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Preparing for Disaster: Response Matrices in the USA and UK

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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.

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  1. List appended

  2. In mathematical terms, a matrix is a rectangular array of quantities that interface via horizontal rows and vertical columns. For the purposes of our discussion, the term “disaster response matrix” is used to describe the multiple interfaces, horizontal and vertical, that must occur among the many agencies at the federal, state, and local levels in order for an effective disaster response to occur.

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Generous support for the Conference in the form of unrestricted educational grants was provided by the GE Healthcare, Pfizer Inc., The John S. and James L. Knight Foundation, The New York Community Trust, and The Royal Society of Medicine Foundation.

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Correspondence to Jeremiah A. Barondess MD.

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UK Sir Liam Donaldson, Chief Medical Officer for England, UK Department of Health; Penny Bevan, Director of Emergency Preparedness, UK Department of Health; Nigel Lightfoot, Director for Emergency Response, Health Protection Agency, UK Centre for Emergency Preparedness and Response; Bruce Mann, Director of Civil Contingencies Secretariat, UK Cabinet Office.

USA Georges Benjamin, Executive Director, American Public Health Association; Isaac B. Weisfuse, Deputy Commissioner, New York City Department of Health and Mental Hygiene, Hon. Glen Gilmore, Mayor, Hamilton Township, New Jersey, Fred Cerise, Secretary, Louisiana Department of Health and Hospitals; and James M. Hughes, Professor, Rollins School of Public Health, Emory University.


Robert Bazell, Chief Science and Health Correspondent, NBC News; Patricia Thomas, Knight Chair in Health and Medical Journalism, Grady College, The University of Georgia; and John Pope, Staff Writer, New Orleans Times Picayune.

Kahn is with the Program on Science and Global Security, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ, USA; Barondess is with the New York Academy of Medicine, New York, NY, USA.

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Kahn, L.H., Barondess, J.A. Preparing for Disaster: Response Matrices in the USA and UK. J Urban Health 85, 910–922 (2008).

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