Paradigm Shift: From Individual Preparedness to Community Resilience

Mar 14, 2013, 3:32 PM preparedness image Ad from

Resilience is about how quickly a community bounces back to where they were before a public health emergency. But it’s not as simple as that.

“Resilience is conceptually messy. We’re all struggling with what is it and how to measure it,” said Anita Chandra, DrPH, Senior Policy Researcher and director of the behavioral and policy sciences department at the RAND Corporation.

A group of public health professionals came together at the Public Health Preparedness Summit in Atlanta, Ga. this week to discuss just how to think about, plan for, measure and improve community resilience in the face of any kind of emergency, be it a hurricane or an act of mass violence.

Part of the reason resilience is so complicated is that so many different things influence community resilience — not the least of which is how well a community is doing before an emergency hits.

“You can’t have community resilience without healthy communities,” said Jonathan Fielding, MD, MPH, MBA, director of Los Angeles County Department of Public Health. “We can’t just be concerned with what goes on in the health sector. We have to think about root causes. If we don’t think about that and sell that to others, we’re in trouble.”

Fielding suggested working closely with other sectors such as housing, transportation and education, and using tools such as health impact assessments to determine the health implications of policy decisions that have the potential to influence the health of the community.

Fielding also pointed to another critical step toward community resilience: strengthening social capital.

How? Say hi to your neighbors. Research shows that if neighbors know one another and prepare together for emergencies, the chances of survival are improved.

The Los Angeles “Be Ready” campaign encourages residents to “Know Your Neighbors,” among other steps to preparedness.

Fielding quizzed the crowd at the Summit: How many of you can name 10 neighbors within a five block radius by name? How many know which of your neighbors might need extra help during an emergency? And how many of you know what to do to help them? The number of hands that remained raised through the last question was telling.

Chandra also encouraged attendees to think broadly about resilience as a “resilience mindset” that goes beyond any one project to integrating preparedness into all routine public health activities. The Los Angeles County Community Disaster Resilience Project aims to bring those goals to life. The project, sponsored by the U.S. Centers for Disease Control and Prevention and National Institute of Mental Health, convened an active network of community agencies across 11 sectors that work consistently with the Los Angeles County Department of Public Health and the Emergency Network of Los Angeles to develop resilience in communities.

Alonzo Plough, director of the Emergency Preparedness and Response Program for the County of Los Angeles Department of Public Health, described the county’s approach to resilience as a paradigm shift: getting past kits and plans, which focus on individual preparedness, to truly working together in a different way to foster whole community resilience.

To help all communities move toward building resilience, Monica Schoch-Spana, Senior Associate with the Center for Biosecurity of UPMC, is part of a committee that is recommending a national data repository to help measure, and therefore continually improve, resilience.

“We have to institutionalize the building of resilience,” said Schoch-Spana. “It doesn’t happen magically.”

This commentary originally appeared on the RWJF New Public Health blog.