As we develop compelling ways to answer the question, “what is public health,” it is worth exploring concepts that can function as useful analogies, potential frames, or rallying concepts. Community resilience could be one such helpful concept for illustrating and supporting public health’s strategic role in community health. In some communities, it could also function as an operational guiding framework for advancing equity, fostering health in all policies, and moving public health upstream.
Some would dismiss resilience because it means many different things depending on your field, kind of like “sustainability.” But a quick review of definitions from different fields reveals a core mathematical concept that is applied metaphorically to systems with different scopes:
- American Psychological Association: “Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress”
- CDC: “Resilience is the sustained ability of communities to withstand and recover from adversity”
- Organization for Economic Co-Operation and Development: “Resilience refers to the capacity of a natural system to recover from disturbance.”
The core operational theme of recovering equilibrium after a shock is present across these definitions, but applied to different system levels – individual, community, and ecosystems. This is just a small sample of definitions, but more substantial reviews reveal the same shared theme.
This multi-level applicability could be an advantage when bringing a variety of partners to the table, which public health is already doing through its mandated preparedness efforts. The term “health” shares this multi-level quality (e.g. individual health, family health, community health), but “health” is too easily conflated with “health care.” Resilience does not share this problem, and individualist conceptions of resilience could be useful starting analogy for explaining community resilience. Because of the core theme, community members concerned about how well their families and neighbors will regroup after an evacuation have a common frame of reference with a business group worried about long-term labor shortages.
Working with a resilience lens could elevate perceptions of interdependence. Community-wide disasters can create shared circumstances for groups that rarely interact. To assess their own resilience, each group must consider system factors outside their typical sphere of relationships, including the health and welfare of people they may come to depend on or who need their support during a disaster. Strategizing around resilience can potentially force people to think about circumstances where they might experience the same inequities, insecurities, and stress that some their neighbors might experience all the time.
Efforts aimed at improving and measuring community resilience are taking a public health approach. Resilience proponents are advocating for multi-sector, “co-benefit” approaches combined with Community Based Participatory Research (CBPR) methods that are strikingly similar to our guiding principles for the future of public health: the Public Health 3.0 model, Chief Community Health Strategist, health in all policies, and advancing equity.
Using community resilience as a rallying concept might not work for every community, and may be more effective in communities that have recently experienced a disaster. Communities that are deeply concerned about the effects of climate change might be particularly receptive. We encourage public health professionals to explore this and other broad, systemic concepts as “flagship” ideals that can inspire more meaningful community participation in public health efforts.