Overview

Disaster managers embrace the concept of community resilience, sometimes as a strategy and sometimes as a vision. Community resilience both requires and supports effective disaster management. To promote community resilience and to improve its application in disaster medicine, this chapter explores the concept, then describes principles for building community resilience and currently available resources and programs, and finally offers recommendations for future research.

Definition of Resilience

Multiple disciplines (e.g., computer science, ecology, economics, engineering, geography, health, physical science, psychology, sociology) define and use “resilience” in application to their specific, and sometimes unique, contexts and purposes. The term is used to describe individuals, materials, networks, ecosystems, and/or communities, all of which have relevance to disasters. For the purposes of this chapter, resilience is defined as “the process of successfully adapting to, and recovering from, adversity.” While this definition has the advantage of being straightforward, it conceals some complexities that may be of importance to practitioners, policymakers, and researchers interested in assessing resilience and in generating and implementing evidence-based strategies to enhance it.

Resilience as an Emergent Process

Resilience is a process of adaptation and recovery that emerges in response to adversity. While some definitions characterize community resilience as an attribute or outcome, a process definition is used here. This distinguishes it from the attributes (e.g., ability, capacity) that characterize a resilient system, and from the outcome of adaptation and recovery. Norris et al. define resilience as “a process linking a set of adaptive capacities to a positive trajectory of functioning and adaptation after a disturbance” (p. 130).¹ Thus, resilience emanates from adaptive capacities, which are resources with dynamic attributes, as described later in this chapter. Resilience leads to adaptation, an outcome characterized by wellness.

Resilience is not the absence of adversity, but successful progress in spite of, in the midst of, and in response to it.² A system may be resilient with respect to some adversities and not others, and it may respond differently to a given stressor at different times and differently to different stressors. Definitions of resilience as an attribute are likely to recognize that it can be affected by circumstances over time, thereby lending a dynamic quality to it.³ Such descriptions, along with process definitions, realize that resilience can be influenced by a variety of determinants, an appreciation of which is important for those who seek to understand and build resilience.

Differences between Personal Resilience and Community Resilience

Although similar definitions may apply, community resilience is not merely a collection of personally resilient individuals. The distinction, which is substantive, may be understood, in part, by recognizing that the whole is more than the sum of its parts.⁴ Rather than a group of individuals acting independently on their own behalf, community resilience involves collective activity in which individuals work together in ways that support response and recovery for the whole. Brown and Kulig describe a community as requiring dynamic, interactive relations between members so that individuals “in communities are resilient together, not merely in similar ways” (p. 43).⁵ Hence, a community of personally resilient individuals is not necessarily resilient.

In addition to inter-relational aspects in which individuals join together in support of the aggregate, community resilience requires physical and social conditions and structures that buttress individual and collective activity and facilitate the resilience process.^5–7 Medical, public health, and disaster medicine infrastructures are examples of systems that help create resilient communities by their attention to identifying, studying, preventing, and resolving threats and potential threats to individual and communal health. These infrastructures, as examples of systems that help create resilient communities, must also be resilient so that they continue to function during and after an event.

Just as personal resilience does not guarantee community resilience, community resilience does not guarantee personal resilience. Community resilience can strengthen the personal resilience of some, perhaps many, community members through systems that attend to behavioral and functional problems at the individual level.⁶ This does not mean, however, that all members will adapt well to particular adversities. Indeed, in the case of disasters, it is unlikely that all members of a community will adapt well. Thus, communities may recover successfully even though some members do not. Communities may be resilient even when some members are not.

Resilient communities care for and support their members. Moreover, for many adversities in which survivors and other community members contribute to response and recovery efforts, the presence of personally resilient individuals benefits others in the community. Such contributions are less likely to be realized during a disaster that affects many members of the community since individuals may be forced by circumstances to focus primarily on themselves and their families, thereby leaving them with little to offer others. This scenario illustrates one way in which disasters can overwhelm a community. In such circumstances, a resilient community is aided by established linkages with external public and private sources of assistance.

The Role of Human Agency

Community resilience reflects an ability to change and adapt^1,3,8 and, in the definition of some researchers, the potential to grow from a crisis.^5–7 Brown and Kulig⁵ base the concept of community resilience in human agency, that is, in the capacity for people to take deliberate, meaningful actions. Community members must communicate effectively to interpret their environment and act together to heal in the aftermath of a crisis. Recovery results from individual and collective decisions and activities that potentially transform the environment to mitigate future adversities. Community resilience thus requires both proactive and reactive efforts.

Properties of Community Resilience

Bruneau, Chang, et al.⁹ describe four properties of resilience for physical and social systems: robustness, redundancy, resourcefulness, and rapidity. Robustness refers to strength or the ability of elements, resources, and systems to withstand stress without degradation or loss of function. Redundancy is the extent to which essential components are substitutable so that critical functional requirements can be met in the event of a crisis. Resourcefulness is the ability to identify problems, determine priorities, and mobilize resources in response to threats and disruptions. Resourcefulness also refers to the ability to use human and material resources to meet priorities and accomplish goals. Rapidity is the ability to meet priorities and reach goals in a timely manner to limit losses and prevent future disruption (Table 6.1).

Attributes of Resilient Communities

Pfefferbaum et al.⁷ drew on community competence and capacity literatures^10–15 to describe eight attributes of community resilience. The eight attributes, which are described subsequently, are: 1) Connectedness, Commitment, and Shared Values; 2) Participation; 3) Support and Nurturance; 4) Structure, Roles, and Responsibilities; 5) Resources; 6) Critical Reflection and Skill Building; 7) Communication; and 8) Disaster Management (Table 6.1).

Connectedness, Commitment, and Shared Values. Connection to a group or a place characterized by shared history, laws, values, interests, and customs is the cornerstone of community. One’s commitment and sense of belonging to a community are likely to be enhanced by the perception that personal well-being is improved by membership in the community and that members are treated fairly. Relationships of mutual concern and benefit can encourage cooperation and consensus building. Communities that support diverse members may be better able to address the plethora of needs that arise during and in the aftermath of disasters.

Participation. Participation in community organizations and activities can strengthen feelings of ownership and a sense of belonging, resulting in increased personal contribution and a commitment to safeguarding community well-being. When participation is valued and fostered, communities are likely to find their members more actively invested and engaged in civic roles. Communities that extend opportunities for involvement to diverse members in ways that are respectful and sensitive to their interests and demographics may be better able to identify and address concerns that arise during and after disasters.

Support and Nurturance. Supportive and nurturing communities attend to the needs of their members regardless of socioeconomic status, ethnicity, experience, education, and background. Such communities listen to and help members to overcome challenges and accomplish goals. They promote member well-being, empower individuals and groups, and instill hope. Communities that are adept at mobilizing and equitably allocating resources may be better able to provide support and nurturance. In resilient communities, support includes early and ongoing assessment of, and assistance to, potentially vulnerable members before, during, and in the aftermath of disasters. Support must be sustained if it is to buffer the personal, social, and economic losses that accompany crises.

Structure, Roles, and Responsibilities. Community structure, roles, and responsibilities must help create and support the capacity for mitigation of, as well as decisive and timely response to crises. Resilient communities reflect an appreciation for equity in establishing and applying community standards, rules, and procedures. Members must learn, and can teach each other, to navigate the complex reciprocal links and overlapping networks of individuals, groups, organizations, and agencies that exist within their community. In resilient communities, interactions are relatively frequent and supportive, with individuals and groups identifying and addressing common concerns. Associations that arise, formally or informally, to establish priorities and resolve issues give rise to solutions. Responsive and effective leadership; teamwork; clear organizational structures; and well-defined roles, responsibilities, and lines of authority advance adaptation and recovery. In a highly uncertain, all-hazard environment, structural elements (e.g., emergency management and medical systems) must permit sufficient flexibility to address unforeseen threats and vulnerabilities. Communities also must manage relations with the larger society.

Resources. A community’s resources include natural, physical, financial, human, and social assets belonging to individual members as well as those attached to the community itself. In addition to land and other raw materials, resources include existing infrastructure and machinery and tools for production. Money and credit are financial resources that facilitate the acquisition of other resources, the production and distribution of goods and services, and exchange within and across communities. Human resources include a workforce, skills and expertise, and leadership, along with member qualities such as hope, work ethic, and the will to improve personal and community well-being. Relationships and support systems within a community and characteristics such as cohesion and collaboration constitute social resources. Community resources may be augmented after a disaster by an infusion of resources from other communities (through, e.g., mutual aid agreements in which emergency assistance is made available across jurisdictional boundaries) and from the larger society, domestically and internationally. Resilient communities acquire, mobilize, allocate, invest in, and utilize resources effectively to serve members and meet community goals. Resources can substitute for and complement each other. Redundancy in critical resources can help maintain essential functions. Ongoing investment in physical, human, and social capital – such as improvements in health facilities, job training, and neighborhood development – may be necessary to create infrastructures and systems that can endure and respond to a wide variety of potential disasters and threats.

Critical Reflection and Skill Building. Resilient communities identify and address local issues, needs, and problems; establish structures to collect, analyze, and use information; recognize and frame collective experiences; and plan, manage, and evaluate programs. Critical reflection about values, community history and experiences, and the experiences of others can help informal and formal community leaders to reason, problem solve, set goals and objectives, and develop and implement strategies for the benefit of the community and its members. Resilient communities evaluate their performance, study their successes and failures, and learn from adversity. They also support skill building at individual and systemic levels. Learning, accommodation, and growth can lead to enhanced capacity and improved disaster resilience.

Communication. Clear, timely, accurate, and effective communication among community members, between authorities and community residents, and with other communities and the larger society is essential for community resilience. To be productive, communication must be based on common meanings and must be perceived to be honest and transparent. All community members and groups should have opportunities to identify and express their views and their needs, and they should be encouraged to participate in community problem-solving, especially so that diversity is embraced. Effective communication fosters trust in leadership, promotes preparedness, increases the likelihood of compliance with disaster directives, facilitates effective response, and simplifies the resolution of existing and emerging unmet needs as well as those arising from disasters. Disaster resilience depends on sufficient redundancy in communication channels to ensure timely resource mobilization and deployment.

Disaster Management. Measures to mitigate, prepare for, and respond to disasters, which limit adverse consequences and set the stage for reconstruction and recovery, are necessary for community resilience. Prevention and mitigation include activities to avoid or control an incident, to reduce risks to people and property, and to lessen actual or potential adverse effects of an incident. Implemented prior to, during, or after an incident, mitigation measures focus on decreasing the likelihood of hazardous incidents and reducing exposure to, or potential loss from, such events. Preparedness is a continuous process that assesses threats, identifies vulnerabilities, determines resource requirements, and amasses resources for response and recovery. Disaster response relates to activities that occur as soon as feasible after an incident. Along with emergency assistance, response includes efforts to limit further damage during and immediately after a disaster; support basic human needs; and maintain the social, economic, and political structure of the affected community. The relatively short-term response phase transitions to a longer period of recovery and reconstruction during which survivors begin to rebuild their lives and their community.

Adaptive Capacities

Norris and colleagues¹ describe a set of four primary adaptive capacities (resilience resources) from which community resilience emerges: Economic Development, Social Capital, Information and Communication, and Community Competence (Table 6.1). Resilience depends on these four resources and their dynamic attributes, which are described by three of the properties identified by Bruneau and colleagues:⁹ robustness, redundancy, and rapidity. Resilience can fail when adaptive capacities are damaged or disrupted by a stressor. Public health and disaster medicine systems contribute to the adaptive capacities of communities to the extent that they establish conditions necessary for the health and wellness of community members through personal and community mitigation, preparedness, response, and recovery programs and services.

Economic Development. As an adaptive capacity, economic development involves the volume and diversity of economic resources (e.g., raw materials; machinery, tools, and equipment; physical infrastructure; service systems; labor force) and equity in resource distribution. Poor and developing communities are not only at greater risk for destruction, they often are less successful in mobilizing support during and in the aftermath of a disaster. Community resilience is directly influenced by the ability to distribute resources to those most in need post disaster.¹

Social Capital. Social capital can be defined as the collection of resources, both actual and potential, that are needed for a durable network of relationships.^1,16 As an adaptive capacity, social capital involves network structures and linkages; social support; and community roots, bonds, and commitments. Network structures and linkages include overlapping, inter-organizational systems with reciprocal links, frequent supportive interactions, and processes for cooperative decision making.^1,13 Social support includes social interactions that provide assistance (received or delivered social support) and those that are expected to provide assistance when the need for it arises (perceived or expected social support). Community roots, bonds, and commitment involve place attachment (i.e., an emotional connection to one’s community), a sense of community involving feelings of trust and belonging, and citizen participation in formal organizations and grassroots leadership.¹

Information and Communication. A communication infrastructure, including the media, is an important element of this adaptive capacity since information and communication are necessary for effective emergency management. Longstaff⁸ argues that a trusted source of accurate information is an individual’s or group’s most important resilience asset. Communal narratives, which give shared meaning to a disaster, also are a beneficial element of the information and communication resource.¹

Community Competence. Community competence involves collective action and decision making, which may stem from collective efficacy and empowerment. Collective efficacy depends on mutual trust and willingness to work toward the common good.¹ Cottrell¹⁰ describes a competent community as one in which various community components collaborate effectively to identify community problems and needs; reach a working consensus on goals and priorities; agree about how to implement these goals; and take effective, collaborative action.

Characteristics of Safe and Resilient Communities

An International Federation of Red Cross and Red Crescent Societies (IFRC)¹⁷ study of its community-based disaster risk reduction programs¹⁸ identifies community perceptions of characteristics required of safe and resilient communities. The six characteristics embody many of the attributes and adaptive capacities described in the previous section. Safe and resilient communities:

State of the Art

As both a vision and a strategy for disaster management, community resilience has captured the attention of community leaders, emergency managers, policymakers, and researchers. This has resulted in the availability of resources and programs to assess and promote community resilience. Principles for enhancing community resilience and examples of current resources and programs are described.

Principles

Ultimately, community resilience emanates from the engagement and collective action of the units (e.g., individuals, families, groups, organizations) comprising a community. Ideally, the development and application of resources, strategies, and programs to build community resilience are guided by underlying principles drawn from research and practice. Fundamental among these principles is an all-hazard approach with attention to the local context that is necessitated by the inherent variation among communities across many dimensions. Other supporting principles involve community engagement, bioethical duties, assessment, asset-based approaches, and attention to skill development and personal resilience.

Community engagement. Community resilience requires the participation of individuals and organizations that reflect the diversity of the community. Public engagement efforts should identify and enlist traditionally underrepresented and underserved populations as well as those in the mainstream. Marginalized individuals or groups may have unexpected perceptions of the relevant roles and responsibilities that support a community’s structure and operations, they may ask fresh questions, and they may bring new insight and energy to the process.¹⁹ Resilience-building efforts should seek to create and bolster connections among constituents. Insofar as feasible, community members and organizations should be empowered to act in the interest of the community.

Bioethical duties. Bioethical principles derive from a system of values regarding relations among individuals. These principles establish obligations for professional and organizational behavior and for research with human subjects. While these principles sometimes give conflicting guidance in a disaster setting, as with all aspects of emergency management, they should be upheld to the extent possible in the development and implementation of activities that build community resilience. The principle of autonomy (respect for persons) requires that individuals be respected, that they be treated as autonomous agents, and that those with diminished autonomy be protected. The principle of beneficence requires contributions to the welfare of others and that interventions be designed to protect people from harm and promote their well-being. When that is not possible, the principle of non-maleficence demands that no harm be done. The principle of justice establishes a duty to be fair, particularly when imposing burdens and allocating benefits. Distributive justice requires an equitable allocation of scarce resources. Other ethical principles (e.g., the principle of fidelity, which requires faithfulness and that one keep promises) establish additional duties for professionals and organizations involved in community resilience work.²⁰

Community assessment. Efforts to enhance community resilience should be based on an assessment that identifies the community’s assets and challenges and its specific vulnerabilities and threats related to disasters and other potential crises. Information from community members and organizations with knowledge of their locality, relationships, and networks can be particularly useful in understanding the local context and dynamics that support or limit disaster resilience. This information should be augmented with risk assessment data, often available through official emergency management agencies. Other sources of information include studies conducted by foundations, newspapers, universities, and other agencies and organizations in the public and private sectors.

Asset-based approaches. Asset-based community development contributes to community resilience. Kretzmann and McKnight¹⁹ recommend asset-based approaches as an alternate to traditional needs-driven approaches to community development. They maintain that needs-based approaches teach people about their problems, encourage reliance on services and resources that may need to be imported from outside the community, and foster a perception of oneself as a consumer rather than a producer. Used in conjunction with needs-based approaches or as an alternate to them, asset-based development identifies, links, and capitalizes on the capacities, skills, and strengths of individuals and their neighborhoods. A community is enriched and becomes more self-reliant when residents work with each other to address problems and when organizations collaborate to take collective action.

Skill development. In the process of community development, community resilience activities should help cultivate and exercise local skills and personal resilience among community members. Leadership, team building, and risk management skills can be important ingredients, as well as potential byproducts, of community resilience efforts. Creating a consciousness of community resilience (e.g., as part of processes that define and develop community resilience such as those described later in the chapter) also can be beneficial by galvanizing community members and organizations, highlighting shared values, focusing on critical reflection and skill development, and reinforcing the belief that resilience must be sustained over time and across adversities.⁷