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J Urban Health. 2018 Apr;95(2):255-266. doi: 10.1007/s11524-017-0223-5.

Factors Related to the Probable PTSD after the 9/11 World Trade Center Attack among Asian Americans.

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Graduate School of Social Service, Fordham University, New York, NY, USA.
Mailman School of Public Health, Columbia University, New York, NY, USA.
Graduate School of Social Service, Fordham University, New York, NY, USA.
College of Global Public Health, New York University, New York, NY, USA.


Despite the fact that Asians constituted a sizeable proportion of those exposed to the World Trade Center attack on September 11, 2001 due to its proximity to Chinatown and many South Asians working in the nearby buildings, no study had focused on examining the mental health impact of the attack in this group. Based on data collected by the World Trade Center Health Registry from a sample of 4721 Asians 2-3 years after the disaster, this study provides a baseline investigation for the prevalence and the risk and protective factors for PTSD among Asian Americans directly exposed to the attack and compared this population against 42,862 non-Hispanic Whites. We found that Asians had a higher prevalence of PTSD compared to Whites (14.6 vs 11.7%). "Race-specific factors" significantly associated to PTSD in the multivariate analyses were noted among sociodemographics: higher education was protective for Whites but a risk factor for Asians; being employed was protective for Whites but had no effect for Asians; and being an immigrant was a risk factor for Whites but had no effect for Asians. However, income was a protective factor for both races. Other "universal factors" significantly increased the odds of PTSD symptoms but showed no racial differences, including exposure to the disaster and the presence of lower respiratory symptoms which intensified odds of PTSD by the greatest magnitude (3.6-3.9 times). Targeted effort to reach out to Asians is essential for prevention and follow up treatment given this group's striking history of underutilization of mental health services.


9/11 World Trade Center attack; Asian Americans; Epidemiology; Mental health; PTSD; Social factors

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