DISEASE AS DISASTER

Escalating health care costs, driven by the use of high technology to manage rather than cure chronic degenerative diseases in rapidly aging populations, are seriously straining Western economies. What are need ed are strategies which seek to mitigate those high order events that ultimately cause disease. Prevention involves deliberately changing no t only environments and lifestyles, but also the nature of health care and perhaps even human biology itself. It is argued that a similar sh ift has occurred in disaster planning, where emphasis has moved from r escuing survivors to achieving greater safety through better planning and more sophisticated infrastructural design. That is, disaster speci alists try to avoid rather than respond to catastrophes. A similar app roach is long overdue in health care.