Relationship of Self-Reported Asthma Severity and Urgent Health Care Utilization to Psychological Sequelae of the September 11, 2001 Terrorist Attacks on the World Trade Center among New York City Area Residents

Joanne Fagan, Sandro Galea, Jennifer Ahern, Sebastian Bonner, David Vlahov

Research output: Contribution to journalArticle

Abstract

Objective: Posttraumatic psychological stress may be associated with increases in somatic illness, including asthma, but the impact of the psychological sequelae of the September 11, 2001 terrorist attacks on physical illness has not been well documented. The authors assessed the relationship between the psychological sequelae of the attacks and asthma symptom severity and the utilization of urgent health care services for asthma since September 11. Materials and Methods: The authors performed a random digit dial telephone survey of adults in the New York City (NYC) metropolitan area 6 to 9 months after September 11, 2001. Two thousand seven hundred fifty-five demographically representative adults including 364 asthmatics were recruited. The authors assessed self-reported asthma symptom severity, emergency room (ER) visits, and unscheduled physician office visits for asthma since September 11. Results: After adjustment for asthma measures before September 11, demographics, and event exposure in multivariate models posttraumatic stress disorder (PTSD) were a significant predictor of self-reported moderate-to-severe asthma symptoms (OR = 3.4; CI = 1.2-9.4), seeking care for asthma at an ER since September 11 (OR = 6.6; CI = 1.6-28.0), and unscheduled physician visits for asthma since September 11 (OR = 3.6; CI = 1.1-11.5). The number of PTSD symptoms was also significantly related to moderate-to-severe asthma symptoms and unscheduled physician visits since September 11. Neither a panic attack on September 11 nor depression since September 11 was an independent predictor of asthma severity or utilization in multivariate models after September 11. Conclusions: PTSD related to the September 11 terrorist attacks contributed to symptom severity and the utilization of urgent health care services among asthmatics in the NYC metropolitan area.

Original languageEnglish (US)
Pages (from-to)993-996
Number of pages4
JournalPsychosomatic Medicine
Volume65
Issue number6
DOIs
StatePublished - Nov 2003
Externally publishedYes

Fingerprint

September 11 Terrorist Attacks
Patient Acceptance of Health Care
Ambulatory Care
Asthma
Psychology
Post-Traumatic Stress Disorders
Health Services
Hospital Emergency Service
Physicians
Office Visits
Physicians' Offices
Panic Disorder
Psychological Stress
Telephone

Keywords

  • Asthma
  • Disaster
  • Mental health
  • Posttraumatic stress

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Psychology(all)

Cite this

Relationship of Self-Reported Asthma Severity and Urgent Health Care Utilization to Psychological Sequelae of the September 11, 2001 Terrorist Attacks on the World Trade Center among New York City Area Residents. / Fagan, Joanne; Galea, Sandro; Ahern, Jennifer; Bonner, Sebastian; Vlahov, David.

In: Psychosomatic Medicine, Vol. 65, No. 6, 11.2003, p. 993-996.

Research output: Contribution to journalArticle

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abstract = "Objective: Posttraumatic psychological stress may be associated with increases in somatic illness, including asthma, but the impact of the psychological sequelae of the September 11, 2001 terrorist attacks on physical illness has not been well documented. The authors assessed the relationship between the psychological sequelae of the attacks and asthma symptom severity and the utilization of urgent health care services for asthma since September 11. Materials and Methods: The authors performed a random digit dial telephone survey of adults in the New York City (NYC) metropolitan area 6 to 9 months after September 11, 2001. Two thousand seven hundred fifty-five demographically representative adults including 364 asthmatics were recruited. The authors assessed self-reported asthma symptom severity, emergency room (ER) visits, and unscheduled physician office visits for asthma since September 11. Results: After adjustment for asthma measures before September 11, demographics, and event exposure in multivariate models posttraumatic stress disorder (PTSD) were a significant predictor of self-reported moderate-to-severe asthma symptoms (OR = 3.4; CI = 1.2-9.4), seeking care for asthma at an ER since September 11 (OR = 6.6; CI = 1.6-28.0), and unscheduled physician visits for asthma since September 11 (OR = 3.6; CI = 1.1-11.5). The number of PTSD symptoms was also significantly related to moderate-to-severe asthma symptoms and unscheduled physician visits since September 11. Neither a panic attack on September 11 nor depression since September 11 was an independent predictor of asthma severity or utilization in multivariate models after September 11. Conclusions: PTSD related to the September 11 terrorist attacks contributed to symptom severity and the utilization of urgent health care services among asthmatics in the NYC metropolitan area.",
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