Journal of Urban Health

, Volume 85, Issue 6, pp 910–922 | Cite as

Preparing for Disaster: Response Matrices in the USA and UK



Disasters, whether man-made or naturally occurring, require complex responses across multiple government agencies and private sector elements, including the media. These factors mandate that, for effective disaster management and because of the unpredictability of such events, response structures must be in place in advance, ready to be activated on short notice, with lines of responsibility clearly delineated and mechanisms for coordination of efforts already established. Disaster response experiences in the USA and the UK were reviewed at a conference convened by the New York Academy of Medicine and the Royal Society of Medicine in June 2007. Lessons to be drawn from these comparisons were sought. The importance of careful advance planning, clear delineation of spheres of responsibility and response roles, effective mechanisms for communication at all levels, and provision for adequate communication with the public were all identified as key elements of effective response mechanisms.


US and UK disaster response matrices Competent leadership, accountability and responsibility during disasters Advance planning and preparation for disasters Integrated hospital and ambulance services during disasters Effective communication within the disaster response matrix and externally, with the public Effective linkages with the media established as part of the disaster matrix 


  1. 1.
    U.K. Resilience. Civil Contingencies Act. Accessed May 7, 2008.
  2. 2.
    London Emergency Services Liaison Panel. Major Incident Procedure Manual. 7th ed. 2007. Accessed May 7, 2008.
  3. 3.
    London Resilience Team Government Office for London. Looking Back, Moving Forward. The Multi-Agency Debrief. Lessons identified and progress since the terrorist events of 7 July 2005. Accessed on: September 2006.
  4. 4.
    U.K. Cabinet Office. Ministerial Committee on Civil Contingencies. Accessed June 10, 2008.
  5. 5.
    U.K. Health Protection Agency. “Who we are.” Accessed June 11, 2008.
  6. 6.
    U.K. Health Protection Agency. “Local and Regional Services.” Accessed June 11, 2008.
  7. 7.
  8. 8.
    Federal Emergency Management Agency (FEMA) 42 U.S.C. 5121 et seq. and Accessed June 18, 2008.
  9. 9.
    Moss ML and Shelhamer C. The Stafford Act: priorities for reform. The center for catastrophe preparedness and response. New York University. Accessed April 3, 2008.
  10. 10.
    U.S. Department of Homeland Security. History: who became part of the department? Accessed April 3, 2008.
  11. 11.
    U.S. Department of Homeland Security. Homeland Security Act of 2002. Accessed April 3, 2008.
  12. 12.
    The White House. Homeland Security Presidential Directive/HSPD-5. Management of Domestic Incidents.
  13. 13.
    Kahn LH. A prescription for change: the need for qualified physician leadership in public health. Health Aff. 2003;22:241–8 Scholar
  14. 14.
    Institute of Medicine. The future of the public’s health in the 21st century. Washington: The National Academies; 2003:108–111.Google Scholar
  15. 15.
    Office of the U.S. Surgeon General. About the Medical Reserve Corps. Accessed April 7, 2008.
  16. 16.
    Day M. Former spy’s death causes public health alert. BMJ. 2006;333:1137.PubMedCrossRefGoogle Scholar
  17. 17.
    Winerip M. “Our Towns’; hail the Mayor (whose name isn’t Giuliani).” New York Times. November 14, 2001.Google Scholar
  18. 18.
    Greene CM, Reefhuis J, Tan C, et al. Epidemiologic investigations of bioterrorism-related anthrax, New Jersey, 2001. Emerg Infect Dis. 2002;8:1048–55.PubMedGoogle Scholar
  19. 19.
    U.S. House of Representatives. “A Failure of Initiative Final Report of the Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina.” Accessed April 7, 2008.
  20. 20.
    Robinson SJ, Newsletter WC. Uncertain science and certain deadlines: CDC responses to the media during the anthrax attacks of 2001. J Health Comm. 2003;8:17–34.Google Scholar
  21. 21.
    Blendon RJ. Harvard School of Public Health Press Release. Survey shows Americans not panicking over anthrax, but starting to take steps to protect themselves against possible bioterrorist attacks. Accessed on: Nov. 8, 2001.
  22. 22.
    Thomas P. “The Anthrax Attacks.” The Century Foundation. 2003. Accessed February 8, 2008.
  23. 23.
    Hsu SS, Glasser SB. “FEMA Director Singled Out by Response Critics,” Washington Post. Page A01.Google Scholar
  24. 24.
    Thevenot B. “Myth-Making in New Orleans. American Journalism Review. December/January 2006.Google Scholar
  25. 25.
    Online NewsHour. “Katrina Media Coverage.” Accessed on: September 29, 2005.
  26. 26.
    Wu E. Study details rising tide of ethnic media. Dallas Morning News. Accessed on: June 15, 2005.
  27. 27.
    Rubin GJ, Page L, Morgan O, et al. Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis. BMJ. 2007;335:1143.PubMedCrossRefGoogle Scholar
  28. 28.
    Aberbach JD, Putnam RD, Rockman BA. Bureaucrats and politicians in Western Democracies. Cambridge: Harvard University Press; 1981:1–23.Google Scholar
  29. 29.
    Pear R. “Embattled Disease Agency Chief is Quitting.” New York Times. February 22, 2002.Google Scholar
  30. 30.
    United States Government Accountability Office. Influenza Pandemic. Federal Executive Boards’ Ability to Contribute to Pandemic Preparedness. Accessed on: September 28, 2007.
  31. 31.
    FEMA. Draft Revised NIMS-August 2007. Pages 3–5. Accessed March 25, 2008.
  32. 32.
    FEMA. Draft Revised NIMS-August 2007. Pages 29. Accessed March 25, 2008.

Copyright information

© The New York Academy of Medicine 2008

Authors and Affiliations

  1. 1.Program on Science and Global Security, Woodrow Wilson School of Public and International AffairsPrinceton UniversityPrincetonUSA
  2. 2.New York Academy of MedicineNew YorkUSA

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