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Frail elderly people are particularly vulnerable during hurricanes. Of the 1,330 people known to have perished along the Gulf Coast as a result of Hurricane Katrina, 71% of those in Louisiana were older than 60 years, 47% were older than 75 years, and at least 68 died in nursing homes. Unfortunately, community disaster planning frequently fails to allow for the needs of the frail elderly before, during, and after hurricanes. This paper discusses the particular vulnerabilities of the frail elderly, especially those with chronic diseases, those in residential care facilities, and those who are dialysis‐dependent. The importance of the Incident Management System (IMS) is discussed, and those who care for the frail elderly in long‐term care facilities must understand and use IMS in dealing with hurricane‐related disasters. Recommendations are made that will improve hurricane disaster planning for the frail elderly. From a policy viewpoint, it is critical that the elderly, especially those with chronic diseases, be included in disaster planning at the federal, state, and local levels to ensure that a repeat of the Hurricane Katrina debacle does not occur.

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In 2010, the earthquake and the subsequent development of a cholera epidemic in Haiti, along with the massive flooding in Pakistan, demonstrated, once again, that international disaster relief operations, though vigorous, lacked effective integration and coordination. Needless duplication of resources and response characterizes international relief efforts. This paper examines evidence of developing international cooperative efforts for more effective disaster preparedness and calls for specific actions needed to move toward international standards of disaster preparedness and response.

Disasters are becoming more frequent worldwide and water figures prominently in many of them. Disasters can result from a severe shortage of water (drought, famine) or too much of it (floods, tsunamis). The recent earthquake and tsunami in Japan offers an excellent example of the critical role water can play, given that the Fukushima Daiichi nuclear power plant weathered the 9.0 moment magnitude earthquake well but suffered catastrophic failure from the resulting tsunami. After disasters, water contamination can compound an already miserable situation. This article will discuss the most current literature on the public health implications of water in disasters and offer recommendations for public policy changes to improve water security. Key policy implications include: reestablishment of water and sanitation are top priorities in the immediate post‐disaster period; shelters must not be overcrowded and should have adequate latrines; public health education about personal hygiene is critically important along with liquid soap and safe water to clean hands; supplies of water chlorination products and covered water storage receptacles need to be adequately stockpiled before a disaster.