Survivor Enrollment Outpaced Responders in Trade Center Health Program for 2024
The World Trade Center Health Program has published statistics for 2024 that paint a sobering portrait of increasing need for medical care among the population of “survivors” of the terrorist attacks of September 11, 2001.
This label denotes residents, students, and workers near the location of the attacks, as distinct from “responders.” While the latter category still forms a majority (about 65 percent) of enrollees in the Health Program, survivors signed up at more than double the rate of responders in the year that recently ended, (7,034 new participants, versus 3,213). Currently, the Health Program covers 132,091 people. During 2024, an additional 3,248 survivors and 1,936 applied for the Health Program, but were “suspended.” The most common reason in both categories was “insufficient documentation.”
Both responders and survivors tend to skew older, with fewer than 4,000 current enrollees (or only around three percent) in the Health Program reporting that they were under 21 years old at the time of the attacks. This cohort appears poised to swell in the years ahead. According to official tallies, there were 41 elementary, middle, and high schools operating in the exposure zone (roughly, Manhattan south of Houston Street) on the morning of September 11, 2001, as well as multiple colleges and universities. The precise number of students enrolled in those schools is unknown, as is how many attended school on that day, or in the weeks and months that followed. Also unknown is the number of preschool-aged children who resided within reach of the toxic debris cloud that blanketed Lower Manhattan in the wake of the collapse of the Twin Towers. It may prove particularly difficult for these people, who are now in their 20s and 30s, to provide the documentation that the Health Program requires, since comparatively fewer records exist for small children, and many of these have been lost in the decades since the attacks.
The most common categories of certified conditions for Health Program enrollees are aerodigestive disorders, cancer, and mental health issues. Among responders, 42,000 participants have aerodigestive disorders, 21,000 have various forms of cancer, and 15,000 are struggling with mental health issues. For survivors, the corresponding benchmarks are 16,000 (aerodigestive), 20,00 (cancer), and 8,000 (mental health).
The five most common health conditions newly certified in 2024 were cancer (3,607 responders and 4,660 survivors), gastroesophageal reflux disease (1,653 and 576, respectively), chronic rhinosinusitis (1,400 and 725), post-traumatic stress disorder (667 and 678), and asthma (530 and 471).
Throughout 2024, 58,000 Health Program enrollees received medical treatment for 577,000 claims, costing $327 million. Of this amount, approximately 95 percent (or $310.8 million) was spent treating responders, with the remainder ($16.5 million) going to treat survivors. During the same period, the Health Program spent $175 million on half a million pharmacy claims. Among these claims, 83 percent (costing $148 million) were for responders, with the remainder going to survivors.