Cities under siege: Urban planning and the threat of infectious disease

Many analysts argue that the potential for a natural, accidental, or nefarious infectious disease event to have a dramatic impact on urban areas in the United States and abroad is growing. After reviewing the justification for this position, this article considers what cities should do to prepare for a major disease event. Recognizing that prevention and preparation receive insufficient attention, we recommend that planners seek out and work with both public and private sector groups with roles in disaster planning; design land and transportation planning information systems to aid and support decision makers during crises; encourage greater self-sufficiency in food production and consumption; assist in the design of humane, realistic evacuation strategies and routes; and consider the effects of their day-to-day recommendations on disease risk and response.