The “Resilience Dividend” and the Culture of Health

Nov 25, 2014, 8:23 AM, Posted by Susan Dentzer

The IKEA in Red Hook, Brooklyn, NY after Hurricane Sandy. The Red Hook IKEA after Superstorm Sandy. Credit: Flickr user Ham Hock https://creativecommons.org/licenses/by-nc-nd/2.0/

Red Hook, Brooklyn, is named for its original red clay soil, and the “hook” of land that juts out into Upper New York Bay. Two stores located close to the water there fared very differently during Superstorm Sandy, which ravaged parts of New York and New Jersey in October 2012.

Judith Rodin, president and CEO of the Rockefeller Foundation, recounts the saga in her new book, The Resilience Dividend: Being Strong in a World Where Things Go Wrong.

Ikea, the Swedish household goods chain opened its Red Hook store in 2008, built on pilings with a ground floor garage, an emergency generator, and show rooms and inventory well above ground level. Although its parking lot flooded during the storm, the inventory was untouched, and the store recovered quickly. It functioned as a local office for representatives from the Federal Emergency Management Agency and served as “a neighborhood hub for the distribution of food, clothing, and other supplies,” Rodin writes. The store also “strengthened its neighborhood connections by taking on a new and important role.” 

By contrast, Fairway, a local supermarket chain, was housed nearby in a 19th century warehouse building that was flooded so badly it had to be gutted, renovated and entirely restocked with inventory. The store, the only large supermarket in the area, didn’t reopen until four months after the storm hit. Rodin’s verdict: “It lost business and lost its connection with the neighborhood during a critical time.”

Rodin isn’t trying to apply Aesop’s fable about the ant and the grasshopper to modern-day retailing; she’s underscoring how forward-thinking communities can take stock of likely dangers, prepare for the worst, and reap a “dividend” later. Taking her theme further, communities — or even countries — that are struggling with health issues could also take proactive steps, and achieve a “resilience dividend,” too.

Consider three pressing health challenges: Obesity, infectious disease epidemics, and climate change.

Obesity: A new McKinsey report says that nearly 30 percent of the world’s population is now overweight or obese, and obesity causes about 5 percent of deaths worldwide. Any community or country seeking to reap a “resilience dividend” from obesity would attack the many probable causes, from shaping a healthier food supply to boosting levels of activity through new parks.

The U.S. already abounds with examples where communities have responded and dividends have been earned. Take the movement to create new parkland out of abandoned railways, such as New York City’s Highline, a 1.5 mile-long “linear” park and walking trail built from an unused elevated freight rail line. City officials estimate that the park will generate $4 billion in private investment and $900 million in additional tax revenues over the next 30 years, part from the real estate boomlet in the surrounding neighborhoods. Atlanta officials are hoping for a similar effect from the Beltline, a network of public parks and trails now being developed along 22 miles of unused railroads.

Infectious disease epidemics: As Rodin notes, disruptions can become disasters “when leadership fails or other human-related factors exacerbate the problem.” In retrospect, it’s clear that this phenomenon contributed to the rapid spread of Ebola in West Africa. But the initial response in the US was also flawed; witness the differing policies that the US military, the Centers for Disease Control and Prevention, and various state governments adopted toward quarantining US health-care workers once they returned from Africa.

University of Michigan medical school professor Howard Markel points to such longstanding problems as “hazy lines of authority and fierce internecine battles among local, state, and federal health agencies as well as individual hospitals and healthcare systems” (How the Ebola Quarantine Became a States’ Rights Issue). A more coordinated set of responses would surely reap a resilience dividend, which could include greater public confidence in epidemic-control measures, and greater willingness of U.S. health care workers to help out overseas.

Climate change:  This phenomenon has emerged as “an undeniable contributor to the severity and extent of [global] disruptions,” Rodin writes. Extreme weather is a factor in the instability seen in Africa, Asia, and the Middle East. The Natural Resources Defense Council predicts that excessive heat caused by climate change could kill more than 150,000 Americans by the end of the century in the nation’s 40 largest cities.  

Although prospects for achieving a new global climate change agreement appear uncertain, efforts to mitigate the damage are gaining steam. Rodin cites Via Verde, a housing development in New York’s South Bronx, where gardens not only boast healthy fruits and vegetables for harvesting by residents, but “provide a soft solution to climate change mitigation by dissipating heat and absorbing water runoff.”

Winston Churchill may have admonished, “Never let a good crisis go to waste,” but “people do ‘waste’ a crisis, by which I mean they do not take the opportunity to address their vulnerabilities nor do they take action to make positive change and improvement,” Rodin writes. Given the clear U.S. health crisis, it’s time to seek an even greater resilience dividend from building a Culture of Health.