Map Your Neighborhood?

Have any of you PREPostrophytes done the Map Your Neighborhood program? It received an award from FEMA and appears simple to do.  Please tell us your experience with it.

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Preventing the Ultimate Disaster

Nuclear disarmament: Move the base camp | The Economist.

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Hot Out of Obama’s Office

What moves us?

The nation’s first National Prevention Strategy came out today and it’s a step forward for creating a disaster resilient nation.  What moves us towards a healthier nation moves us towards greater resilience.

Where did the distinguished authors and advisors place disaster resilience in their thinking?  High up.  They specifically mentioned it in the first paragraph:

The strength and ingenuity of America’s people and communities have driven America’s success. A healthy and fit nation is vital to that strength and is the bedrock of the productivity, innovation, and entrepreneurship essential for our future. Healthy people can enjoy their lives, go to work, contribute to their communities, learn, and support their families and friends. A healthy nation is able to educate its people, create and sustain a thriving economy, defend itself, and remain prepared for emergencies. 

While it might instead have said “…and demonstrate resiliency to emergencies,” I am glad the issue of preparedness got such prominent mention.

The Strategy promotes resilience again in the section on “Healthy and Safe Community Environments” which is the first of four Strategic Directions. “Healthy and safe community environments are able to detect and respond to both acute (emergency) and chronic (ongoing) threats to health.” (p.14) Strengthening public health departments to provide essential services is a key recommendation in this section with which we all agree (p.15). Many of the activities that the Strategy states the Feds should do under this Strategic Direction do promote resilience and the one that most directly does is for the Feds to “support state, tribal, local, and territorial partners in strategic health security planning efforts for pandemics, biological and chemical attacks, incidents affecting food and agriculture, natural disasters, and other catastrophic events.”  Still, this lukewarm statement is further evidence that we must work at hyper-local levels to improve resilience.

A word search for “resilience” finds it only once in the text (“Supportive relationships, such as family connections, long- term friendships, and meaningful connections between youth and adults including students and teachers or coaches, build resilience and well-being.”) (p.48)

Missed opportunities for mentioning resilience IMHO:

  • The text accompanying the recommendation to strengthen health departments focuses on laboratory capacity and quality improvement with no mention specifically of their leadership role in building resilient communities.
  • The Key Indicator of success for the goal of strengthening public health departments is the, “proportion of state public health agencies that can convene, within 60 minutes of notification, a team of trained staff who can make decisions about appropriate response and interaction with partners”.

I guess we had no better indicators to use?

But resilience is a “latent” concept—it’s not measured directly but rather by other indicators that we think underlay resilience.  So, here are some Indicators that I’d say are directly related to a resilient community:

  • Proportion of children and adults who are vaccinated annually against seasonal influenza (child target = 80; 65+ target = 90%)
  • Proportion of adults reporting that they receive the social and emotional support they need (target = 88%)
  • Proportion of adults (from racial/ethnic minority groups) in fair or poor health (target = 8.8%, the baseline for non-Hispanc Whites)

Oh, the Feds will “support research and evaluation studies that examine health literacy factors in the study of other issues (e.g., patient safety, emergency preparedness, health care costs).”  Now that’s an RFA I can respond to.

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You Must Read This: RWJ’s Resilience Fiction

I recommend reading pages 31 to 34 of the RWJ report entitled “Vulnerability 2030:  Scenarios on Vulnerability in the United States.” Scenario 4, “Creative Communities”, imagines an United States in which the federal government is so constrained by budget cuts that Americans seek solutions to their community problems by engaging at a very local level.  In their words, “the policy focus is shifting from creating a safety net to helping everyone achieve his or her full potential.”  Though the report was not meant to address disasters or resiliency, the Creative Community scenario depicts community activities that will improve resiliency nonetheless.  It’s a must read.

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These Doctors Are In

Keep an eye on the National Physicians Alliance.  They include “civic engagement” among the principles they stand for.   Here’s one example from their website that is relevant to building resilience:

The NPA is a founding member of Rx Democracy, a national nonpartisan network of more than 18 national and regional groups representing America’s best clinicians, health professionals and students. Together with concerned citizens’ groups, this network helps patients and those who care for them to have a voice in their health care and their community.  We partner with civic organizations to provide opportunities for nonpartisan voter and civic engagement in health care settings and beyond.

Those of us looking for support in resilience building may find support in this group:

If you have an idea for a local project or pilot program that shares the NPA’s vision, we want to enable your success.  If you are already working on projects that resonate with the NPA’s mission, we want to help.  If you’re simply frustrated, we want to connect you with docs who share your feelings and are ready to do something about them

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