"This important book by one of our leading experts on disaster preparedness offers a compelling narrative about our nation's inability to properly plan for large-scale disasters and proposes changes that can still be made to assure the safety of its citizens. Five years after 9/11 and one year after Hurricane Katrina, it is painfully clear that the government's emergency response capacity is plagued by incompetence and a paralyzing bureaucracy. Irwin Redlener, who founded and directs the National Center for Disaster Preparedness, brings his years of experience with disasters and health care crises, national and international, to an incisive analysis of why our health care system, our infrastructure, and our overall approach to disaster readiness have left the nation vulnerable, virtually unable to respond effectively to catastrophic events. He has had frank, and sometimes shocking, conversations about the failure of systems during and after disasters with a broad spectrum of people--from hospital workers and FEMA officials to Washington policy makers and military leaders. And he also analyzes the role of nongovernmental organizations, such as the American Red Cross in the aftermath of Katrina. Redlener points out how a government with a track record of over-the-top cronyism and a stunning disregard for accountability has spent billions on "random acts of preparedness," with very little to show for it --other than an ever-growing bureaucracy. As a doctor, Redlener is especially concerned about America's increasingly dysfunctional and expensive health care system, incapable of handling a large-scale public health emergency, such as pandemic flu or widespread bioterrorism. And he also looks at the serious problem of a disengaged, uninformed citizenry--one of the most important obstacles to assuring optimal readiness for any major crisis. Redlener describes five natural and man-made disaster scenarios as a way to imagine what we might face, what our current systems would and would not prepare us for, and what would constitute optimal planning--for government and the public--in each situation. To see what could be learned from others, he points up some of the more effective ways countries in Europe, Asia, and the Middle East have dealt with various disasters. And he concludes with a real prescription: a nine-point proposal for how America can be better prepared as well as an addendum of what citizens themselves can do. An essential book for our time, Americans at Risk is a devastating and realistic account of where we stand today."--Publisher's website.

Foreword -- Introduction -- I. After the storm -- Help on hold, lives at stake -- II. How is America still vulnerable? -- The American health-care system: unready for prime time in an age of megadisasters -- Scenario: pandemic avian flu hits New York City -- Natural megadisasters: not just business as usual -- Scenario: earthquake in Seattle and Puget Sound -- Terrorism: still vulnerable five years later -- Scenario: going nuclear: the ultimate terror nightmare -- The built environment: a crumbling infrastructure and high-consequence industrial accidents waiting to happen -- Scenario: a chemical release in a tornado-risk zone -- Special populations, special needs, and soft targets: why I'm worried about the vulnerability of American's children -- Scenario: American children as targets of terror -- III. Why we're not prepared: four barriers to optimal readiness -- Barrier 1: Goals and accountability -- or random acts of preparedness? -- Barrier 2: Failures of imagination: it's always in the details -- Barrier 3: Missing and misplaced leadership: who's in charge? -- Barrier 4: The strange psychology of preparedness and why the public isn't buying -- IV. Making America safer: what we need to do now -- Introducing change -- International models: Who does it right? And who doesn't? -- Rational preparedness for an uncertain future: a nine-point plan -- Final thoughts: Coping and resiliency in a dangerous world -- Beyond batteries and go packs: Redlener's eight principles of disaster preparedness and survival.