Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
J Urban Health. 2013 Jun;90(3):369-87. doi: 10.1007/s11524-012-9769-4.
Past research provides evidence for trajectories of health and wellness among individuals following disasters that follow specific pathways of resilience, resistance, recovery, or continued dysfunction. These individual responses are influenced by event type and pre-event capacities. This study was designed to utilize the trajectories of health model to determine if it translates to population health. We identified terrorist attacks that could potentially impact population health rather than only selected individuals within the areas of the attacks. We chose to examine a time series of population birth outcomes before and after the terrorist events of the New York City (NYC) World Trade Center (WTC) attacks of 2001 and the Madrid, Spain train bombings of 2004 to determine if the events affected maternal-child health of those cities and, if so, for how long. For percentages of low birth weight (LBW) and preterm births, we found no significant effects from the WTC attacks in NYC and transient but significant effects on rates of LBW and preterm births following the bombings in Madrid. We did find a significant positive and sustained effect on infant mortality rate in NYC following the WTC attacks but no similar effect in Madrid. There were no effects on any of the indicator variables in the comparison regions of New York state and the remainder of Spain. Thus, population maternal-health in New York and Madrid showed unique adverse effects after the terrorist attacks in those cities. Short-term effects on LBW and preterm birth rates in Madrid and long-term effects on infant mortality rates in NYC were found when quarterly data were analyzed from 1990 through 2008/2009. These findings raise questions about chronic changes in the population's quality of life following catastrophic terrorist attacks. Public health should be monitored and interventions designed to address chronic stress, environmental, and socioeconomic threats beyond the acute aftermath of events.
过去的研究为灾难后个体的健康和幸福轨迹提供了证据，这些轨迹遵循特定的适应力、抵抗力、恢复力或持续功能障碍的路径。这些个体反应受到事件类型和事前能力的影响。本研究旨在利用健康轨迹模型来确定它是否适用于人群健康。我们确定了可能对人群健康产生影响的恐怖袭击，而不仅仅是袭击地区内的特定个人。我们选择研究 2001 年纽约市世界贸易中心袭击事件和 2004 年西班牙马德里火车爆炸事件前后的人口生育结果时间序列，以确定这些事件是否影响了这些城市的母婴健康，如果有影响，影响持续多久。对于低出生体重（LBW）和早产的百分比，我们发现纽约市世界贸易中心袭击事件对纽约市没有显著影响，而马德里爆炸事件对 LBW 和早产的发生率有短暂但显著的影响。我们确实发现，在纽约市世界贸易中心袭击事件后，婴儿死亡率有显著的正持续影响，但马德里没有类似的影响。在纽约州的比较区域和西班牙其余地区，没有对任何指标变量产生影响。因此，纽约和马德里的人群母婴健康在这些城市发生恐怖袭击后出现了独特的不良影响。对马德里 LBW 和早产率的短期影响以及对纽约市婴儿死亡率的长期影响是在分析 1990 年至 2008/2009 年的季度数据时发现的。这些发现引发了关于灾难性恐怖袭击后人群生活质量的慢性变化的问题。公共卫生应受到监测，并设计干预措施，以应对事件急性后果之外的慢性压力、环境和社会经济威胁。
