Community resilience, or the sustained ability of a community to withstand and recover from adversity (e.g., economic stress, influenza pandemic, man-made or natural disasters) has become a key policy issue, especially in recent years (HHS, 2009; National Security Strategy, 2010; DHS, 2010a). This emphasis on resilience is being embraced at federal (Department of Health and Human Servicesf [HHS], Department of Homeland Security [DHS], the White House), state, and local levels. The National Health Security Strategy (NHSS) identifies community resilience as critical to national health security, i.e., ensuring that the nation is prepared for, protected from, and able to respond to...

This chapter provides a foundation for the remainder of the report by presenting the definition of community resilience that resulted from the literature review, focus groups, and meetings with SMEs, along with a conceptual framework for organizing the activities for building community resilience presented in subsequent chapters.

In order to develop a definition of community resilience, we created an inventory of the definitions of community resilience in the literature (see Appendix B). The definitions were included in articles from diverse disciplinary backgrounds, including disaster sciences, psychology, and sociology. The findings from the literature review were also used to identify the...

The extent to which a community and its resources are affected by a health incident depends in part on the existing wellness levels of community members—their physical, behavioral, and social well-being at the time the incident occurs. Because collective well-being before a health incident can affect people’s need for resources and the length of the recovery period, sustaining an overall level of wellness can serve as a social and individual resource for resilience (Norris et al., 2008; Pfefferbaum et al., 2008). The overall resilience of a community can rest on the extent to which community members practice healthy lifestyles...

Vulnerable or poorer households and communities tend to recover slowly after a health incident. Their already low levels of resilience may be exacerbated by lack of access to adequate resources and services. For instance, in rural communities, scarce resources due to poverty and geographic dispersion mean that, in the aftermath of a disaster, local public health departments, rural health centers, and other organizations may be stretched too thin or be inadequately equipped to handle the unique needs of their community (Dobalian et al., 2007). Access to high-quality resources and services—such as serviceable infrastructure—is an important part of community...

Community education is an ongoing process in which the community acquires knowledge about roles, responsibilities, and expectations for individual preparedness as well as the ways in which individuals can work collectively with other community members to respond to and recover from a health incident. Public health education is an important lever for ensuring that individuals and communities are educated about health security risks and know how to prepare, respond, and recover. Community education also means that individuals know where to turn for help both for themselves and their neighbors, enabling the entire community to be resilient in the face of...

The resilience of a community rests on its ability to draw upon its own internal resources in the face of health incidents while also being able to rapidly restore a state of self-sufficiency following a crisis. Given these attributes, participatory citizen engagement in decisionmaking for planning, response, and recovery activities is specifically identified as a key theme within the National Health Security Strategy. Citizen engagement entails the active participation of community residents in response and recovery planning, to ensure that plans reflect the views and perspectives of a wide range of public health system stakeholders, particularly those representing populations who...

Self-sufficiency is a critical component of community resilience and entails increasing the capacity of individuals, communities, or institutions to become more self-reliant. In the context of community resilience, the concept of “self” in self-reliance or self-sufficiency can be extended beyond the individual citizen to include the community. The “ self” can apply to the individual who stockpiles supplies, the household that develops a household emergency plan, or the community that expects to manage an emergency without immediate external assistance following an incident. To work toward self-sufficiency, individuals should take responsibility for personal preparedness and support the preparedness efforts of other...

Developing the capacity of a community to prevent, withstand, and mitigate the stress of a health incident is a fundamental element of community resilience. Because much of this capacity may currently exist across a loosely associated system of groups, networks, and organizations, the importance of forming robust partnerships within communities and across government and civil society is a central concern for building community resilience. Researchers have argued that building community resilience entails a process of linking a set of networked adaptive capacities, and that organizational linkages help build collective resilience (Norris et al., 2008). By developing effective partnerships across government...

This chapter offers suggestions for how federal, state, and local organizations that are implementing the community resilience–building activities described in Chapters Three through Eight can monitor and evaluate progress. A community’s ability to collect, analyze, and utilize data is a critical lever needed to monitor and evaluate progress on building community resilience. If a community cannot adequately monitor disease incidence and the quality and continuity of care over the course of response, then its ability to recover quickly is compromised (Williams, 2008). Understanding of the pre- and post-disaster physical health state of the community (e.g., the percentage of community...

A focus on community resilience will require not only a new level of engagement from a diverse set of community stakeholders but also an investment—of time, money, and personnel resources—in supporting and bolstering resilience. Monetary and other investments in community resilience must be made efficiently. In a resource-limited environment, such as that facing communities across the nation at the time of this writing, it is necessary to identify activities, partnerships, and resources with dual benefit to improve both health security planning as well as other community health priorities (Baezconde-Garbati et al., 2006; Pant et al., 2008). In addition,...

In this chapter, we describe some of the critical questions to consider when developing a local community resilience plan. As communities review this roadmap, it is important to determine an approach to implementation, including monitoring and evaluating implementation and determining the effectiveness of particular activities. The chapter also includes a brief summary of the questions that remain unanswered for the field of community resilience and national health security.

Once a community plan is developed or modified based on this roadmap, it is essential that communities answer these questions:

1.How will we know if these activities are working?There is...