Coping Responses and Psychological Outcomes in Hispanic World Trade Center (WTC) Responders

Background: Thousands of people are estimated to have endured distressing experiences during the recovery efforts at the WTC site. While the effects of 9/11 continue to be studied, few studies have looked at how first responders are coping since 9/11 and how their coping influences their psychological wellbeing.  This study aimed to compare differences in coping responses between Hispanics, Non-Hispanic Whites, and Non-Hispanic Blacks. Further, we examined how the relationship between active coping and wellbeing varies by language preference and US nativity among Hispanics.

Methods: Data from a cohort of 4,169 WTC responders who attended monitoring visits at the Mount Sinai WTC Health program (WTC-HP) and participated in a web-based survey were used for secondary data analyses.  Multiple regression analyses were used to compare differences in coping responses between Hispanics, Non-Hispanic Whites, and Non-Hispanic Blacks, while controlling for demographic variables (age, sex, education, income, employment status) and trauma exposure. We also tested a moderation effect to examine if the relationship between active coping and wellbeing varies by language preference and US nativity among Hispanics.

Results: We found that Non-Hispanic Black responders are similar to Hispanic responders in that they both report commonly using religion as a mode of coping. Further, Non-Hispanic White responders report coping by using humor at a higher rate than other responders. While there are similarities in coping among Hispanic responders, Hispanic responders born in the US are more likely to report using humor as a mode of coping. In WTC responders, Hispanic ethnicity, identifying as female, and trauma exposure were strongly associated with PTSD. Conversely, Hispanic ethnicity, identifying as female, being older in age, being employed, PTSD, positive religious coping, and perceived social support were strongly associated with post-traumatic growth. Similarly, identifying as Hispanic or Non-Hispanic Black, being older in age, being employed, having a higher level of education, and higher income were significantly associated with positive affect. Moreover, completing the survey in English had a significant increase in variance in the relationship between active coping and positive affect, and quality of life for Hispanic responders. There was a significant moderation effect.

Conclusion: Our findings are consistent with other studies that have identified Hispanic ethnicity as a risk factor for PTSD. However, our findings also show that positive religious coping and perceived social support are strongly associated with Hispanic responders experiencing post-traumatic growth and positive affect. Further, language preference in completing the survey among Hispanic responders moderates the relationship between active coping and positive affect, and quality of life. These findings are of importance for prevention and treatment efforts in this population.