ASTHO President’s Challenge: Core Principles for Building Community Resilience

The Association of State and Territorial Health Officials (ASTHO) President’s Challenge seeks to promote healthy and resilient communities by encouraging state and territorial health officials to invest in community-led, place-based, and cross-sector approaches. This challenge stems from the understanding that community resilience is, at its core, exquisitely contextual, as the history and circumstances of any community, down to the neighborhood level, play a large role in the ability of a community to withstand expected and unexpected stressors. The challenge emphasizes the role of community leadership in resilience work. There is also a focus on building strong cross-sector approaches, as the work of community resilience cannot be effective if done in silos. The challenge urges public health professionals to consider these three important factors in the context of community resilience work: community leadership, social cohesion, and the concept of “bouncing forward.”

The concept of community resilience is helpful in connecting the public health mission for prevention and disaster response to the public’s instinctive understanding of the need to be able to withstand adversity. Since public health adopted the framework of community resilience, it has appropriately sought to better define what this means and how to measure resilience and track progress. We have come to understand that resilience is affected by factors such as racial equity, language access, and income inequality. Disasters such as Hurricane Katrina in 2005 gave a sobering view of how, in the face of natural disasters, stark disparities exist in the ability of communities to avoid harm and get back on their feet. Such inequities often fall on historical fault lines of racial and socioeconomic disparities.

FOSTERING COMMUNITY LEADERSHIP

The concerns of those who live, work, and play in the area being served must be at the core of community resilience-building efforts. The ASTHO President’s Challenge urges state and local public health officials to find ways to increase community leadership in their work. Over the past year, ASTHO has culled examples of place-based approaches from across the nation. One example is Rhode Island’s Health Equity Zone (HEZ) initiative. Through this initiative, the Rhode Island Department of Health funds collaboratives of community-based organizations, business leaders, policymakers, local government, and community members to collaborate to build healthier, more resilient communities. The HEZs range from small neighborhoods to large counties. Each HEZ works on different, community-driven projects, including healthy food access, the built environment, youth support, affordable housing, and transportation, with the goal of improving the health and well-being of community members by addressing root causes of health disparities. The infrastructure of the HEZs enables HEZ partners and community members to better organize and address communities’ vulnerabilities and stressors.

The City of Los Angeles, California, through its work in the 100 Resilient Cities Network, a global initiative to foster community resilience, exemplifies community leadership in action. The Los Angeles resilience strategy highlighted the importance of community connectedness, making this one of its four stated goals.¹ The Neighborly Microgrants Program, part of the city’s resilience strategy, funds community-driven projects to encourage neighbors to build resilience in their neighborhoods. Strategies such as these, which support community leadership and promote innovation rooted in an intimate knowledge of one’s community, help ensure that resilience-building efforts are relevant and effective.

BUILDING SOCIAL COHESION

Social cohesion and social connections underlie effective community resilience efforts.² Work on improving social cohesion should involve an inventory of historical and cultural factors that build social connection and examine factors that lead to marginalization or disenfranchisement. The City of Tulsa, Oklahoma outlined a resilience strategy that highlights the elimination of systemic discrimination. Tulsa officials convened race reconciliation conversations, in partnership with the faith community, designed to provide residents a safe space to discuss important issues such as structural racism. The Tulsa resilience strategy also addressed welcoming immigrants to Tulsa neighborhoods as important for improving social cohesion.³

Older adults are often at risk for social isolation, putting them at additional risk of poor outcomes in times of natural disasters and other unexpected community stressors.⁴ Rhode Island’s Pawtucket and Central Falls HEZ fosters relationships between youths and older adults as one key strategy for improving the health and well-being of the community, thus combating social isolation as a key resilience-building effort. The HEZ works to connect older adults at risk for social isolation to adolescents in the community through a snow-removal program. The adolescents help older adults shovel snow in the winter, preventing possible slips, falls, and injuries. This program is working to go beyond snow removal and foster a year-round connection between the youths and older adults by having youths help with other physical tasks throughout the year.⁵ Promoting social cohesion through targeted efforts such as these are important for building strong communities that can withstand community stressors.

REFRAMING RESILIENCE TO BOUNCE FORWARD

The ASTHO President’s Challenge encourages state and local health officials working on building community resilience to go beyond simply making sure that community members can withstand stressors and maintain their current health status. Community resilience work provides an opportunity for communities to bounce forward. The ASTHO President’s Challenge reframes the concept of resilience, viewing success in terms of a community not just returning to an inequitable baseline, but also advancing to more equitable conditions. Applying an equity lens to this concept of bouncing forward should help all members of the community feel as though they are advancing toward better health.

A survey of New Orleans, Louisiana, residents 10 years after Hurricane Katrina noted that only 44% of Black respondents versus 70% of White respondents agreed that New Orleans has mostly recovered from Katrina. When asked if it was a good time for children to grow up in New Orleans, a similar racial disparity existed, with only 37% of Black respondents versus 70% of White respondents saying yes.⁶ Disparities in these perceptions point to continuing inequities in the ability of communities to bounce forward. New Orleans, another member of the 100 Resilient Cities cohort, released a resilience strategy 10 years after Katrina that includes prioritizing racial equity, noting that “with a strategy that prioritizes racial equity we will be stronger as a society and more capable of responding to adversity.”⁷

The goal of using community adversity to serve as an impetus for positive change must always be at the forefront of community resilience work. We should not be content with maintaining the status quo but should find ways to reduce disparities and improve health and well-being outcomes by embracing the core concepts of the ASTHO President’s Challenge: fostering community leadership, building social cohesion, and bouncing forward to advance health equity.