Article

Threats to health

Public perceptions of the threat of terrorist attack in

Australia and anticipated compliance behaviours

Garry Stevens, Melanie Taylor Abstract

School of Medicine, University of Western Sydney, New South Wales Objective: To determine the perceived
threat of terrorist attack in Australia and
Margo Barr preparedness to comply with public safety
Centre for Epidemiology and Research, New South Wales Department of Health directives.
Methods: A representative sample
Louisa Jorm of 2,081 adults completed terrorism
School of Medicine, University of Western Sydney, New South Wales perception questions as part of the New
South Wales Population Health Survey.
Results: Overall, 30.3% thought a terrorist
Michael Giffin, Ray Ferguson
attack in Australia was highly likely,
Centre for Epidemiology and Research, New South Wales Department of Health
42.5% were concerned that self or family
would be directly affected and 26.4% had
Kingsley Agho and Beverley Raphael changed the way they lived due to potential
School of Medicine, University of Western Sydney, New South Wales terrorist attacks. Respondents who spoke a
language other than English at home were
2.47 times (Odds Ratios (OR=2.47, 95%

I
f a terrorist attack should occur, it is
essential that public health authorities
are prepared to act. Understanding how
the public perceives the threat of a terrorist
attack, and is likely to respond, is integral to
incident preparedness and planning.1-2
Studies following large-scale terrorist
attacks show that the perceived risk of further
attacks is linked with changes in behaviour,
such as restricting travel, avoiding places of
perceived high risk and increased substance
use.3-5 There is evidence that some of these
changes will persist in the medium term and be
associated with negative health and economic
outcomes.6-8 There is also evidence that some
of these population impacts may be mitigated
through public information campaigns and
other preparedness initiatives.5
Information is also emerging from
populations that have not experienced a
major attack but are at risk of such events.9-
11
In one Canadian study, only 20% of the
population thought a terrorist attack was
extremely or very likely to occur. Perceived
threat to themselves as individuals was
even lower. Most respondents worried little
Submitted: August 2008 Revision requested: February 2009 Accepted: April 2009
Correspondence to:
Garry Stevens, Senior Research Fellow, School of Medicine, University of Western Sydney,
Building EV, Parramatta Campus, Locked Bag 1797, Penrith NSW DC1797. Fax: (02) 9685 9554;
e-mail: g.stevens@uws.edu.au
about terrorism; preparatory behaviours
were consistent with these perceptions,
with less than 5% establishing a family
emergency plan for terrorism or avoiding
public places of perceived risk. While
specific preparedness was low, there was
high willingness to follow public safety
directives during such incidents.9
Australia, like Canada, is a country that has
experienced little terrorism within its borders.
However, in recent years Australians have been
affected by large-scale terrorist attacks within
the region, including bombings in Bali in
2002 and 2005, and the 2005 Jakarta bombing
presumed to have targeted the Australian
Embassy. Australians were also among those
killed in the Mumbai attacks of 2008. In
this environment of increasing international
threat, there is a need for planning to protect
public health and safety should terrorist
attacks occur within Australia.12
Disaster planning requires information about
community perceptions of risk, associated
behaviours and information about vulnerable
sub-populations.13 Researchers and planners
stress the importance of developing specific
CI:1.58-3.64, p<0.001) more likely to be
concerned self or family would be affected
and 2.88 times (OR=2.88, 95% CI:1.95-
4.25, p<0.001) more likely to have changed
the way they lived due to the possibility of
terrorism. Those with high psychological
distress perceived higher terrorism
likelihood and greater concern that self or
family would be directly affected (OR=1.84,
95% CI:1.05-3.22, p=0.034). Evacuation
willingness was high overall but those with
poor self-rated health were significantly
less willing to leave their homes during a
terrorism emergency.
Conclusion: Despite not having
experienced recent terrorism within
Australia, perceived likelihood of an attack
was higher than in comparable western
countries. Marginalisation of migrant
groups associated with perceived terrorism
threat may be evident in the current
findings.
Implications: This baseline data will be
useful to monitor changes in population
perceptions over time and determine
the impact of education and other
preparedness initiatives.
Key words: terrorism, threat perception,
risk perception, evacuation, ethnicity,
psychological distress.
Aust N Z Public Health. 2009; 33:339-46
doi: 10.1111/j.1753-6405.2009.00405.x

2009 vol. 33 no. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 339
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
Stevens et al. Article

measures of risk perception, and their behavioural correlates, as an risk), life changes and compliance with government authorities.
integral part of disaster planning.14 Such instruments can support The primary reference was a study by Canadian researchers on
the establishment of baseline data against which the trajectory of anticipated public response to terrorism.9-10 Questions on threat
psychosocial recovery can be measured. They can also be used to likelihood, effect on family and behavioural compliance were
monitor other shifts in community perceptions over time, including adapted, with permission, by subject matter experts and survey
the effectiveness of risk communication strategies and education methodologists. Each proposed question was considered for
programs. For these reasons, the relative absence of baseline data has clarity, ease of administration and possible biases. A set of five
been cited as a significant impediment to disaster planning.14-15 questions was developed for field-testing as well as the additional
The aim of this paper is to determine perceptions of the threat open question “Do you have any comments that you would like to
of terrorist attack in Australia and preparedness to comply with make on any of the questions or any other issues?”
evacuation directives in the event of such incidents. A further aim of
the wider study has been to establish a surveillance tool and source of Field testing
baseline data to allow ongoing monitoring of terrorism risk perception The terrorist attack questions were field tested for test–retest
and behavioural correlates within the Australian population. reliability using the protocol of the New South Wales Health
Survey Program.16 A detailed description of its application in this
Methods study is presented elsewhere.17 Data manipulation and analysis
Question design were conducted using SAS Version. 9.2.16 Kappa values for the
A literature search was conducted to identify existing tools for indicators derived from the questions ranged between 0.27 and
collecting information on perceptions of terrorist attack with the 0.64 in the second field test. There were low rates of ‘don’t know’
underlying themes of likelihood, effect on family (vulnerability and responses (0.0–3.9%) and refusal (0.0–0.5%).
Table 1: Prevalence estimates for each question by response category including don’t know and refused.
Question Response % 95% LCI 95% UCI
How likely do you think it is that a terrorist attack will occur in Australia? Not at all 8.8 7.0 10.6
A little 23.1 20.4 25.8
Moderately 33.6 30.7 36.5
Very 21.5 19.0 23.9
Extremely 8.9 7.2 10.6
Don’t know 3.4 2.2 4.6
Refused 0.7 0.3 1.2
If a terrorist attack happened in Australia, how concerned would you Not at all 10.6 8.8 12.5
be that you or your family would be directly affected by it? A little 22.4 19.7 25.0
Moderately 21.7 19.1 24.2
Very 24.3 21.8 26.9
Extremely 18.2 15.7 20.6
Don’t know 2.1 1.3 3.0
Refused 0.7 0.3 1.2
How much have you changed the way you live your life because of the Not at all 71.4 68.6 74.2
possibility of a terrorist attack? A little 14.7 12.4 16.9
Moderately 7.6 5.9 9.4
Very 2.9 1.9 4.0
Extremely 1.1 0.6 1.7
Don’t know 1.6 0.9 2.3
Refused 0.7 0.2 1.1
In case of an emergency situation such as a terrorist attack, how willing Not at all 6.3 4.8 7.9
would you be to evacuate your home? A little 7.0 5.2 8.8
Moderately 18.2 15.9 20.6
Very 31.3 28.4 34.3
Extremely 33.9 31.0 36.8
Don’t know 2.4 1.6 3.2
Refused 0.8 0.3 1.2
How willing would you be to evacuate your workplace or a public facility? Not at all 1.8 1.1 2.5
A little 3.8 2.6 5.0
Moderately 8.9 6.9 10.9
Very 34.5 31.6 37.5
Extremely 48.8 45.7 51.8
Don’t know 1.5 0.9 2.0
Refused 0.8 0.3 1.2
Source: New South Wales Health Survey Program. Sydney: New South Wales Department of Health, 2008.

340 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2009 vol. 33 no. 4
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
Threats to health Public perceptions of threat of terrorist attack
The survey
The New South Wales Adult Population Health Survey is a
continuous telephone survey of the health of the state population
using the in-house CATI facility of the New South Wales
Department of Health.16
The terrorist attack question module was administered as part of
the survey between 22 January and 31 March, 2007. The terrorist
attack questions were submitted to the ethics committees of the
NSW Population Health and Health Services and the University of
Western Sydney, for approval prior to use. The survey also included
other modules on health behaviours, health status (including
psychological distress, using the Kessler K10 measure, and self-
rated health status) and access to health services, as well as the
demographics of respondents and households. As field test data
had indicated high assumed knowledge regarding the concept of
terrorism and presumptions this typically involved bombings or
shootings (i.e. ‘conventional’ terrorism), a specific definition of
terrorism was not outlined in the preamble. The target population
for the survey was all state residents living in households with
private telephones. Up to seven calls were made to establish initial
contact with a household and five calls were made in order to
contact a selected respondent.
Response categories were dichotomised into indicators of
interest and responses of ‘don’t know’ or ‘refused’ were excluded.
For the hypothetical questions (i.e. likelihood of a terrorist attack
in Australia, concern that self or family would be directly affected,
willingness to comply with evacuation of home, willingness
to comply with evacuation of workplace or public facility) the
responses of extremely likely and very likely were combined
into the indicator of interest. For the non-hypothetical question
“changed the way you live because of the possibility of a terrorist
attack”, the responses ‘a little’, ‘moderately’, ‘very much’ and
‘extremely’ were combined into the indicator of interest: that is,
changed way of living.
The survey data were weighted to adjust for probability of selection
and for differing non-response rates among males and females and
different age groups.17 Data were manipulated and analysed using
SAS version 9.2.16 The SURVEYFREQ procedure in SAS was used
to calculate point estimates and 95% confidence intervals.
Odds ratios were calculated as described by Bland.18 All
calculations were performed using the ‘SVY’ commands of Stata
version 9.2 (Stata Corp, College Station, TX, USA), which allowed
for adjustments for sampling weights.
Results
In total 2,081 state residents aged 16 years and over completed
the module on terrorist attack. The overall response rate was
65%. The demographics of the weighted survey population were
comparable with the Australian Bureau of Statistics 2006 Census.19
These comparisons are reported elsewhere.20
Overall, 30.3% of the population thought a terrorist attack was
extremely or very likely, 42.5% were extremely or very concerned
that they or their family would be affected by a terrorist attack
2009 vol. 33 no. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 341
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
and 26.4% had made some (small to extreme) level of change
to the way they lived their life because of the possibility of an
attack. Table 1 shows the prevalence estimates for all of the survey
questions by response category.
Table 2 presents prevalence estimates for the likelihood, concern
and changed way of living variables by demographic and socio-
economic characteristics, and the indicators of level of psychological
distress and general self-rated health status. When these variables
were combined, the greatest proportion of the population (37.0%)
thought a terrorist attack was unlikely to occur, were not concerned
that they or family members would be directly affected and had not
changed the way they lived their life because of the possibility of a
terrorist attack. Less than 1 in 10 people (9.0%) thought a terrorist
attack was likely, were concerned that they or family members
would be directly affected and had made changes to the way they
lived their life due to the prospect of an attack.
The results of univariate analyses identified a number of
statistically significant factors associated with threat likelihood,
concern and changed way of living (see Table 2). For the latter
variable, a sensitivity analysis comparing the current indicator
(‘a little’, ‘moderately’, ‘very’ and ‘extremely’) and the more
conservative indicator (‘moderately’, ‘very’ and ‘extremely’)
showed that the association did not change for the co-variates and
therefore the current indicator was retained for the analysis.
The univariate analysis indicated that young people (16-24
years) were significantly less likely to report high terrorism
likelihood compared to all other age categories. Those with no
formal qualifications were 2.09 times (Odds Ratios (OR=2.09,
95% CI:1.32-3.31, p=0.002) more likely to think that a terrorist
attack was very or extremely likely compared to those with a
university degree or equivalent and women were significantly
more likely (OR =1.54, 95% CI:1.20-1.99, p=0.001) to be very
or extremely concerned for themselves or family members in the
event of an attack.
Those who spoke a language other than English at home were
2.47 times (OR=2.47, 95% CI=1.58-3.64, p<0.001) more likely
to be concerned for self or family and 2.88 times (OR=2.88, 95%
CI:1.95-4.26, p<0.001) more likely to have made changes in living
due to the risk of terrorism attack. When these indicators were
combined, those with high psychological distress were found to
perceive higher terrorism likelihood and to have greater concern
that they or family members would be directly affected (OR=1.84,
95% CI:05-3.22, p=0.034).
Table 3 shows the prevalence estimates for willingness to
evacuate home, workplace/public facility, and both home and
workplace/public facility, by demographic characteristics and the
indicators psychological distress and health status. Table 3 also
shows combined indicators of evacuation willingness for those
concerned about self and family and who also thought a terrorist
attack was likely. Overall, if an emergency such as a terrorist attack
were to occur, the majority of the population would be willing to
evacuate their home (67.4%), their workplace or a public facility
(85.2%), or both location types (65.8%). Conversely, 12.5% would
be willing to evacuate neither of these locations. Fewer than 20%
 Table 2: Prevalence and Odds Ratios (95% confidence intervals) of terrorist attack likely, concern for self/family, changed way of living and combined indictors.

342
Independent Terrorist attack likely Concerned self or family Changed way of living due Terrorist attack likely and Terrorist attack likely and
variable directly affected to possibility of terrorism concerned for self/family concerned and changed
way of living
Weighted OR 95% CI P Weighted OR 95% CI P Weighted OR 95% CI P Weighted OR 95% CI P Weighted OR 95% CI P
(%) value (%) value (%) value (%) value (%) value
Stevens et al.

NSW pop’n 31.6 - - - 43.7 - - - 27.0 - - - 18.9 - - - 9.0 - - -

Gender
Male 30.8 1.00 38.5 1.00 24.7 1.00 16.8 1.00 7.9 1.00
Female 32.5 1.08 0.83,1.41 0.55 49.1 1.54 1.20,1.99 <0.01 29.3 1.26 0.94,1.69 0.12 21.1 1.35 0.98,1.86 0.07 10.1 1.31 0.82,2.10 0.26
Location
Urban 31.2 1.00 45.7 1.00 29.2 1.00 19.1 1.00 9.7 1.00
Rural 32.5 1.06 0.83,1.36 0.64 39.5 0.78 0.61,0.98 0.04 22.1 0.69 0.52,0.90 0.01 18.4 0.94 0.71,1.25 0.66 7.4 0.76 0.51,1.14 0.19
High psychological distress (≥22)
No 29.9 1.00 45.2 1.00 25.1 1.00 17.3 1.00 7.7 1.00
Yes 40.0 1.55 0.95,2.53 0.08 52.1 1.31 0.82,2.09 0.25 30.9 1.33 0.79,2.25 0.28 27.9 1.84 1.05,3.22 0.03 13.9 1.98 0.93,4.22 0.08
Age
16-24 17.4 1.00 39.5 1.00 27.9 1.00 14.1 1.00 7.6 1.00
25-34 30.5 2.09 1.12,3.90 0.02 51.1 1.60 0.93,2.78 0.09 26.1 0.91 0.49,1.69 0.77 22.3 1.76 0.87,3.58 0.12 12.2 1.71 0.67,4.36 0.26
35-44 34.1 2.46 1.36,4.46 <0.01 32.6 0.74 0.44,1.26 0.27 28.7 1.04 0.57,1.88 0.90 13.0 0.98 0.48,2.01 0.97 7.4 1.05 0.40,2.75 0.92
45-54 36.4 2.72 1.55,4.76 <0.01 45.0 1.25 0.77,2.04 0.37 31.7 1.20 0.69,2.07 0.52 21.3 1.77 0.93,3.36 0.08 9.7 1.33 0.55,3.17 0.56
55-64 35.3 2.59 1.49,4.50 0.01 44.6 1.23 0.76,2.00 0.39 25.4 0.88 0.51,1.52 0.65 19.7 1.60 0.87,2.94 0.13 8.1 1.10 0.48,2.52 0.81
65-74 33.6 2.40 1.37, 4.18 <0.01 51.7 1.64 1.02,2.66 0.04 23.8 0.80 0.46,1.39 0.42 24.0 1.99 1.06,3.72 0.03 10.4 1.42 0.60,3.39 0.43
75+ 36.2 2.69 1.47,4.93 <0.01 52.9 1.72 1.02,2.91 0.04 14.3 0.43 0.23,0.81 0.01 24.9 2.36 1.19,4.67 0.01 5.9 0.71 0.25,2.03 0.52
Children in household
No 29.7 1.00 45.7 1.00 26.3 1.00 19.1 1.00 8.7 1.00
Yes 33.3 1.13 0.84,1.51 0.43 40.1 0.79 0.60,1.06 0.12 30.4 1.31 0.96,1.78 0.09 17.8 0.91 0.64,1.30 0.61 9.9 1.27 0.78,2.08 0.34
Born in Australia
No 32.4 1.00 50.4 1.00 36.0 1.00 20.1 1.00 10.5 1.00
Yes 31.3 0.94 0.68,1.29 0.70 41.3 0.69 0.52,0.93 0.02 23.8 0.56 0.40,0.77 <0.01 18.4 0.90 0.61, 1.33 0.61 8.4 0.83 0.48,1.45 0.52
Speak language other than English at home
No 32.1 1.00 40.1 1.00 23.2 1.00 17.8 1.00 8.0 1.00
Yes 29.1 0.87 0.56,1.34 0.53 62.4 2.47 1.68,3.64 <0.01 46.5 2.88 1.95,4.26 <0.01 24.8 1.45 0.90,2.33 0.12 14.3 1.77 0.94,3.33 0.08
Living alone
No 31.2 1.00 43.4 1.00 27.9 1.00 18.5 1.00 9.2 1.00
Yes 35.0 1.18 0.92,1.53 0.19 46.1 1.12 0.88,1.42 0.38 19.5 0.62 0.47,0.84 <0.01 21.6 1.21 0.90,1.62 0.20 6.9 0.71 0.46,1.12 0.14

© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
Highest formal qualification
University 27.4 1.00 35.3 1.00 24.3 1.00 11.5 1.00 5.6 1.00
degree/equivalent
TAFE 34.9 1.43 0.97,2.10 0.07 41.0 1.28 0.89,1.84 0.19 26.6 1.13 0.74,1.71 0.58 17.4 1.61 0.96,2.69 0.01 7.9 1.44 0.66,3.14 0.36
certificate/Diploma
High school 25.8 0.92 0.60,1.43 0.72 44.0 1.44 0.95,2.18 0.09 28.9 1.27 0.80,2.01 0.31 17.6 1.63 0.95,2.80 0.08 7.1 1.28 0.57,2.85 0.55
certificate
School certificate 35.2 1.44 0.99, 2.08 0.05 52.1 1.99 1.41,2.82 <0.01 28.4 1.24 0.84,1.83 0.29 26.7 2.68 1.68,4.27 <0.01 13.4 2.53 1.32,4.87 0.01
None 44.5 2.09 1.32,3.31 <0.01 62.9 2.92 1.87,4.58 <0.01 32.2 1.43 0.87,2.36 0.16 37.3 4.52 2.63,7.75 <0.01 18.1 3.46 1.58,7.60 <0.01
Employed

2009 vol. 33 no. 4

No 32.5 1.00 49.3 1.00 26.7 1.00 22.4 1.00 10.8 1.00
Article

Yes 31.7 0.94 0.72,1.22 0.63 41.3 0.71 0.55,0.91 0.01 26.9 1.02 0.77,1.35 0.90 17.7 0.71 0.52,0.96 0.03 8.4 0.74 0.47,1.16 0.19
 Threats to health Public perceptions of threat of terrorist attack

would be willing to evacuate their workplace or a public facility

value

0.10
0.77
0.70
0.21

0.11

0.36
0.84
0.75
Terrorist attack likely and
Table 2 continued: Prevalence and Odds Ratios (95% confidence intervals) of terrorist attack likely, concern for self/family, changed way of living and combined indictors.

concerned and changed

P
but not their home, whereas far fewer (1.9%) would be willing to
evacuate their home but not their workplace or public facility.

9.2 1.00
14.1 1.67 0.90,3.10
9.5 1.12 0.52,2.39
9.6 1.17 0.52,2.65
5.6 0.63 0.31,1.29
Health self-rated as good
8.3 1.00
13.8 1.79 0.88,3.63
Marital status
8.6 1.00
11.2 1.35 0.71,2.58
8.1 1.07 0.56,2.05
7.8 0.91 0.50,1.64
Notes: Psychological distress was measured using the K10. Values range from 10-50, with ‘high’ psychological distress considered as being ≥22. Source: New South Wales Health Survey Program. Sydney: New South Wales
R 95% CI
way of living

(%) Univariate analyses of evacuation intentions, also presented in

Table 3, indicated that females were 1.45 times (OR=1.45, 95%
CI:1.11-1.89, p=0.007) more willing to evacuate their homes than
Weighted O

males, employed Australians were 1.37 times (OR=1.37, 95%

CI:1.06-1.79, p=0.018) more willing to evacuate their homes
Household income (before tax)

than those unemployed and respondents with poor self-rated

health were significantly less willing (OR=0.63, 95% CI: 0.42-
value

0.96, p=0.032) to evacuate their homes than those with good or

21.9 1.00
26.5 1.33 0.85,2.07 0.21
19.5 0.89 0.53,1.49 0.66
22.7 1.10 0.61,1.99 0.75
12.3 0.52 0.32,0.84 0.01

18.3 1.00
26.0 1.61 0.99,2.62 0.06

18.9 1.00
24.8 1.42 0.93,2.17 0.10
22.6 1.26 0.83,1.91 0.26
15.9 0.81 0.53,1.23 0.32
Terrorist attack likely and
concerned for self/family

excellent self-rated health.

With regard to evacuation of work/public facilities, females were
95% CI

1.62 times (OR1.62, 95% CI:1.14-2.32, =0.008) more willing

(%)

than males, people with children were 1.84 times (OR=1.84, 95%

CI:1.10-3.05, p=0.019) more willing than those without children

Weighted OR

and those with higher household incomes ($A80,000 and over)

were 2.57 times (OR=2.57. 95% CI:1.48-4.44, p=0.001) more
willing than those with lower incomes.
value
Changed way of living due
to possibility of terrorism

27.4 1.00
25.8 0.92 0.57,1.48 0.74
31.8 1.24 0.76,2.01 0.39
22.1 0.75 0.43,1.33 0.33
28.0 1.03 0.66,1.61 0.89

26.2 1.00
25.9 0.98 0.61,1.58 0.95

27.9 1.00
26.6 0.93 0.62,1.40 0.73
30.5 1.13 0.75,1.70 0.56
23.7 0.80 0.55,1.17 0.25
P

Discussion
Almost one-third of the population perceive a high likelihood
Weighted OR 95% CI

of terrorist attack within Australia, with a greater proportion

(%)

expressing high levels of concern that they, or a family member,

could be directly affected should a terrorist attack occur. More
than one-quarter had made some level of accommodation in the
way they live due to this possibility. In the context of an immediate
threat, the majority of the population would be willing to follow
public safety directives to evacuate homes, workplaces and public
facilities should a terrorist attack occur.
54.2 1.59 1.12,2.24 0.01
44.2 1.06 0.74,1.51 0.74
43.5 1.03 0.75,1.42 0.85
value

47.6 1.00
49.7 1.09 0.73,1.61 0.68
41.7 0.79 0.52,1.20 0.27
44.2 0.87 0.54,1.42 0.59
35.2 0.60 0.41,0.87 0.01

43.4 1.00
50.6 1.34 0.89,2.01 0.19

42.8 1.00
Concerned self or family

To date, there have not been recent substantial acts of terrorism

within Australia. Our findings indicate a lower level of terrorism
directly affected

Weighted OR 95% CI

risk perception than that observed in countries such as the US and

(%)

UK where significant terrorist events have occurred.3,5 However,

the level of perceived risk within the Australian population is
notably higher than in comparable western countries that have
not experienced recent attacks. Although comparisons with other
studies are difficult to make, only 20% of Canadians perceived
a high likelihood of domestic terrorism compared with 30.3%
of Australians. Possible reasons for this may include Australia’s
value

34.5 1.00
39.5 1.24 0.84,1.84 0.28
33.7 0.96 0.63,1.48 0.87
30.9 0.85 0.51,1.41 0.53
29.1 0.78 0.53,1.14 0.20

33.4 1.00
35.1 1.08 0.71,1.65 0.73

34.7 1.00
32.9 0.92 0.63,1.35 0.68
Separated/divorced 43.2 1.43 0.99,2.06 0.06
21.6 0.52 0.36,0.74 <0.01
P

regional exposure to terrorism, such as the Bali bombings in

Terrorist attack likely

2002 and 2005. These and associated events such as the naming
Weighted OR 95% CI

of Australia as a specific target by terrorist organisations such as

(%)

Al-Qaeda are likely to have increased the awareness of Australians

variable

to such threats domestically.12

Concurrent high concern and changed way of living were noted
Department of Health, 2008.

among those born outside Australia and/or who spoke a language

other than English in the home. Given that these groups did not
perceive a higher likelihood that an attack would occur, these
results may reflect a perceived ‘secondary’ threat from within
Independent

Never married

the wider population. There is broad evidence that heightened

Widowed
$20-40k
$40-60k
$60-80k

Married

community threat perception is associated with increased

<$20k

>$80k

ethnocentrism and xenophobia.21 In terrorism affected countries,

Yes
No

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Stevens et al. Article

Table 3: Prevalence and Odds Ratios (95% confidence intervals) of willingness to evacuate home, willingness to
evacuate office/public facility and combined indicator.
Independent variable Willing to evacuate home Willing to evacuate Willing to evaluate home and
office/public facility office/public facility
Weighted OR 95% CI Pvalue Weighted OR 95% CI Pvalue Weighted OR 95% CI Pvalue
(%) (%) (%)
NSW population 67.4 - - - 85.2 - - - 65.8 - - -
Gender
Male 63.4 1.00 82.2 1.00 62.2 1.00
Female 71.5 1.45 1.11,1.89 0.01 88.3 1.62 1.14,2.32 0.01 69.3 1.37 1.06,1.79 0.02
Location
Urban 66.3 1.00 84.4 1.00 64.6 1.00
Rural 69.7 1.17 0.91,1.50 0.22 86.9 1.22 0.88,1.69 0.26 68.3 1.18 0.93,1.51 0.18
High psychological distress (≥22)
No 68.5 1.00 86.7 1.00 67.4 1.00
Yes 70.0 1.07 0.65,1.76 0.76 80.1 0.61 0.33,1.12 0.11 66.3 0.95 0.59,1.54 0.85
Age
16-24 66.1 1.00 80.0 1.00 63.0 1.00
25-34 69.2 1.15 0.65,2.06 0.63 88.4 1.91 0.89,4.07 0.10 67.6 1.27 0.72,2.24 0.40
35-44 68.9 1.14 0.65,1.99 0.66 89.1 2.05 0.89,4.70 0.09 67.4 1.26 0.73,2.18 0.40
45-54 73.2 1.40 0.84,2.33 0.20 86.6 1.62 0.85,3.08 0.14 72.4 1.52 0.92,2.50 0.10
55-64 65.8 0.99 0.60,1.63 0.96 87.1 1.68 0.88,3.20 0.12 65.0 1.10 0.67,1.80 0.70
65-74 61.6 0.82 0.50,1.34 0.43 81.0 1.06 0.59,1.92 0.85 59.5 0.86 0.53,1.38 0.53
75+ 54.1 0.60 0.36,1.03 0.06 73.7 0.70 0.38,1.30 0.26 52.0 0.62 0.37,1.04 0.07
Children in household
No 64.9 1.00 82.6 1.00 63.3 1.00
Yes 71.6 1.36 0.99,1.88 0.06 89.7 1.84 1.10,3.05 0.02 69.9 1.40 1.02,1.92 0.04
Born in Australia
No 70.0 1.00 82.3 1.00 67.8 1.00
Yes 66.5 0.85 0.62,1.18 0.33 86.2 1.34 0.89,2.01 0.16 65.1 0.90 0.66,1.23 0.51
Speak language other than English
No 67.0 1.00 86.4 1.00 65.5 1.00
Yes 69.4 1.12 0.73,1.71 0.61 78.9 0.59 0.36,0.96 0.03 67.1 1.07 0.71,1.60 0.75
Living alone
No 67.7 1.00 85.5 1.00 66.0 1.00
Yes 65.3 0.90 0.70,1.16 0.42 82.9 0.82 0.59,1.15 0.25 63.7 0.87 0.68,1.12 0.28
Highest formal qualification
University degree/ 70.7 1.00 88.9 1.00 70.0 1.00
equivalent
TAFE certificate/Diploma 67.7 0.87 0.59,1.29 0.49 87.0 0.83 0.45,1.53 0.56 66.7 0.85 0.58,1.26 0.42
High school certificate 63.5 0.72 0.46,1.12 0.15 83.2 0.61 0.32,1.17 0.14 63.0 0.68 0.44,1.05 0.08
School certificate 66.0 0.81 0.55,1.18 0.26 80.9 0.53 0.30,0.92 0.02 61.8 0.69 0.47,0.99 0.05
None 62.9 0.76 0.47,1.22 0.25 81.3 0.57 0.30,1.07 0.08 60.3 0.68 0.43,1.09 0.11
Work (paid or unpaid)
No 62.7 1.00 80.7 1.00 60.3 1.00
Yes 70.5 1.37 1.06,1.79 0.02 89.0 1.68 1.17,2.42 0.01 69.4 1.46 1.12,1.89 0.01
Household income (before tax)
<$20k 61.0 1.00 77.2 1.00 60.0 1.00
$20-40k 70.4 1.52 1.01,2.27 0.04 84.4 1.60 0.97,2.65 0.07 68.1 1.41 0.95,2.11 0.09
$40-60k 66.7 1.28 0.82,1.99 0.28 87.6 2.08 1.18,3.67 0.01 64.3 1.23 0.80,1.89 0.35
$60-80k 62.1 1.04 0.62,1.76 0.87 88.5 2.27 0.80,6.47 0.12 61.7 1.14 0.68,1.92 0.62
>$80k 70.7 1.54 1.03,2.29 0.03 89.7 2.57 1.48,4.44 <0.01 70.7 1.68 1.13,2.49 0.01
Health self-rated as good
Yes 69.6 1.00 85.6 1.00 68.1 1.00
No 59.1 0.63 0.42,0.96 0.03 79.7 0.66 0.39,1.12 0.12 57.5 0.65 0.43,0.98 0.04
Marital status
Married 68.3 1.00 86.2 1.00 66.5 1.00
Widowed 59.0 0.67 0.47,0.96 0.03 81.7 0.72 0.45,1.16 0.17 54.9 0.61 0.43,0.88 0.01
Separated/divorced 70.9 1.13 0.77,1.66 0.54 89.3 1.34 0.77,2.34 0.30 69.0 1.12 0.77,1.64 0.55
Never married 65.8 0.89 0.64,1.25 0.51 82.5 0.76 0.49,1.18 0.22 62.5 0.84 0.60,1.17 0.30
Notes: Psychological distress was measured using the K10. Values range from 10-50, with ‘high’ psychological distress considered as being ≥22. Source: New South
Wales Health Survey Program. Sydney: New South Wales Department of Health, 2008.

344 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2009 vol. 33 no. 4
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
Threats to health Public perceptions of threat of terrorist attack
culture, appearance and religion have been found to be strong
predictors of high terrorism-related distress and appear to reflect
increased stigmatising of these groups.5 Further studies are needed
to explore the possible reasons for this in the Australian context.
While the Australian government has produced recent population-
level information campaigns to address terrorism concerns, the
current results highlight potential vulnerabilities in these sub-
populations and a possible need for tailored risk communication
to address unease in these groups.
There is evidence that mental health factors such as stressful life
events and exposure to trauma are associated with increased fear
of terrorism. In this study, those with high levels of psychological
distress where almost twice as likely to perceive high terrorism
likelihood and greater concern that they or a family member
would directly affected. This is consistent with recent data from
the Australian Unity Wellbeing Index, which showed that those
with the highest ratings of perceived terrorism likelihood also had
significantly lower levels of personal wellbeing compared to the
population average.22 There is evidence from the therapeutic field
that those with greater risk appraisal and vigilance tendencies are
at greater risk of negative mood states.1,23 The findings occurred
in the absence of specific domestic terrorist incidents and suggest
increased vulnerability may exist even with the general threat of
terrorism. Recent practices in Australia such as the issuing of
national terror alerts may have adverse impacts on this sub-group
that may warrant further examination.22
The findings regarding willingness to evacuate were quite
emphatic and indicate high levels of intent where the specific
threat also appears to be high. The proportion of people with
low willingness to evacuate based on terrorism threat (12%) was
found to be about half the ‘non-compliance’ rate observed during
mandatory natural disaster evacuations.24 Little is known about the
observed lower willingness of those with poor self-rated health.
This may reflect lower confidence about receiving or recognising
warnings as well as perceptions about the physical attributes
needed for escape. This finding is consistent with protection
motivation theory which posits that low perceived self-efficacy
reduces the motivation for protective acts even when these actions
are regarded as effective. Proactive disaster planning and education
can potentially overcome these limitations, which highlights the
importance of identifying and engaging these vulnerable groups
early in the process.
Limitations
There are several limitations of our study. The question “Have
you changed the way you live your life because of the possibility of
a terrorist attack?” was intentionally broad, since current evidence
indicates that where specific incidents have not occurred, preparatory
changes for terrorism are limited and general in focus.9,10 We sought
to determine broader markers of change (experiential as well as
behavioural) that may be sensitive to public health messages or
varied threat status over time. The decision to adopt the full response
set (a little, moderately, very and extremely) as positive indicators
2009 vol. 33 no. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 345
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
for this question was made on related conceptual grounds: that
is, lower level change reflecting change of some kind. The more
conservative range (very, extremely), produced a response rate
of 4%, which is consistent with the rate of preparatory response
noted in the Lemyre et al. study.9 As anticipated, the broader range
produced a notably higher response rate (27%). This may indicate
that more specific behaviours are being endorsed at the upper end
of the range, with more subtle or even ‘felt’ changes being endorsed
by a larger group at the lower end of the range.
The aim of this paper is to explore population threat perceptions
of terrorist attack in Australia and some anticipated responses
in the acute context. The cross-sectional design of this study
captures only a snapshot view of these frequencies and no firm
conclusions can be made regarding causes. Also, OR’s reported in
this study may lead to bias due to a failure to account for multiple
relationships, which may lead to inflation of type 1 error and the
over interpretation of any apparent positive findings. As this is a
baseline analysis, further studies can examine trends over time
and the consistency of these findings.
It is also important to consider whether recent terrorism
information campaigns significantly affected this baseline data,
which was gathered in early 2007. The ‘Be alert, not alarmed’
campaign was conducted in late 2002 and again, in a modified
form, from July 2005.25 The National Security Hotline was also
launched as part of the initial campaign and has been advertised
periodically. Given that the 2005 campaign ran for a three week
period 18 months prior to the survey, it is unlikely that any
specific shifts in threat perception would have been maintained
so as to have significantly affected the current data. Nonetheless,
it remains possible that the cumulative effects of these public
awareness campaigns have contributed to longitudinal change e.g.
as one significant factor in the rate differences observed between
Australian and Canadian population surveys.
Finally, the questions regarding evacuation only provide a
measure of behavioural intent. While its specific translation to
evacuation compliance is unclear, evidence from experimental
psychology shows that concurrent high intent and high perceived
positive outcomes predict high levels of behavioural translation.26
The data establish high intent, while perceived positive outcomes
in this situation (presumably safety and survival) could reasonably
be assumed based upon these results.
Conclusion
Perceived terrorism likelihood and associated concerns were
moderately high, with some groups notably affected. Community
terrorism concerns may have increased ‘out group’ social dynamics
for some ethnic sub-populations and this has implications for the
framing of risk communications. In the context of immediate
threat, the majority of Australians would follow terrorism-related
evacuation directives and at higher rates than is typical of natural
disasters. The study has also established a source of pre-event
baseline data and is one of the few available sources of such
information internationally.
Stevens et al. Article
Acknowledgements
This study was funded by Emergency Management Australia
and supported by the New South Wales Department of Health. This
analysis is part of the first author’s thesis for a doctoral dissertation
with the College of Health and Science at the University of
Western Sydney. Our thanks to Matthew Gorringe, Centre for
Epidemiology and Research, New South Wales Department
of Health, who assisted with question development and data
collection.
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