title: Population effects of the bombing of Oklahoma City.
abstract: OBJECTIVE
  The explosion at the Murrah Federal Building in Oklahoma City on April 19, 1995, affected many members of the community as well as direct victims. Our goal was to measure the exposure and effects among the general population.
  
  
  METHODS
  We conducted surveys of the Oklahoma City metropolitan area and a control area to measure exposure and impact, primarily stress and psychological distress.
  
  
  RESULTS
  Of the adults in the Oklahoma City MSA, 61.5 percent (58.5 percent to 64.5 percent with 95 percent confidence) reported experiencing at least one direct result of the bombing. In population terms, about 433 thousand adults (between 412 thousand and 457 thousand, with 95 percent confidence) were exposed to one or more of the consequences of the bombing. Oklahomans reported higher rates (about double) of increased alcohol use, smoking more or starting smoking. They reported more stress (about double), psychological distress (about double), post-traumatic stress-disorder components, and intrusive thoughts (double) related to the bombing than in the control area. Oklahomans also reported higher rates of seeking help for their stress or taking steps to reduce stress. The differences persisted into 1996, more than a year after the bombing.
  
  
  CONCLUSIONS
  The exposure to the bombing was widespread, including more than half the adults in the metropolitan area surrounding Oklahoma City. The psychological effects were high and, while decreasing, persisted more than a year after the bombing. Primary care practitioners should screen their patients, who may normally not be considered victims, for exposure to the effects of a terrorist disaster for an extended period of time.
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma, Oklahoma City 73190, USA. David-Smith@ouhsc.edu
authors.forename: D W
authors.initials: DW
authors.lastname: Smith
authors.forename: E H
authors.initials: EH
authors.lastname: Christiansen
authors.forename: R
authors.initials: R
authors.lastname: Vincent
authors.forename: N E
authors.initials: NE
authors.lastname: Hann
mesh_terms: D000328:Adult; D005107:Explosions; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D009825:Oklahoma; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D013315:Stress, Psychological; D014754:Violence