Disasters often impact fundamental elements of a community—physical infrastructure, health and social services, social connectedness—that affect the health of its residents. Accordingly, the recovery period, with its attendant influx of resources and synchronization of planning processes, presents an important opportunity to redesign physical and social environments in a manner that will improve a community’s long-term health status while simultaneously reducing its vulnerability to future hazards. In response to concerns that health considerations are not adequately incorporated into disaster recovery decision making, the Institute of Medicine assembled an ad hoc committee to develop recommendations and guidance on strategies for mitigating disaster-related health impacts and optimizing the use of recovery resources and pursue more deliberately and thoughtfully the goal of healthier and more resilient and sustainable communities.
The committee found that, although there is growing emphasis on incorporating resilience-building efforts into the recovery process, such efforts tend to focus on hardening critical infrastructure and not on strengthening the health and resiliency of individuals and communities. Unfortunately, the idea of using disaster recovery efforts to enhance the health of communities and their residents is not widespread. The committee noted few communities taking this forward-looking and synergistic approach; as a result, important opportunities are being missed.
Recognizing that disaster recovery is a process of community strategic planning and that communities can build on prior strategic planning initiatives and cross-sector collaborations, the committee developed a framework for integrating health considerations into recovery decision making. Each step in the strategic planning process presents opportunities for this integration:
- Visioning—Recovery is viewed as an opportunity to advance a shared vision of a healthier and more resilient and sustainable community.
- Assessment—Community health assessments and hazard vulnerability assessments provide data that show the gaps between the community’s current status and desired state and inform the development of goals, priorities, and strategies.
- Planning—Health considerations are incorporated into recovery decision making across all sectors. This integration is facilitated by involving the health sector in integrated planning activities and by ensuring that decision makers are sensitized to the potential health impacts of all recovery decisions.
- Implementation—Recovery resources are used in creative and synergistic ways so that the actions of the health sector maximize health outcomes and the actions of other sectors yield co-benefits for health. A learning process is instituted so that the impacts of recovery activities on health and well-being are continuously evaluated and used to inform iterative decision making.
In this report, the committee presents 12 recommendations, along with sector-specific guidance, that provide strategies for leveraging each of these opportunities. Success, however, will depend on breaking down the barriers to cross-sector collaboration, thereby enabling community planners, emergency managers, health professionals, and other key governmental and nongovernmental stakeholders to come together around a shared goal, with each sector bringing its resources (knowledge, tools, funding streams) to bear. The end result will be a community that is a healthier, more livable place in which current and future generations can grow and thrive, and one better prepared for future adversities.