Oral

The concept of resilience has been receiving increasing attention as a theoretical and practical basis for understanding and mitigating the public health impacts of major stressors. Comparable to the early days of defining exposure in the context of environmental health, resilience encompasses differing discipline-specific realms. The growing literature on environmental public health resilience generally has considered the response of ecosystems, ranging in scale from micro areas to the planet; or of species, particularly those that are endangered. The core tenet of resilience- “bouncing back after a disaster”-- inherently embodies community protection and prevention. Resilience is central to medicine and public health, and the term is increasingly being used in relation to response to disasters. Examples of public health activities that promote resilience of individuals and of communities include vaccination to help the body fight off an infectious agent and lessen the spread of disease; and worker safety and health training to decrease the likelihood of injuries. Public health has a strong and well-tested theoretical base that is highly relevant to the growing theoretical base underlying practical approaches to ecosystem resilience – which in turn can inform public and environmental health. The stressors resulting from Hurricanes Katrina (2005), Rita (2005), Gustav (2008) and Isaac (2012), as well as the Gulf of Mexico Oil Spill (2010), have caused significant physical/structural damage and psychological distress in Gulf Coast communities from Texas to Florida. Within this disaster-prone population, communities in Louisiana, Mississippi and Alabama are uniquely vulnerable because of their historic burden of health disparities. These areas are already characterized by high levels of poverty and limited access to healthcare. Especially in rural areas, many Gulf Coast communities rank at the bottom of the list of most leading health indicators, are served by a fragile public health infrastructure, and remain in a slow, lagging state of disaster recovery. A growing portfolio of research and response related to severe weather events and disasters is underway to unravel complex questions regarding the impact of repeated stressors faced by health-disparate populations. In addition, the Gulf Region Health Outreach Program (GRHOP) represents four integrated, five-year projects to strengthen healthcare in Gulf Coast communities in Louisiana, Mississippi, Alabama, and the Florida Panhandle. Capacity building foci include strengthening primary care community health clinics in the region; increasing environmental health, mental and behavioral health expertise of health professionals; and training community health workers to help residents navigate access to care. This session will examine resilience in the context of repeated natural and technological disasters and severe weather events experienced by disaster-prone, health-disparate populations. Both ongoing research and unprecedented capacity building offer critical lessons learned to address man-made and weather-related stressors, both locally and globally. Presenters will address the scientific tenets of resilience from both an ecosystem and public health perspective; highlight resilience research findings from a public health perspective and in the context of climate change; ascertain the impact of capacity building through GRHOP as an example of strengthening resilience; and describe a biospychosocial approach to resilience, examining the role of culture framed in the context of the natural and built environment. The session will culminate with a transdisciplinary research framework integrating ecosystem and public health resilience.

Session Objectives: 1. Describe the scientific tenets of resilience and their relevance to public health. 2. Identify factors influencing resilience in communities experiencing repeated natural and technological disasters and other severe weather events. 3. Discuss transdisciplinary research approaches to examine the interconnectedness of ecosystem and public health resilience. 4. Examine the role of public health capacity building in strengthening resilience of disaster-prone Gulf Coast communities with a historical burden of health disparities.