Both Caribbean and Central America regions share a common fate with regard to similar natural risks. Responses to past disasters followed similar tendencies and major mitigation actions often resulted from major crises during the last decades. This presentation is a reflection on the efficiency of risk reduction in Central America and the Caribbean region when the efforts of mitigation were never as important and adapted to social evolutions as today. Nevertheless, the constant recent increase of human land occupation in at risk areas, as well as the consequences of global change, mainly on coasts and flood prone areas have induced a succession of crises that all the responses and mitigation measures didn't succeed to avoid. It is nowadays convenient to question the current limits of mitigation policies. As they are highly vulnerable exposed sectors, insular coasts are specially analyzed.