United States

Stay safe & healthy

Stay safe / healthy


Stay safe

Crime

Headline-grabbing major crimes and slightly unfavorable statistics give the United States a reputation for crime. However, few visitors experience any problems; common-sense precautions and staying alert are sufficient to avoid trouble. Crime is usually connected with gangs and drugs in the inner cities, and with heated disputes. Avoid those and you'll be fine. Urban tourist areas are heavily policed and are safe from all but petty crimes.

Rural crime in America tends to be very rare and very local, occurring primarily in very poor, troubled communities which are very easy to avoid.

Urban areas tend to have homeless people who may aggressively ask for money. If you feel harassed, say "No" firmly and walk away.

Illegal immigration and drug smuggling, and the authorities' heavy-handed treatment of them, make the Mexican border undesirable to visit. Official border crossings are safe to use.

Police

American police are generally polite, professional, and honest. When in uniform, they are also more formal, cautious, and cold than police in, say, Latin America—especially in large cities. If stopped by traffic police, you should stay calm, be polite and cooperative, avoid making sudden movements, and state what you are doing if you need to reach for your purse or wallet to present your identification. It is particularly important for you to appear calm and cooperative if you are a non-white person, as people of color are much more likely to be subjected to police harassment and violence in the United States than white people. Turn on the inside car lights and keep your hands on the wheel to make it clear that you are not a threat; do not exit the vehicle unless told to do so. Generally the driver of the car should speak to the officer when they approach.

Do not offer bribes to a police officer in any way or under any circumstances. U.S. police culture categorically rejects bribes, and the mere suggestion would very likely result in your immediate arrest. If you need to pay a fine, don't try to pay the officer; he or she can direct you to the appropriate police station, courthouse, or government office. Most minor traffic infractions can be paid by mail. Increasingly fines can be paid online or over the phone within a matter of minutes of receiving the ticket, though often for a convenience fee of a few dollars. Instructions are often printed on the ticket.

There are three types of police you are most likely to encounter: state police/highway patrol units on state highways, deputy sheriffs employed by county governments in rural areas, and police officers employed by city or town governments in urban areas. There are also smaller police departments, like transit or airport police, which patrol public transportation and university or "campus" police, which patrol universities. Federal law enforcement officers are generally found only in or near federal facilities, such as ports of entry, national parks, and government offices. If you encounter them elsewhere, it is usually because they are investigating specific allegations of federal crimes.

Emergency services

Dialing 9-1-1 at any telephone will reach the emergency services (police, fire, ambulance, etc.). Any U.S. phone, regardless if it is "active" or not, must be able to dial 911 if it is connected to the network, and such calls are always free. Unless you are calling from a mobile or Internet-based phone, the operator should be able to locate you from the phone you are using even if you do not say anything. Modern cell phones will send a GPS fix of your location down to a few meters within a few seconds of dialing 911. Dialing 911 and leaving an open line will bring all 3 emergency services to your location in under 5 minutes in most populated areas. Response time may be longer in sparsely populated areas or along the Interstates.

On any GSM mobile phone (the standard technology in most of the world, especially in Europe), you can also dial 112, which is the standard emergency number for GSM networks worldwide. U.S. GSM carriers (AT&T, T-Mobile, and smaller regional operators) automatically redirect 112 calls to 911.

As in most countries, misuse of the emergency services number will result in, at the least, a call back from authorities; at most, arrest. If you reach 9-1-1 accidentally (for instance, if a misdial of the 011- international prefix gets a "9-1-1, what's your emergency?" response) stay on the line for long enough to explain to the dispatcher that you have reached a wrong number. Even then, an officer may still show up.

Border Patrol

The United States Border Patrol works near both the Canadian and the Mexican borders, as well as in Southern coastal areas like the Florida Keys. They can verify immigration status and enforce immigration laws in the "border zones"—generally within 40 miles of Canada and 75 miles of Mexico (although the law allows for 100 miles from any border, including sea and the Great Lakes). Near Canada they tend to be unobtrusive and generally focus their work on long-distance buses and trains. In the South, systematic vehicle checkpoints or being stopped on the street with a friendly "Papers, please..." is much more likely. They tend not to target tourists specifically.

Foreigners are always required to carry their passports, visas, and landing cards (or Green Cards). Being found without them near the border could lead you to being detained until your status is verified, or possibly fined. If your documents are in order, you generally won't be questioned. In most states (Arizona is a notable exception), police and other local authorities are not allowed to question you about your immigration status or to ask to see your passport or visa unless you're arrested and charged with a crime, and then only for the purpose of connecting you with your embassy. As a result of the 9/11 attacks, some statistics have shown that Muslims or those who are assumed to be Muslims may be disproportionately targeted for additional screenings at airports despite claims that passengers are chosen at random. A minority of law enforcement agency officials may express a disposition towards racism or ethnocentricism.

Natural disasters

The U.S. is a huge country with very varied geography, and parts of it are occasionally affected by natural disasters: hurricanes and tropical storms from June through November in the South(including Florida), blizzards (a specific and common type are "Nor'easters") in New Englandand the areas near the Great Lakes and the Rocky Mountains, tornadoes mostly in the Great Plainsand Midwest, earthquakes in California and Alaska, floods in areas of the Midwest and wildfires in the late summer and early fall in Texas and on the West Coast, particularly California. See the regions in question for more details.

Because tornadoes are so common between the Rocky Mountains and the Appalachian Mountains, this area has earned itself the colloquial name Tornado Alley. The San Andreas Fault is a tectonic plate boundary running through California, an area prone to earthquakes. Hawaii contains several active volcanoes, but they are not usually a threat to life and limb. The last high profile eruption in the mainland US was that of Mount Saint Helens in 1980.

In the case of a natural disaster, local, state or federal authorities can issue a warning over the Emergency Alert System. It has a very distinctive electronic screeching followed by a sound similar to a dial tone prior to any message. It will override AM/FM radio broadcasts as well as TV systems. Smartphones sold since about 2011 will often receive an alert message based on the current location of the phone (depending on the phone's settings, this may include a loud alert tone). Coast Guard weather is broadcast continuously on VHF marine radio for seafarers; a separate system (seven frequencies around 161 MHz) provides conditions ashore. Special "weather radios" are able to monitor the frequency, even in standby mode, and sound the alarm if deadly storms (such as tornadoes or hurricanes) are brewing. In most tornado-prone regions, a system of sirens will sound when a tornado warning is issued. If you hear the siren, seek shelter immediately. 

Gay and lesbian

In general, the U.S. is a safe destination for gay and lesbian travelers, though as a whole, homosexuality is not quite as well accepted as in Australia, New Zealand, Canada or Western Europe. Most Americans take a live-and-let-live approach to sexuality, but there are significant exceptions. It's generally not a problem to be open about your sexual orientation, though you may receive unwanted attention or remarks in some situations. Attitudes toward homosexuality vary widely even in regions with a reputation for tolerance or intolerance. Acceptance is most common in major cities throughout the country and smaller cities, suburbs and college towns especially around the Pacific Coast, the Northeast and Hawaii, with acceptance in these areas generally being on par with Western Europe. Homophobia and anti-gay violence may be encountered anywhere, especially in some suburban and rural areas of the Southeast and interior West, but the chances of this happening to you are low.

Gay-friendly destinations, where openly gay couples are common, include New York's Chelsea, Rochester in Western New York State, Chicago's Boystown, Seattle's Capitol Hill, San Francisco's Castro Street, Washington's Dupont Circle, Miami Beach's South Beach, Atlanta's Midtown and Los Angeles' West Hollywood. Even outside of gay neighborhoods, many major cities are gay-friendly, especially in the Northeast and the West Coast. An increasing number of resort areas are known as gay-friendly, including Fire Island, Key West, Asheville, Provincetown, Ogunquit, Rehoboth Beach, Saugatuck, and parts of Asbury Park. In other smaller cities, there are neighborhoods where gay people tend to congregate, and many have resource centers for LGBT people.

Legally speaking, homosexual relationships are treated the same as heterosexual relationships. If you're married to someone of the same sex, you may yet encounter some difficulties in more conservative areas of the country, but recent Supreme Court rulings have made it clear that no state or federal authority is allowed to treat your marriage differently from any other. Some states do still allow individual businesses to refuse service to gays and lesbians; sexual orientation is not yet a protected category nationwide, the way race and gender are. Some businesses specifically advertise that they are LGBT-friendly by displaying symbols (typically a rainbow flag) on their storefront. A few large cities have alternative monthly or weekly publications which provide news and lists of venues or events specifically for the LGBT communities.

Men planning to engage in any sexual activity should be aware of the heightened risk of HIV and other infections in the United States. A gay American man is 44 times more likely to contract HIV than a heterosexual one, and 46 times more likely to contract syphilis. This risk grows greatly among men likely to engage in one-night stands and other higher-risk behavior. In a nation where 0.5% of the population are infected with HIV, unprotected sex is a very real risk. Precautions, including safer sex, are strongly advised during your stay. Most cities have affordable or free testing and treatment centers for STIs, though hours may be limited and waits may be long. Planned Parenthood clinics are often an affordable alternative. The lifelong repercussions of HIV or other STIs aren't covered by many insurance policies. Seeking health care elsewhere can be very pricey, as the U.S. medical system is private and largely operates on a for-profit basis.

Drugs

In general U.S. drug laws can be pretty severe: even possession or transportation of small amounts can lead to prison or deportation and should be avoided by travelers. However, laws and attitudes concerning the most commonly available drug, marijuana, vary wildly from state to state. States like Louisiana and Florida impose large fines and lengthy prison sentences, while in other states marijuana use has been largely decriminalized. 18 states currently allow medical use of marijuana, where persons can obtain marijuana for medicinal use with a doctor's prescription and a "medical marijuana card". In some states, particularly cities on the West Coast, medical marijuana dispensaries are so commonplace that they seem almost ordinary. Colorado, Washington state, Oregon and Alaska allow limited recreational use of marijuana, as does the District of Columbia, although the status of legalization there is currently in doubt due to the District's unique Federal status. Under no circumstances should you transport marijuana or other drugs that are illegal under federal law across state lines, onto (some) Indian reservations, onto federal lands (such as federal office buildings, military bases, post offices etc) or internationally as doing so is drug trafficking and could subject you to a lengthy prison term. Even if transporting on a direct flight or through the mail between places where marijuana is legal or tolerated such as between the U.S. and the Netherlands or between Washington state and Colorado, it is still illegal under U.S. federal law. In some countries trace amounts such as marijuana residue, poppy seeds, or legitimate drugs containing certain substances such as codeine that were purchased in the U.S. are subject to penalty under that country's drug laws. Even drugs such as marijuana that were consumed in the U.S prior to departure can be subject penalty if detected in your system on arrival to another country even if no drugs or paraphernalia for their use were found on your person or in your luggage.

Prostitution

Prostitution is illegal except at licensed brothels in rural Nevada. Tolerance varies considerably between states. Police officers occasionally pose as prostitutes to catch and arrest anyone offering to pay for sex.

Guns

It's true: the U.S. has a strong gun culture, and many (but by no means all) Americans own a firearm. Possession of firearms is regulated by individual states, and while these regulations (obtaining necessary permits, the kinds of arms permitted) vary greatly from state to state and, sometimes, from city to city within the same state, the U.S. is generally considered to be a place with lenient attitudes towards firearm ownership, especially compared to Europe and Asia.

Although U.S. citizens have a constitutionally guaranteed right to own and carry firearms, non-immigrant aliens present in America for fewer than 180 days cannot legally possess a firearm or ammunition, unless they traveled specifically for hunting or sporting shooting, orthey have a valid hunting license from the state they are shooting in. Entry in a recognized shooting competition also qualifies. Anything else is strictly illegal.

WARNING: People who have renounced U.S. citizenship are not allowed to possess firearms or ammunition, even for sporting purposes.

Your chances of getting shot are very low, but bear in mind that:

  • In a city, a civilian with an openly visible firearm is generally a rare sight, and thus potentially more of a concern than one in the country. Nonetheless, since many states do permit "open carry", you may encounter somebody with a holstered firearm. Many states also have "concealed carry" laws which permit the possession of a concealed firearm in clothing or in a vehicle. Keep in mind that people with permits to carry a firearm, openly or concealed, are usually not criminals and not going to harm you.
  • Hunting is popular in rural America. Use of marked trails should not be a risk, but if venturing off the beaten path try to inquire if and where any hunting may currently be afoot. If there is, wear bright colors (particularly "Blaze Orange") to be highly visible to the hunters. This includes putting a bright vest on any dogs you take too. If you wish to hunt, obtain the correct permits and review the local regulations.
  • Target shooting is a popular sport. Many ranges welcome tourists and will have a variety of firearms available to rent and shoot at the range. Many implement a "two person minimum" rule and consider it unsafe to rent firearms to lone individuals.
  • The legal carry of firearms for protection by individuals hiking/exploring/camping in the wilderness is on the rise due to a small number of highly publicized incidents along well-known hiking trails. This is a controversial issue in the hiking/camping community, with strong arguments on both sides. Generally speaking, the legal possession of a firearm does not increase the level of danger for bystanders. Those who carry may very well have military or police backgrounds and be more than willing to assist others in an emergency.

Racism

Compared to many European and Asian countries, the U.S. is, at least publicly, a racially tolerant country. The U.S. Constitution, coupled with both state and federal legislation and case law, prohibits racial discrimination in a range of public spheres such as employment, university admissions and receiving services from retail businesses. That said, the Constitution also guarantees freedom of speech, and so it's still possible to hear racist remarks even in very public fora.

Still, most Americans are, or at least profess to be, tolerant of other races, and it is rare to face open aggression from random people solely as a result of one's race. The country goes through occasional periods of increased animosity toward racial minorities or immigrants (including at the present time, in 2016), but the overall trend has been one of increased tolerance and acceptance.


Stay healthy

Disease

Being a highly industrialized nation, the United States is largely free from most serious communicable diseases found in many developing nations; however, the HIV rate is higher than in Canada and Western Europe, with about a 0.5% infection rate in the overall population.

Two infectious diseases that are worth becoming educated about are rabies and Lyme disease. Human cases of rabies are quite rare in the United States, though the disease is more prevalent in eastern regions of the country. Rabies may be contracted from animal bites; if you are bitten by any mammal see a doctor as soon as possible – if you wait until you get symptoms of rabies, you are almost guaranteed to die (in all of medical history there are only a handful of documented cases of patients with rabies surviving it after symptoms had already developed, but if you get the vaccine before symptoms occur, you have a very high chance of surviving without any harm). Bats and other small, wild animals are especially prone to carry the rabies virus. If you get bitten, especially if you can't identify the animal and even if it is "just a scratch", go to a doctor as soon as possible.

Lyme disease is spread via the deer tick, which is prevalent in the woodlands and open fields of many rural areas. There have been cases of Lyme disease in every state, but the great majority have been reported in the Northeast, Mid-Atlantic states and Great Lakes states such as Wisconsin, Minnesota and Illinois. When venturing into the outdoors, it is a good idea to apply an insect repellent onto exposed skin surfaces that is effective against deer ticks. Should you get flu-like symptoms after hiking through wooded areas, make sure to get tested for Lyme disease, as it is often confused with other diseases, and early treatment is usually quite effective.

Other diseases that are endemic within the United States, but are of far less concern, include Hantaviral Pulmonary Syndrome (found in western regions), Rocky Mountain Spotted Fever (mostly in the Rocky Mountain region), West Nile Virus (all regions) and Eastern/Western Equine Encephalitis (particularly in the mid-west region).

These diseases are extraordinarily rare and the medical system of the United States is very much capable of handling any of these when necessary.

For the latest in traveler's health information pertaining to the United States, including advisories and recommendations, visit the Centers for Disease Control and Prevention destination United States website.

Due to the high amount of travel to and from the U.S. and the fact that diaspora communities from almost every country in the world have some presence in the U.S., the U.S. is somewhat more likely than other places to have "imported" cases of pandemics, as seen in the case of the Ebola epidemic of 2014, that had a few cases in the U.S. Usually those cases are treated and isolated before they spread and you are unlikely to ever be affected by them.

Health care

American health care is generally first-class but can be very expensive. Most Americans have private health insurance. The largest state-run health program, Medicare, is mainly for the elderly. Medicaid is a largely similar program for the poor. Travelers should ensure their travel insurance is valid for the U.S. Given the high costs, some "world-wide" insurance specifically does not cover the U.S. Long-term visitors to the U.S. (e.g. Work or Student visa holders) are generally required to take up private health insurance as part of their visa conditions. Many Americans receive health insurance coverage through their employers as part of their employee benefits. If you are planning to work in the US, check with your employer to see if such an arrangement is possible for you.

To the patient, America's public (20%), private profit-making (20%), and private non-profit-making (60%) hospitals are generally indistinguishable. Inner city public hospitals may be more crowded and less well maintained, but as a whole both costs and service levels are consistently high in all types. No hospital can refuse a life-threatening emergency case.Private hospitals may only stabilize such patients before sending them to a nearby public hospital, which will generally act as the regional center for 24-hour emergency treatment.

In a life-threatening emergency, call 911 to summon an ambulance to take you to the nearest hospital emergency room ("ER"), or in less urgent situations get to the hospital yourself and register at the ER's front desk. Ambulance fees typically range from a few hundred to a few thousand dollars, and though they will never refuse to transport you in an emergency, the ambulance fees will be billed to you at a later date. Emergency rooms treat patients regardless of their ability to pay, even though their services are not free. Expect to pay at least $500 for a visit, plus the cost of any specific services or medications you are given. Avoid using ERs for non-emergency walk-in care; they are 3–4 times more expensive than other options and your non-urgent condition means you will have a wait of hours or maybe days. Most urban areas also have minor emergency centers (also called "urgent care", etc.) for conditions that don't require a visit to the emergency room (e.g. superficial lacerations). Their hours may be limited; few are open at night.

Walk-in clinics can provide routine medical care; to find one, check the yellow pages  under "Clinics", or call a major hospital and ask. Patients see a doctor or nurse practitioner without an appointment (but often with a bit of a wait). They are typically very up-front about fees, and always accept credit cards. Make sure the clerk knows you will be paying "out of pocket"; if they assume an insurance company is paying, they may inflate the bill with unnecessary extras.

Dentists are common across the country. They are accustomed to explaining fees over the phone, and most will accept credit cards. Health insurance typically does not provide dental coverage; you will need to take up separate dental insurance for that.

Government-supported clinics offering free or low-cost testing and treatment for sexually transmitted diseases are widespread. Local Health Departments will provide more details. Many county clinics offer primary health care services as well; however, these services are geared towards low-income residents and not foreign travelers. Planned Parenthood (1-800-230-7526) is a private agency with clinics and centers around the country providing birth control and other reproductive health services for both females and males.

 

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