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Study of Asthmatic
Medicaid Enrollees Suggests Negative 9/11 Impact
By Michelle Chen, The
NewStandard, March 4, 2005
Mar 4 - According to a study by researchers with the New York State Department of Health,
nearly half of a survey population of low-income asthma patients in New York City
experienced worsened symptoms after the September 11, 2001 destruction of the World Trade
Center. The study analyzed the health impact of the September 11 terrorist attacks on
asthma patients enrolled in Medicaid managed care, and sheds light on how low-income and
minority communities might have been affected by the disaster with respect to both
respiratory and mental health.
The findings, published in the latest issue of the Journal of Urban Health, corroborate
previous studies on the public health ramifications of the collapse of the WTC, which
released massive amounts of pulverized glass, cement particles and other irritants into
the environment. Activists have charged that the government has failed to respond
adequately to public health problems associated with the collapse, and they have demanded
more comprehensive treatment measures and further research on the possible long-term
effects of the environmental contamination.
Department of Health researchers analyzed over 3,600 responses to a mail survey
administered in the summer of 2002. Of those surveyed, approximately 40 percent were black
and an additional 40 percent were Hispanic. All received Medicaid benefits through
assistance programs for families, childless households or the disabled and elderly. Though
the vast majority did not live in lower Manhattan, where the attacks occurred, about
one-third reported spending on average at least one day per week in the area after the
attacks. Nearly 60 percent of survey responses were from parents or guardians on behalf of
asthmatic children in their care.
According to the analysis, 45 percent of respondents reported worsened asthma symptoms
after September 11. Many of these perceived environmental change as a factor influencing
their health, with over 60 percent attributing their worsened asthma to "more dust in
the air." The 14 percent of respondents who reported poor overall health experienced
worsened symptoms at the highest rate.
Drawing on medical records from the Medicaid Encounter Data System, the study also
revealed that in the months following the terrorist attacks, 57 percent of respondents
reported increasing the use of at least one asthma medication, and those with worsened
asthma were more likely to have been hospitalized for their symptoms. Approximately one in
five respondents said they sought diagnosis or treatment for mental health problems
following the attacks. The study furthermore found a link between experiencing aggravated
asthma and using mental health resources: over half of respondents reporting worsened
asthma sought post-9/11 mental health medications or services.
The study also yielded new indicators as to the geographic scope of the potential health
impact. Self-reported adverse health effects were significantly correlated with residency
not just in lower Manhattan, but also across the river from the disaster site in Western
Brooklyn. Respondents living in other parts of the city reported worsened asthma as well.
For years, environmental and public health advocates, including the Sierra Club and the
New York Committee for Occupational Safety and Health, have cited studies such as this one
in efforts to raise awareness of potential long-term, widespread health damage from
irritants and toxins released at the Ground Zero disaster site.
Kimberly Flynn, a local activist with the advocacy group 9/11 Environmental Action, told
The NewStandard that the study "adds an environmental injustice dimension to the
abysmal failure of the federal government to provide a program that tracks and treats
emergent post-9/11 illnesses in the community."
Early last month, a coalition of elected officials, including Senator Jon Corzine (D-NJ),
Representative Carolyn B. Maloney (D-NY) and Representative Jerrold Nadler (D-NY), sent a
letter to the secretary of the Department of Health and Human Services, Michael O.
Leavitt, advocating for "a thorough and immediate response" to the unmet health
needs of workers and residents affected by the attacks.
Maloney said in a January press statement, "a long-term medical monitoring program is
critically needed, as well as safety-net health care coverage for all 9/11 [emergency]
responders and area residents." She has introduced legislation in Congress that would
provide special health programs for Ground Zero workers and residents, and would extend
the deadline and eligibility requirements for the September 11th Victim Compensation Fund,
which provides federal funds to those injured, and families of those killed, as a result
of the attacks.
The researchers commented that their data could enable the public health system to cope
more effectively with future urban disasters like the September 11 terrorist attacks.
"Results from this study," they wrote, "provide guidance to health care
organizations in the development of plans to ensure the health of people with asthma
during disaster situations." The authors suggested that, measures like asthma health
registries, specialized training for physicians and public education could help
communities deal with exacerbated asthma brought on by an environmental catastrophe.
However, Flynn and other activists are wary that these recommendations do not address
current problems. She commented, "We believe these critical measures need to be put
into place not only for the future, but right now, as part of a broad screening and
treatment program to address the 9/11 health impacts that are already unfolding."
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