1. Disaster Risk Reduction: The global paradigm shift
Mark Keim, MD
Associate Director for Science
National Center for Environmental Health
Agency for Toxic Substances and Disease Registry

2. An Evolution in Approaches
Response
Preparedness
Risk Management

3. What is Disaster Risk Management?
Definition
“The systematic process of using administrative directives, organizations, and operational skills and capacities to implement strategies, policies and improved coping capacities in order to lessen the adverse impacts of hazards and the possibility of disaster”.
Components
Risk assessment
Risk avoidance
Risk reduction
Risk transfer
Risk retention
UNISDR 2009,

4. Disaster risk management and the emergency management cycle
4/20/2017
Disaster risk management and the emergency management cycle
Risk reduction measures are
Delivered pre-impact
Most cost-effective
Community based
Sustainable
Pre- impact
Post - impact
Risk retention measures are
Delivered post-impact
Least cost-effective
Nationally and internationally based
Non-sustainable
From: Keim M. Building human resilience. Am J Prev Med 2008;35(5):

5. Prevention and disaster risk management
From: Keim M. Disaster Risk Management for Health. In Ed., David S. Textbook of Emergency Medicine. Lippincott) New Dehli 2012

6. How Do We Estimate Disaster Risk?
D = H x V, where V = E x S R
D = Risk of disaster
H = Hazard
V = Vulnerability of population
E = Exposure to the hazard
S = Susceptibility to the hazard
R = Resilience

7. What is a hazard? Definition of a hazard
“A dangerous phenomenon, substance, human activity or condition that may cause loss of life, injury or other health impacts, property damage, loss of livelihoods and services, social and economic disruption, or environmental damage”
UNISDR 2009,

8. Examples of hazards Earthquakes Floods Radiation Typhoons Outbreaks
Tornadoes

9. What is vulnerability?
“The characteristics and circumstances of a community, system or asset that make it susceptible to the damaging effect of a hazard” UNISDR 2009
Or simply put…
Likely to incur physical or emotional illness or injury
UNISDR 2009,

10. Public health vulnerability
Certain populations are more vulnerable to disaster-related morbidity and mortality

11. Vulnerability = (E x S) / R
Factors affecting vulnerability:
Exposure
Susceptibility
Resilience

12. What is exposure? Exposure Example of exposure
“People, property, systems, or other elements present in hazard zones that are thereby subject to potential losses”
Example of exposure
Living in an area that floods
UNISDR 2009,

13. What is susceptibility?
“The state of being at risk, if exposed to a hazard”
Example of susceptibility
Not being able to swim
UNISDR 2009,

14. What is resilience? Resilience Example of resilience
“The ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions”.
Example of resilience
Living among people that can help you
UNISDR 2009,

15. Mapping human vulnerability

16. How can we reduce our vulnerability to disasters?
Disaster reduction occurs at the community level †
Community health sectors can play an active role in reducing human vulnerability
Reducing susceptibility
“Health people” ††
Reducing exposure
“Healthy homes” ††
Increasing resilience
“Healthy communities” ††
† Schipper L, Pelling M 2006, Disaster risk, climate change and international development. Disasters, vol. 30, no. 1, pp
†† Srinivasan S, Creating healthy communities, healthy homes and healthy people. Am J Public Health 2003;93:

17. Vulnerability reduction: reducing exposures
Floodplain management
Dams, levees, weirs
Population protection measures
Evacuation
Mass care
Land use planning and regulation
PPE, sanitation/hygiene

18. Vulnerability reduction: reducing susceptibility
Health promotion
Health care
Poverty reduction
Healthy lifestyles
Immunization

19. Human resilience as a means for vulnerability reduction
The ability to cope with and recover from disasters
Resilience is comprised of:
Adaptive capability
Response capacity
Recovery capacity
Human behaviors that increase disaster resilience
Preparedness
Response
Recovery

20. Our milestones for international DRR
August 2011
NCEH inducted as a member of the Asia-Pacific Disaster Risk and Resilience consortium
November 2012
TA to WHO/HQ for development of a Global DRR Framework for Health
Feb 2013
Hosting regional workshop for proposal-writing, “Reducing Disaster Risk for a Healthy Pacific”

21. To learn more about international DRR:

22. Thank You mjk9@cdc.gov National Center for Environmental Health
Agency for Toxic Substances and Disease Registry