A community-medical partnership following an urban environmental disaster

The destruction of the World Trade Center (WTC) in New York City (NYC) on 9/11/01 resulted in the massive release of pulverized dust and combustion products in surrounding residential and commercial neighborhoods. Local residents and clean-up workers included immigrants and members of low-income communities. Beyond Ground Zero Network (BGZ), a coalition of community-based organizations approached Bellevue Hospital, a public hospital, and an unfunded pilot program was developed to address unmet health needs in these vulnerable populations. Joint community and medical advocacy resulted in funding from the American Red Cross Liberty Disaster Relief Fund and subsequently from the Mayor of NYC for a program providing medical, mental health, and social services for WTC-related illness. Barriers to care included unfamiliarity with the health care system, lack of insurance and immigration status. BGZ provided an interface to facilitate access to care, navigate the medical system, and community support programs. Difficulties for the health care team included language and cultural barriers, multiplicity of untreated medical problems, and unaddressed mental and social issues. Translation services and the interdisciplinary nature of the program improved the capacity to overcome these obstacles. Data on the first 793 individuals demonstrate that these individuals were almost equally male (55%) and female, often from immigrant populations (55.0% Latino, 19.0% Asian) and uninsured (59.0%). The alliance between a community-based organization and a public hospital medical team provide a model program for the advocacy for and delivery of health care to a disenfranchised population adversely affected by an urban environmental disaster.