Research has shown that certain marginalized groups -- including the mentally ill, the disabled and ethnic minorities such as African Americans and Latinos -- fare worse than others in the aftermath of natural disasters, suffering disproportionate impoverishment, injuries and fatalities.
Now, a new study by UCLA researchers and colleagues has found that they also experience greater terrorism-related fears and make more behavioral changes based on those fears -- such as avoiding certain activities -- than others. These groups also tend to overestimate the threat of terrorism, perceiving the risk as high even when the Homeland Security Advisory System's (HSAS) color-coded alert system rates it lower.
The study, published in the January issue of the American Journal of Public Health, is currently available online at www.ajph.org/cgi/content/full/99/1/168.
"Just like natural disasters have been shown to affect certain groups of people more than others, we're now seeing evidence that terrorism fears are having a disproportionate effect on some of our most vulnerable groups," said leady study author David P. Eisenman, assistant professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. "It's important for the public to know this because it shows that terrorism's intention to induce fear and change does work -- on the most vulnerable. Terrorism affects these groups even when there has not been an event in a long time.
"It also shows," he added, "that the HSAS color-coding is misjudged by citizens, and the same persons who have the most fear and avoid activities are also misjudging it."
The findings are based on random-digit dial surveys conducted in in six languages in Los Angeles County between October 2004 and January 2005. Respondents were asked the color of the country's alert level at that time, as well as how often they worried about terrorist attacks and how often they avoided activities because of those fears.
Researchers found that the mentally ill, the disabled, African Americans, Latinos, Chinese Americans, Korean Americans and non-U.S. citizens were likelier to think the HSAS alert level was higher than it was, and to worry more and change their behavior due to those fears.
These findings present evidence that the structure of the HSAS alerts need to be reevaluated -- in part to ensure that terrorism alerts better reach these vulnerable populations, Eisenman said. Also, vulnerable groups need assistance to help them reduce their fears and avoidance. Ensuring that structures can be safely evacuated in the event of a terrorist act, for example, can help reduce some of these fears among the physically disabled.
"Terrorism-related fears and avoidant behavior can be considered part of the 'disaster burden' -- the amount of adverse health effects ranging from loss of well-being or security to injury, illness or death caused by a disaster associated with terrorism and national terrorism policies," the researchers conclude. "The disaster burden associated with terrorism and consequent policies may fall disproportionately on the vulnerable groups we studied."
In addition to Eisenman, study researchers included Michael Ong, Qiong Zhou and Chi-Hong Tseng of the David Geffen School of Medicine at UCLA; Steve Asch of the Geffen School of Medicine, the Veterans Affairs Greater Los Angeles Healthcare System and the RAND Corp.; Deborah Glik of the UCLA School of Public Health; Jonathan Fielding of the UCLA School of Public Health and the Los Angeles County Department of Public Health; and Anna Long of the Los Angeles County Department of Public Health.
Grants from the Centers for Disease Control and Prevention funded the study.
The General Internal Medicine and Health Services Research Divison in the department of medicine at the David Geffen School of Medicine at UCLA provides a unique interactive environment for collaborative efforts between health services researchers and clinical experts with experience in evidence-based work. The division's 100-plus clinicians and researchers are engaged in a wide variety of projects that examine issues related to access to care, quality of care, health measurement, physician education, clinical ethics and doctor-patient communication. Researchers in the division have close working relationships with economists, statisticians, social scientists and other specialists throughout UCLA and frequently collaborate with their counterparts at the RAND Corp. and the Charles Drew University of Medicine and Science.