Disasters: Introduction and State of the Art

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Abstract
Fifteen years have passed since the last update on this topic was published in Epidemiologic Reviews (1) and 24 years since the first (2). In the intervening years, disaster prevention, mitigation, and preparedness have evolved in important ways (3). Clearly, it was time to update the last review. Fifteen years ago, disaster management was simply left to a few dedicated professionals. Roles were clear: Rescue workers rushed to help victims, and certain agencies stepped in to provide temporary shelter and food. Usually within weeks after the disaster's impact, most people forgot about the disaster—until the next one came to wreak new destruction. Unfortunately, disasters throughout the world, such as the series of four destructive hurricanes that struck the southeast coast of the United States from August to September of 2004 (4) and the tsunami disaster in December 2004, have provided ample opportunities to test the policies and recommendations set out in the late 1980s. At least 80 percent of the population growth in the 1990s has occurred in towns and cities. According to the United Nations, in the year 2005, one half of the world's population will live in urban areas, crowded onto just 3 percent of the earth's land. This is an alarming increase in population density. Problems inherent in such rapid growth are especially unwieldy in developing countries; 17 of the 20 largest cities are now in developing countries compared with seven of 20 in 1950. By 2025, 80 percent of the world's population will reside in developing countries. One of every two large cities in the developing world is vulnerable to natural disasters such as floods, severe storms, and earthquakes (3).
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