Community Resilience: A Dynamic Model for Public Health 3.0

Abstract

Objective: To establish a model for Public Health 3.0 in order to define and measure community resilience (CR) as a method to measure equity, address structural racism, and improve population health. Design: To develop the CR model, we conducted a literature review in medicine, psychology, early childhood development, neurobiology, and disaster preparedness and response and applied system dynamics modeling to analyze the complex interactions between public systems, policies, and community. Main Outcome Measures:The CR model focuses on community and population health outcomes associated with the policies and practices of the housing, public education, law enforcement, and criminal justice sectors as CR measures. The model demonstrates how behaviors of these systems interact and produce outcome measures such as employment, homelessness, educational attainment, incarceration, and mental and physical health. Results: The policies and practices within housing, public schools, law enforcement, and criminal justice can suppress resilience for families and communities because they are shaped by structural racism and influence the character and nature of resources that promote optimal community health and well-being. Conclusions: Community resilience is relational and place-based and varies depending on the demographic makeup of residents, historical patterns of place-based racism and discrimination, jurisdictional policy, and investment priorities-all influenced by structural racism. Implications for Policy and Practice: Using system dynamics modeling and the CR approach, chief health strategists can convene partners from multiple sectors to systematically identify, measure, and address inequities produced by structural racism that result in and contribute to adverse childhood and community experiences.

Key features of a trauma-informed public health emergency approach: A rapid review

“…Five commentaries ( 65 , 71 , 75 , 89 , 92 ) and 11 descriptive analytic/strategies ( 58 , 60 , 62 , 64 , 72 , 77 , 80 , 82 , 85 , 87 , 93 ) were included. Six “other” types of references were included: a descriptive overview ( 66 ), a letter to the editor ( 70 ), blog post/government information ( 59 ), editorials ( 69 , 76 , 87 ), and one thesis ( 86 ).…”

“…Most of the included studies were led by authors based in and writing about the United States [US 16 ( 58 , 59 , 64 – 67 , 71 – 73 , 80 – 82 , 85 , 86 , 91 , 95 )] or were unclear, with a global/generic perspective [other 13 ( 60 – 63 , 68 , 69 , 74 , 79 , 84 , 89 , 92 – 94 )]. There were two studies each from Sierra Leone ( 76 , 83 ) and China ( 70 , 97 ), and one study each from Australia ( 87 ), Canada ( 88 ), Germany ( 96 ), Czech Republic ( 78 ), South Africa ( 75 ), Argentina ( 77 ), and South Korea ( 90 ).…”

“…Three studies were not related to an emergency response but were trauma-informed strategies more generally ( 58 , 64 , 66 ). Two other references were neither a trauma-informed approach specifically or an emergency response [one discussed the ethics of distressing social marketing campaigns ( 84 ), one a thesis, outlined a proposed community resilience model in addressing adverse childhood experiences ( 86 )].…”

Early relational health: Innovations in child health for promotion, screening, and research

“…The promotion of wellness has now come to be understood as “thinking developmentally,” especially attending to the family's social and relational context, the social determinants of health, and the resilience, resources and safety of local neighborhoods and communities (Ellis & Dietz, 2017; Garner, 2016; Hagan et al., 2017). This pivot for pediatrics toward ensuring the wellness and resilience of the next generation requires a bold and disruptive change from its focus on the individual child's health alone to a contextual and relational focus on the well‐being of the family, the capacities of parents, and the resilience and resources of local communities (Ellis et al., 2022; Garner & Yogman, 2021; Halfon et al., 2014; Schor, 2021; Zuckerman, 2016).…”

“…New approaches and policies are needed, and they are needed now. In some communities, leaders in pediatrics, IMH, public health and anti‐racism are already intensifying their partnerships for change and are including families in the co‐development of early relational approaches and transformative efforts for building community resilience (Ellis et al., 2022; M. Biel, personal communication, September 22, 2021; M. Woodruff, personal communication, October 28, 2021).…”