Community resilience looks at a community’s ability to withstand, adapt, and recover from a disaster or public health emergency. The overall health of a community is a key role when planning for a healthy, resilient, and sustainable community. To address community resilience, local health departments (LHDs) are working to strengthen their public health and healthcare systems, allowing them to improve their community’s physical, behavioral, and social health as they prepare for, respond to, and recover from a disaster or public health event.
NACCHO’s preparedness portfolio focuses on encouraging social connectedness, enhancing coordination of health and human services through partnerships, and building a culture of resilience. More specifically, NACCHO’s projects emphasize how LHDs can optimize the use of resources and mitigate future disaster-related impacts by sharing lessons learned and promising practices of working towards the goal of creating healthier, sustainable, and resilient communities.
The National Association of County and City Health Officials, the Association of State and Territorial Health Officials, the Council of State and Territorial Epidemiologists, and the Association of Public Health Laboratories partnered to conduct an impact assessment survey on recent cuts to Public Health and Emergency Preparedness (PHEP) grants. Congress has not passed emergency supplemental funding for Zika, and as a result the Centers for Disease Control and Prevention will be redirecting $44.25 million of PHEP funds away from local and state health departments to support the national Zika response. As a result, state and local health departments are losing the resources they need to effectively respond to Zika and other emergencies at the community level. The coordinating organizations released the following two complementary reports describing the impact of redirected PHEP funds.
NACCHO, in partnership with the Office of the Assistant Secretary for Preparedness and Response (ASPR) is working to promote, disseminate, and evaluate the awareness of the 2015-2018 National Health Security Strategy (NHSS) at the local level.
When looking through the lens of the NHSS, NACCHO’s projects are working to enhance national health security, foster community resilience, and strengthen healthcare, public health, and emergency management systems. Through this initiative, NACCHO has developed a number of resources, as well as an awards program to highlight national health security at the local level.
- NHSS Communication Strategy: NACCHO developed a NHSS strategic messaging guide, which can be used to encourage LHDs and other entities to embrace and understand the 2015 NHSS by utilizing talking points and key messages when referring to work related to national health security.
- NHSS Awards Program: NACCHO will recognize three winners at NACCHO Annual 2016 by working with a task force to review and score applications. These awards will recognize the work being done at the local level and will help make the connection between national health security and LHDs’ daily activities.
NACCHO continues to evaluate the current status of the NHSS at the local level by working to determine the qualitative experiences of LHDs in regard to national health security through an evaluation of ongoing activities, key-informant interviews, and stories from the field. Results from the ongoing evaluation will be used to inform future NHSS-related strategies and initiatives related to communicating NHSS at the local level.
Using Mobilizing for Action through Planning and Partnerships (MAPP), NACCHO piloted the Community Resilience Project to determine whether the MAPP process can be used to effectively improve community resilience. Three local health departments were selected as pilot sites and were able to seamlessly integrate community resilience into existing MAPP processes.
The LHD pilot sites leveraged established relationships and partnerships within the community to address priority areas. As a result, the three sites showed measures of improvement in community resilience, which indicates that these results can be replicated by other LHDs in the MAPP process
Public health and emergency response agencies are responsible for safeguarding the nation’s welfare during public health emergencies and disasters. Having this responsibility comes with a frequently strained and stressed work environment, which may induce stress reactions among the workforce. If this stress is unaddressed, workers may cause harm to themselves, their families, and the overall community. LHDs can play a role in supporting a resilient workforce and helping colleagues during an intense time, as well as during the transition back to a normal state of activities.
NACCHO developed the Psychological First Aid for Leaders (PFA-L) training. This free 90-minute interactive online training video helps leaders understand and address their staff’s stress risks and reactions to create a resilient workplace. PFA-L is based on the principles of Psychological First Aid, which is an evidence-informed approach for assisting children, adolescents, adults, families, and responders in the aftermath of a disaster. The purpose of this course is to:
- Introduce leaders to the concept of Psychological First Aid as a leadership tool to build workforce resilience
- Educate leaders about the core components of Psychological First Aid
- Provide an opportunity for leaders to apply Psychological First Aid within scenario-based exercises
Alternative Language and Accessible Disaster Behavioral Health Videos
NACCHO, in collaboration with the Northeast Texas Public Health District and the City of El Paso Department of Public Health, produced two sets of behavioral health videos (one set in English and the other in Spanish) to help first responders, children, and the general public manage and cope with stress after disasters or traumatic events. All videos also contain both closed captioning and an on-screen American Sign Language (ASL) interpreter. These videos can be used at response sites, such as points of dispensing (PODs) or emergency shelters, during and following an emergency or traumatic event to provide information and guidance to those dealing with stress and the psychological effects of the event. Visit the NACCHO Youtube page to access the English video playlist and the Spanish video playlist.
While disaster planning is not a new field for public health, recovery planning has become a greater area of interest for LHDs as real-world events have demonstrated that long-term recovery and community resiliency are critical to the population’s post-disaster health and well-being. NACCHO continues to collect data on recovery planning and practice.
More specifically, NACCHO is focusing on lessons learned from Hurricane Sandy and is working to collect and analyze evaluations, after action reports from Sandy-affected areas, research findings, and other published materials, as well as collecting qualitative data through facilitated workshops and key informant interviews.
As the older adult population continues to rise, preparing this population for a public health emergency or event can lead to barriers for LHDs.
For example, characteristics of older adults such as impaired mobility, weakened sensory awareness, multiple chronic diseases, and social economic limitations can put the older adult population at a greater risk of illness or death during an emergency. With a growing need to better coordinate the way we prepare for and address the needs of older adult populations, NACCHO continues to research and develop resources that can be utilized by both LHDs and their partners.
- Directory of Organizations Serving Older Adults: NACCHO developed this tool to aid LHDs in identifying and reaching out to organizations that can be of assistance when preparing for and responding to events that impact older adults within a community.
- Action Options to Improve Preparedness for Community-Dwelling Older Adults: NACCHO funded three LHDs to implement and test recommendations in the Centers of Disease Control and Prevention’s (CDC’s) Identifying Vulnerable Older Adults and Legal Options for Increasing Their Protection During All-Hazards Emergencies. The selected LHDs tested the feasibility of realistically implementing the guide’s strategies by characterizing their community-dwelling older populations; and determining whether gaps existed that could be filled by additional guidance. This report summarizes the LHDs activities and findings.
NACCHO is also exploring ways to leverage private sector partners, specifically chain and independent pharmacies, for the distribution and dispensing of antiviral medications in emergencies. As healthcare professionals, pharmacists already play a critical role in the provision of health and wellness services, in chronic disease management, health screenings, and providing health education. In recent years, pharmacists have become a “first line” resource for health as highly trained and accessible professionals.
In July 2015, the NACCHO Board approved the Statement of Policy, “Local Health Department and Pharmacy Partnerships for Enhancing Medication Dispensing during Emergencies,” which offers recommendations on collaborating with pharmacy partners. To put these recommendations into action, NACCHO established a Pharmacy Partners workgroup that develops practical tools for local health departments. NACCHO is also exploring pharmacy practice laws and the roles of pharmacists in public health emergencies.
Through this research and its technical assistance program, NACCHO is helping health departments build partnerships with pharmacies that are formalized through contracts and memorandum of understanding (MOUs). These can be used to ensure pharmacists practice at the full extent of their license in a severe pandemic or other public health emergency