World Trade Center Non-Traditional Responders' Employment and Mental Health: Project Summary World Trade Center (WTC) responders observed traumatic destruction and loss of life during months of rescue and recovery work. In this study, we will focus on WTC non-traditional responders (NTR), such as construction, electrical, and transportation workers, who have experienced persistently high rates of mental health diagnoses in the two decades since 9/11. Gainful employment and the quality of one's working conditions are important social determinants of health and well-being that can impact mental health, health behaviors, and lifestyle medicine factors. Workplaces offer ideal settings for interventions that target mental health, well-being, and health behaviors by improving the conditions of work, and ensuring that workplace policies, programs, and practices promote health. However, little research has focused on the important role that work has in supporting (or hindering) WTC NTR mental health, health behaviors, and lifestyle medicine factors. This proposed study will take advantage of rigorous longitudinal data collected from the WTC General Responder Cohort. These data will also provide a foundation for collecting new data and pursuing new areas of inquiry. The objective of this study is to identify how different employment profiles, working conditions, and union and employer policies, programs, and practices have affected WTC NTR mental health, worker well-being, and health and lifestyle behaviors in the 20 years since 9/11. We will use data from the General Responder Cohort and link these data to new survey data collected from WTC NTR who are currently working. Specifically, we aim to: 1) Determine the relationships between employment profiles of WTC NTR and their mental health, health behaviors, and lifestyle medicine factors; and 2) Among currently employed WTC NTR, identify working conditions, policies, and practices that are supportive of (or harmful to) mental health, work-related well-being, healthy behaviors, and other lifestyle factors. We will consider four of the six pillars of lifestyle medicine: avoidance of substance misuse, sleep hygiene, social connectedness, and stress management and positive psychology. Specifically, we will focus on how NTR employment profiles and working conditions, as well as current organizational (employer and union) policies, programs, and practices, have cascading effects on these pillars of lifestyle medicine. At the completion of this study, we expect to determine the extent to which employment and supportive working conditions promote responders' mental health and health behaviors. The new knowledge we generate on the relationships between WTC NTR mental health and employment can be used as the foundation for future epidemiologic and intervention research. Our study results may also inform recommendations for workplace policies, programs, and practices to improve the health and well-being of WTC NTR. ...