178879 Terrorism-Related Fear and Avoidance Behavior in a Multi-Ethnic Urban Population

Monday, October 27, 2008

David Eisenman, MD , Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA
Deborah Glik, ScD , School of Public Health, University of California Los Angeles (UCLA), Los Angeles, CA
Michael K. Ong, MD PhD , Division of General Internal Medicine & Health Services Research, University of California, Los Angeles, Los Angeles, CA
Qiong Zhou, MS , Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA
Anna Long, PhD , Los Angeles County - Department of Public Health, Los Angeles, CA
Jonathan E. Fielding, MD, MPH , Los Angeles County - Department of Public Health, Los Angeles, CA
Steven Asch, MD , Health Program, RAND Corporation, Santa Monica, CA
BACKGROUND: Terrorism aims to spread fear and change public behavior. Public health needs to know who is most affected by fears of terrorism and related policies. We hypothesized that groups traditionally vulnerable to disasters would report greater worry about terrorism and avoidance of activities due to terrorism concerns.

METHODS: A random-digit-dial survey of the Los Angeles County population conducted October, 2004 -- January, 2005 in 6 languages. Respondents were asked how often they worry about terrorist attacks and how often they avoid activities because of terrorism. Multivariate regression modeled determinants of worry and avoidance, including mental illness, disability, demographic factors, and perceived current level of the color-coded alert system.

RESULTS: Greater fear and/or avoidance were reported among the mentally ill, the disabled, African Americans, Latinos, Chinese, Korean, and non-U.S. citizens. Persons who believed the alert system was at red/severe or orange/high level when the actual level was yellow/elevated reported greater fear and avoidance.

CONCLUSIONS: Three years after 9/11 and the anthrax attacks, vulnerable populations continue to bear a disproportionate mental health burden from terrorism. Moreover, the alert system may be contributing to this fear.

Learning Objectives:
1. Understand the evidence showing an association between membership in a vulnerable population group and likelihood of avoiding activities due to terrorism fears. 2. Understand the evidence showing an association between perception of the current status of the color-coded terrorist alert system known as the Homeland Security Advisory System and avoiding activities due to terrorism fears.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am PI
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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