Skip to main content Accessibility help

Effects of the 2002 Sniper Attacks on the Homeless Population in Washington, DC

  • Carol S. Fullerton, Robert K. Gifford, Brian W. Flynn, Karen M. Peterson, Frederick L. Ahearn, Linda Plitt Donaldson and Robert J. Ursano...


Objective: Despite the prevalence of homelessness, this population has rarely been included in disaster and terrorism planning. To better understand the mental health needs of the homeless during a terrorist event and to highlight the need to address methodological limitations in research in this area, we examined responses to the October 2002 Washington, DC, sniper attacks.

Methods: We interviewed 151 homeless individuals 1 year after the Washington, DC, sniper attacks.

Results: The majority (92.7%) was aware of the sniper events; 84.1% stayed informed through the media and 72.7% had someone to turn to for emotional support. Almost half (44%) reported identification with victims and 41% increased substance use during the attacks. More than half (61.7%) felt extremely frightened or terrified and 57.6% reported high perceived threat. Females, nonwhites, and participants with less than a high school education experienced greater threat. Women, nonwhites, and younger (<43 years old) participants were more likely to have decreased more activities and 32.7% increased confidence in local law enforcement; however, 32.7% became less confident.

Conclusions: During a terrorist attack the homeless population may be difficult to reach or reluctant to comply with public health programs. Addressing barriers to health care in vulnerable groups is critical to effective public health disaster response. (Disaster Med Public Health Preparedness. 2009;3:163–167)


Corresponding author

Address correspondence and reprint requests to Carol S. Fullerton, PhD, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814-4799 (e-mail:


Hide All
1. Homelessness in the United States and the Human Right to Housing. The National Law Center on Homelessness and Poverty. Accessed July 31, 2009.
2.North, CS, Eyrich, KM, Pollio, DE, et alAre rates of psychiatric disorders in the homeless population changing? Am J Pub Health. 2004;94:103108.
3.Folsom, DP, Hawthorn, W, Lindamer, L, et alPrevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. Am J Psychiatry. 2005;162:370376.
4.US Conference of Mayors. A Status Report on Hunger and Homelessness in America’s Cities: 2005. Washington, DC: US Conference of Mayors; 2007.
5.Martinez, TE, Burt, MR.Impact of permanent supportive housing on the use of acute care health services by homeless adults. Psychiatr Serv. 2006;57:992999.
6.Phelan, JC, Link, BG.Who are “the homeless”? Reconsidering the stability and composition of the homeless population. Am J Pub Health. 1999;89:13341338.
7.North, CS, Pollio, DE, Smith, EM, et alCorrelates of early onset and chronicity of homelessness in a large urban homeless population. J Nerv Mental Dis. 1998;186:393400.
8.Klinenberg, E.Heat Wave: A Social Autopsy of Disaster in Chicago. Chicago: University of Chicago Press; 2002.
9.Ursano, RJ, Fullerton, CS, Weisaeth, L, Raphael, B. Individual and community responses to disasters.Ursano RJ, Fullerton CS, Weisaeth L, Raphael B. Textbook of Disaster Psychiatry. Cambridge, UK: Cambridge University Press; 2007:326.
10. Kessler R, Katrina Scientific Advisory Group. Baseline Katrina Report August 2006. Accessed July 19, 2009.
11.North, CS, Pollio, DE, Pfefferbaum, B, et alConcerns of Capitol Hill staff workers after bioterrorism: focus group discussions of authorities’ response. J Nerv Ment Dis. 2005;193:523527.
12.Solomon, SD, Smith, EM. Social support and perceived control as moderators of responses to dioxin and flood exposure. Ursano RJ, McCaughey BG, Fullerton CS. Individual and Community Responses to Trauma and Disaster. Cambridge, UK: Cambridge University Press; 2004:179200.
13.Vlahov, D, Galea, S, Resnick, H, et alIncreased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. Am J Epidemiol. 2002;155:988996.
14.Jainchill, N, Hawke, J, Yagelka, J.Gender, psychopathology, and patterns of homelessness among clients in shelter-based TCs. Am J Drug Alcohol Abuse. 2000;26:553567.
15.Ursano, RJ, Mccarroll, JE. Exposure to traumatic death: the nature of the stressor.Ursano RJ, McCaughey BG, Fullerton CS. Individual and Community Responses to Trauma and Disaster. Cambridge, UK: Cambridge University Press; 2004:4671.
16.Ursano, RJ, Fullerton, CS, Vance, K, et alPosttraumatic stress disorder and identification in disaster workers. Am J Psychiatry. 1999;156:353359.
17. Burt MR. 1998 National Symposium on Homeless Research Demographics and Geography: Estimating Needs. Accessed July 19, 2009.
18.Brickner, PW, Sharer, LK, Conanan, BH, et alUnder the Safety Net. New York: WW Norton; 1990.
19.Institute of Medicine. Homelessness: Health and Human Needs. Washington, DC: National Academy Press; 1988.
20.Gelbert, L, Siecke, N.Accuracy of homeless adults’ self-reports. Med Care. 1997;35:287290.
21.Ropers, R, Robertson, M.Basic shelter research project. Los Angeles: UCLS School of Public Health; 1984.
22.Health care for the homeless. Disaster planning requires time, resources, collaboration. Healing Hands. 2004;8:14.
23. Simonsen G. Promoting Personal Preparedness: Universal Design and Health Interventions. Accessed July 19, 2009.
24.Lasker, RD.Redefining Readiness: Terrorism Planning Through the Eyes of the Public. New York: New York Academy of Medicine; 2004.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed