Extraordinary attention, ordinary neglect: the high cost of disaster preparedness and response

Hahn, R. A.

Background: Funds allocated to disaster preparedness and response in the U.S. have grown rapidly in recent decades. This analysis examines the ratio of cost per outcome of public health events classified as disasters and those not classified as disasters, e.g., smoking-related morbidity and mortality. Methods: Mortality is taken as an outcome metric; the validity of this measure is assessed by examination of ratios of tangible and intangible costs of disaster and non-disaster outcomes to mortality from two conditions, using available data. The relative allocation of CDC funding to disaster and non-disaster events is assumed to conservatively represent the U.S. overall relative funding allocation. Results: Non-disaster deaths are 2,500 more likely than disaster deaths; we allocate 370 times more funding per disaster death than we do per non-disaster death. Conclusion: The rationality of this implicit decision be reconsidered