Twenty-Five Years After 9/11 — Lessons from the World Trade Center Health Program

Paper examines 9/11-related health outcomes and lessons learned in the quarter century since the disaster.

WASHINGTON — The Journal of the American Medical Association (JAMA) today published "Twenty-Five Years After 9/11 — Lessons from the World Trade Center (WTC) Health Program," a paper by Program staff that demonstrates robust outcomes in preventive care and chronic disease management in the quarter century since the September 11, 2001, terrorist attacks.

The paper examines three key insights that have emerged from the long term follow up of the 9/11 impacted population:

• Disaster-related health effects are often chronic, dynamic, and involve multiple organs in the body.
• Individuals exposed to the 9/11 attacks have a greater prevalence of chronic conditions and poorer health-related quality of life compared to the general population. At the same time, those enrolled in the WTC Health Program have improved survival compared to those not enrolled, illustrating the connection between exposure-related risk and access to beneficial care.
• Integrated systems of care improve health outcomes. Effective approaches require ongoing, connected systems of care and research. In this way, the Program provides a model for how health systems can respond to such events, not only in the immediate aftermath but also in the long term.

"Since its launch in 2011, the WTC Health Program has evolved into a national model for longitudinal care and surveillance of disaster-exposed populations," said Dr. John Howard, MD, Director of CDC's National Institute for Occupational Safety and Health (NIOSH) and Administrator of the WTC Health Program. "By linking surveillance, clinical care, and research, the Program functions as a continuous learning model that informs clinical practice and advances understanding of the long-term effects of 9/11 exposures among an aging population."

In 2024, 54% of eligible Program members who met U.S. Preventive Services Task Force criteria underwent lung cancer screening. This far exceeds the 7.5% national lung cancer screening benchmark and the 18% actual U.S. national rate of lung cancer screening in 2022. Program research also showed that responders with cancer enrolled in the Program experienced 26% to 64% lower mortality rates compared with other New York residents living in the same area across multiple cancer types, including prostate, lung, kidney, and colorectal.

The WTC Health Program's mission includes evaluating health outcomes experienced by the 9/11 impacted population to identify ways to improve their treatment and care. Program members contribute to these efforts by participating in research studies. Findings from these efforts can help others who may face similar health exposures in the future.

The paper reflects on the courage and sacrifice of those selfless responders who answered the call of duty, as well as those who lived, worked, or went to school or daycare in the New York City Disaster Area. It also provides insights on how the WTC Health Program makes a real difference in helping to improve quality of life and positive health outcomes among 9/11 responders and survivors enrolled in the Program.

For more information visit www.cdc.gov/wtc/research.

The WTC Health Program is a limited federal health program administered by the National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention in the U.S. Department of Health and Human Services. The Program provides no out-of-pocket cost medical monitoring and treatment for certified WTC-related health conditions to those directly affected by the 9/11 attacks in New York, at the Pentagon, and in Shanksville, Pennsylvania, and is authorized through 2090.