Interview by Taylarr Lopez, Communications Specialist, NACCHO
This entry is the second in a series of “NACCHO Annual preview” blog posts, which feature interviews with presenters ahead of NACCHO Annual 2018. Alison Hare, MIA, Community Resilience Officer and Jennifer Kiger, MPH, Chief of the Office of Public Health Preparedness and Response at Harris County Public Health (HCPH), will discuss the importance of community resilience in preparedness and recovery in their upcoming presentation, “Community Resilience After Hurricane Harvey.” Below, they share how Hurricane Harvey created a need for HCPH to create a Community Resilience Officer position and methods used to evaluate a community’s resilience after a catastrophic event.
How do you define resilience and why is it important? What led to HCPH to create the Community Resilience Officer position?
We define community resilience as a community’s capacity to prepare for, withstand, mitigate the effects, and recover from public health emergencies, using a health equity lens. Community resilience is important to us because the healthier and stronger a community is, the more able they are to get through and rebuild after a disaster. Consequently, the more assistance and information we can provide on healthy living, preventative care, and preparedness before a disaster, the better off the community members will be during the disaster and in the long term as they recover and rebuild. Therefore, when Harris County is hit with a disaster, the response and recovery assistance needed within these more resilient communities may be lessened.
HCPH looks at health at the local, state, national, and global levels. When responding to recent global health issues such as Ebola, it became even more apparent that the health concerns of our citizens are affected by what is happening globally. There are some communities within Harris County that are harder to reach than others due to cultural and linguistic isolation, and the Community Resilience Officer (CRO) position was created to make connections with these communities—to link them to the information and services at HCPH, to assist in strengthening their resilience, and to be a resource to them during local and global disasters. The mission of the CRO is to address and strengthen the health and preparedness of individuals and communities within Harris County by creating and sustaining strong relationships between HCPH, external partners, and communities.
How do you evaluate your community’s resilience—both before and after a catastrophic event like Hurricane Harvey?
As there is a growing body of research around measuring community resilience, we have started using several techniques to measure community resilience and are still evaluating best practices. We have conducted several non-emergency and post-disaster Community Assessments for Public Health Emergency Response (CASPERs). These have allowed us to gather a variety of resilience-specific data such as mental health needs, how individual households receive information/communication, and community cohesion before and after floods. Immediately after Hurricane Harvey, we conducted two CASPERs in different areas of the county that were impacted to both evaluate preparedness levels before the storm and quickly assess disaster impact and current needs after the storm. This data was used to respond to immediate needs and guide our priorities and planning for the future.
We are also using geographic information systems to map vulnerabilities and assets with census data, and are fostering partnerships through meetings, focus groups, interviews. We are also currently working on defining a set of indicators, using a mix of data already being captured by HCPH—like mosquito data and epidemiological data—and “resilience-specific” data—like social cohesion indicators among others—to create a numerical base line to determine community’s resilience, and a methodology to measure the impact of HCPH on community resilience.
How involved were the affected communities in providing information about response and recovery efforts?
On the planning side, as we created the Community Health Resilience Strategic Plan, we spoke with a variety of community members and community partners to provide information on what community resilience is and how we, as the public health department, can best support our communities in strengthening our resilience. This influenced how we designed our community engagement plan and how we plan to communicate with our communities and partners.
During our response to Hurricane Harvey, affected communities were also able to provide information to our efforts through our CASPER. The CASPER questions captured the immediate needs of the community—including access to mental health, food, and assistance with mucking/gutting homes. We then used this information to inform where we took our public health services and what services and resources we provided. In addition, we were able to provide this information to our Office of Emergency Management partners, who were able to work with FEMA and other state and federal partners to bring services to the areas that needed it the most.
What was the most valuable lesson learned about resilience after Harvey? How does the department plan to use the information gathered to prepare for the next disaster?
So much of our work is focused on assisting those communities with fewer economic resources, and linguistic or cultural barriers, that we can lose sight of one of the biggest lessons we found from data after Hurricane Harvey. Resilience is needed in all Harris County communities. After Harvey and other recent flooding events, data has shown that even the communities most financially equipped to bounce back from a disaster also need to be better prepared physically, emotionally, and mentally. For example, our assessment of two communities impacted by Hurricane Harvey (one was more affluent, and the other less so) revealed that about 25% of the population in each community demonstrated symptoms of depression or anxiety after the storm that signaled a need for mental health services. However, in the less affluent community, over 50% of the households that reported a mental health need also reported not knowing how to access mental health services. Therefore, it is also important to remember that although all our communities will have needs following a disaster, one of our most important roles can be in facilitating access to care, resources, and information.
Interested in learning more about innovative initiatives like this one? View the full schedule, conference tracks, and objectives, and start making your plans to join hundreds of local public health professionals from across the nation for NACCHO Annual 2018. We look forward to seeing you and your team July 10–12 in New Orleans!