch, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY 11101, USA
Links with this icon indicate that you are leaving the CDC website.
The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website's privacy policy when you follow the link.
CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.
For more information on CDC's web notification policies, see Website Disclaimers.
CDC.gov Privacy Settings
We take your privacy seriously. You can review and change the way we collect information below.
These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
Cookies used to make website functionality more relevant to you. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests.
Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data.
Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. These cookies may also be used for advertising purposes by these third parties.
Thank you for taking the time to confirm your preferences. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page.