Discover Wellness

September 11, 2024

I remember exactly what I was doing and how I learned about 9/11 on that day. Even after 20+ years, the vivid images of the day are unforgettable. It was shock, sadness, fear, and anger. It was a devastating emotional day.

The attacks caused the deaths of 2,996 people (2,977 victims and 19 hijackers). Thousands more were inured, and long-term health effects have arisen as a consequence of the attacks. A month after 9/11, nearly 50% of people living near the WTC site who participated in a survey about their health needs and concerns said they had nose, throat, and eye irritation. Respiratory hospital admissions increased significantly among lower Manhattan residents the first week after 9/11 compared with a similar demographic in Queens. Cardiovascular and cerebrovascular disease admissions also increased two to three weeks after 9/11, especially among women and those over 65 years of age. Two literature reviews focusing on birth outcomes among WTC-exposed pregnant women suggest that environmental exposure or attack-related stress reduced fetal growth in some women, a finding similar to that in studies of birth outcomes after other terrorist attacks, environmental/chemical disasters and natural disasters. 

Those directly affected by 9/11 were more likely to report post-traumatic stress disorder (PTSD) symptoms 6 months after 9/11.  However, a substantial number not directly affected also met the criteria for probable PTSD.

In a study that examined the prevalence of resilience among New Yorkers during the 6 months after 9/11, 65% of participants showed resilience (ability to recover). This suggests that more New Yorkers demonstrated resilience during the 6 months after 9/11 than previously believed. Even  among those with the highest levels of exposure and highest probable PTSD, the proportion that were resilient never dropped below 33%.

A study of low-income patients seven to 16 months after 9/11 found that:

• Those suffering a 9/11-related loss were twice as likely to be diagnosed with a mental health condition, such as depression, anxiety or PTSD.

• This group was also more likely to suffer functional impairment and work loss.

• Patients with loved ones in danger on 9/11 or who knew someone involved in the rescue and recovery effort were twice as likely to suffer from an anxiety disorder.

A small study of New Yorkers 18 to 21 years of age with and without generalized anxiety disorder compared their mental health before and after 9/11.  Among those with generalized anxiety disorder, findings showed high rates of functional impairment but no increase in  post-traumatic stress symptoms.

A study of 2,300  New Yorkers interviewed 1, 2 and 3 years after 9/11 showed that:

• People who received early, brief interventions at their worksites reported better mental health than those who received more extensive interventions, such as  psychotherapy of 30 minutes or longer.  Although the study adjusted for  9/11 exposure, it  did not adjust for illness severity.  Support from friends, neighbors and spiritual communities was also beneficial.

• Problem drinking and alcohol use were connected with psychological trauma up to 4 years after 9/11, as well as other mental health problems.

Analyses of NYC death records that compared suicide rates before and after 9/11 found that suicide rates did not increase four years after the terrorist attacks.

Among a sample of 455, mostly female patients who were screened for mental health conditions when they sought primary care at a general medicine clinic in New York City, the PTSD rate decreased significantly from 9.6% 1 year after 9/11 to 4.1% 3 years later. Patients who reported pre-9/11 depression, the only significant predictor of PTSD trajectory, were 10 times more likely to have PTSD 4 years after the WTC attacks than those who didn’t.

A study of national mortality data showed that suicide rates among New Yorkers declined significantly six months after 9/11.

Lower-income New Yorkers exposed to ongoing stress and trauma were more likely to suffer from persistent depression.

While low-income adolescents and mothers exposed to the WTC disaster were more likely to suffer from depression and PTSD 15 months after 9/11, respectively, there were few long-term associations between 9/11 exposure and mental health among this group.

More than 21% of residents enrolled in the WTC Health Registry reported new PTSD symptoms 5 to 6 years after 9/11.  Probable PTSD among residents increased from more than 13% 2-3 years after the attacks to more than 16% 5-6 years later. Risk factors included:

• Intense dust cloud exposure

• Witnessing horror

• Returning to a home with a heavy layer of dust

• Job loss

• Lack of social support

To search for 2003/2004 baseline survey data, visit the Health Department's interactive data tool.

A small, cross-sectional study assessed more than 300 low-income, trauma-exposed patients in a large urban primary care clinic, including some who had been exposed to the WTC disaster, for mental health disorders and functioning at 2 time points after 9/11. Although patients with a past PTSD diagnosis functioned better than patients with a current PTSD diagnosis, they continued to experience more difficulties with their social and family lives than patients who had never been diagnosed with PTSD.

References:

NYC 9/11 Health: https://www.nyc.gov/site/911health/researchers/physical-and-mental-health.page

Casualities of the September 11 attacks: https://en.wikipedia.org/wiki/Casualties_of_the_September_11_attacks

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