RESUMEN
Community resilience is a community's ability to maintain functioning (ie, delivery of services) during and after a disaster event. The Composite of Post-Event Well-Being (COPEWELL) is a system dynamics model of community resilience that predicts a community's disaster-specific functioning over time. We explored COPEWELL's usefulness as a practice-based tool for understanding community resilience and to engage partners in identifying resilience-strengthening strategies. In 2014, along with academic partners, the New York City Department of Health and Mental Hygiene organized an interdisciplinary work group that used COPEWELL to advance cross-sector engagement, design approaches to understand and strengthen community resilience, and identify local data to explore COPEWELL implementation at neighborhood levels. The authors conducted participant interviews and collected shared experiences to capture information on lessons learned. The COPEWELL model led to an improved understanding of community resilience among agency members and community partners. Integration and enhanced alignment of efforts among preparedness, disaster resilience, and community development emerged. The work group identified strategies to strengthen resilience. Searches of neighborhood-level data sets and mapping helped prioritize communities that are vulnerable to disasters (eg, medically vulnerable, socially isolated, low income). These actions increased understanding of available data, identified data gaps, and generated ideas for future data collection. The COPEWELL model can be used to drive an understanding of resilience, identify key geographic areas at risk during and after a disaster, spur efforts to build on local metrics, and result in innovative interventions that integrate and align efforts among emergency preparedness, community development, and broader public health initiatives.
Asunto(s)
Desastres/estadística & datos numéricos , Modelos Teóricos , Características de la Residencia/estadística & datos numéricos , Resiliencia Psicológica , Capital Social , Estrés Psicológico , Humanos , Ciudad de Nueva YorkRESUMEN
OBJECTIVES: This study empirically examines preparedness with a kit, medication, and a disaster plan on disaster outcomes including perceived recovery, property damage, and use of medical or mental health services. METHODS: Using a cross-sectional, retrospective study design, 1114 households in New York City were interviewed 21-34 months following Super Storm Sandy. Bivariate associations were examined and logistic regression models fit to predict the odds of disaster outcomes given the level of preparedness. RESULTS: Respondents with an evacuation plan were more likely to report not being recovered (odds ratio [OR] = 2.4; 95% confidence interval [CI]: 1.5-3.8), property damage (OR = 1.4; 95% CI: 1.1-1.9), and use of medical services (OR = 2.3; 95% CI: 1.1-4.5). Respondents reporting a supply of prescription medication were more likely to report using mental health (OR = 3.5; 95% CI: 1.2-9.8) and medical services (OR = 2.3; 95% CI: 1.1-4.8). CONCLUSIONS: Having a kit, plan, and medication did not reduce risk of adverse outcomes in Superstorm Sandy in this sample. Disaster managers should consider the lack of evidence for preparedness when making public education and resource allocation decisions. Additional research is needed to identify preparedness measures that lead to better outcomes for more efficient and effective response and recovery.
Asunto(s)
Defensa Civil/normas , Tormentas Ciclónicas/estadística & datos numéricos , Composición Familiar , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Defensa Civil/estadística & datos numéricos , Estudios Transversales , Tormentas Ciclónicas/prevención & control , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Ciudad de Nueva York , Oportunidad Relativa , Estudios Retrospectivos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: Policy-makers and practitioners have a need to assess community resilience in disasters. Prior efforts conflated resilience with community functioning, combined resistance and recovery (the components of resilience), and relied on a static model for what is inherently a dynamic process. We sought to develop linked conceptual and computational models of community functioning and resilience after a disaster. METHODS: We developed a system dynamics computational model that predicts community functioning after a disaster. The computational model outputted the time course of community functioning before, during, and after a disaster, which was used to calculate resistance, recovery, and resilience for all US counties. RESULTS: The conceptual model explicitly separated resilience from community functioning and identified all key components for each, which were translated into a system dynamics computational model with connections and feedbacks. The components were represented by publicly available measures at the county level. Baseline community functioning, resistance, recovery, and resilience evidenced a range of values and geographic clustering, consistent with hypotheses based on the disaster literature. CONCLUSIONS: The work is transparent, motivates ongoing refinements, and identifies areas for improved measurements. After validation, such a model can be used to identify effective investments to enhance community resilience. (Disaster Med Public Health Preparedness. 2018;12:127-137).
Asunto(s)
Adaptación Psicológica , Planificación en Desastres/métodos , Víctimas de Desastres/psicología , Modelos Teóricos , Características de la Residencia/clasificación , Planificación en Desastres/tendencias , Humanos , Reproducibilidad de los Resultados , Análisis de SistemasRESUMEN
This paper explores the provision of disaster-related behavioural and mental health (DBH) services as a problem of institutional collective action in the United States. This study reviews the challenges that providers have in surmounting multi-organizational disconnects, unstable professional legitimacy, ambiguous information, and shifting disaster needs in developing a system for delivering DBH services. Based on the adaptive governance framework, it argues that existing protocols such as the National Incident Management System (NIMS) and Incident Command System (ICS) may be helpful in advancing collective action, but that real progress will depend on a recognition of norms, expectations, and credentials across many spheres-in other words, on the ability of responders to continuously adjust their procedures and administrative boundaries for behavioural health institutions.
Asunto(s)
Planificación en Desastres/organización & administración , Agencias Gubernamentales/organización & administración , Necesidades y Demandas de Servicios de Salud/organización & administración , Servicios de Salud Mental/organización & administración , Humanos , Servicios de Salud Mental/provisión & distribución , Estados UnidosRESUMEN
In this paper we examine the reconstitution of the Emergency Operations Centre (EOC) after its destruction in the World Trade Center attack, using that event to highlight several features of resilience. The paper summarises basic EOC functions, and then presents conceptions of resilience as understood from several disciplinary perspectives, noting that work in these fields has sought to understand how a natural or social system that experiences disturbance sustains its functional processes. We observe that, although the physical EOC facility was destroyed, the organisation that had been established to manage crises in New York City continued, enabling a response that drew on the resources of New York City and neighbouring communities, states and the federal government. Availability of resources--which substituted for redundancy of personnel, equipment and space--pre-existing relationships that eased communication challenges as the emergency developed and the continuation of organisational patterns of response integration and role assignments were among the factors that contributed to resilience following the attack.