title: Social risk management--reducing disparities in risk, vulnerability and poverty equitably.
abstract: Hurricane Katrina, which struck the Gulf Coast on August 29, 2005 and took 1,000 lives or more, was the third deadliest storm to hit the United States, falling behind only the Galveston Hurricane of 1900 and the 1928 Okeechobee Hurricane. It is New Orleans' worst natural disaster in its nearly 300-year history. The storm left hundreds of thousands without access to shelter, food, water, clothing and basic sanitation. The human suffering and health consequences are immeasurable. Dissatisfaction with the federal, national and local governments' planning and response is widespread. Many believe that the system discriminated cruelly by race and class against those in greatest need. The storm revealed serious flaws in disaster relief and preparedness structures, which require major reform. As an alternative, this article proposes a social risk management system to provide both universal risk protection and an efficient, more equitable approach to managing and reducing disparities in vulnerability. While one must realize that incremental rather than comprehensive reform of the system is most likely and most politically feasible, Katrina's horrific consequences and revealed inequities necessitate an alternative model.
authors.affiliation: Yale University School of Medicine and Graduate School of Arts and Sciences, Department of Epidemiology and Public Health, New Haven, CT, USA.
authors.forename: Jennifer Prah
authors.initials: JP
authors.lastname: Ruger
mesh_terms: D004190:Disasters; D006801:Humans; D012308:Risk Management; D012946:Social Welfare