The work is transparent, motivates ongoing refinements, and identifies areas for improved measurements. After validation, such a model can be used to identify effective investments to enhance community resilience. (Disaster Med Public Health Preparedness. 2018;12:127-137).
This is a checklist of actions for healthcare, public health, nongovernmental organizations, and private entities to use to strengthen the resilience of their community’s health sector to disasters. It is informed by the experience of Hurricane Sandy in New York and New Jersey and analyzed in the context of findings from other recent natural disasters in the United States. The health sector is defined very broadly, including—in addition to hospitals, emergency medical services (EMS), and public health agencies—healthcare providers, outpatient clinics, long-term care facilities, home health providers, behavioral health providers, and correctional health services. It also includes community-based organizations that support these entities and represent patients. We define health sector resilience very broadly, including all factors that preserve public health and healthcare delivery under extreme stress and contribute to the rapid restoration of normal or improved health sector functioning after a disaster. We present the key findings organized into 8 themes. We then describe a conceptual map of health sector resilience that ties these themes together. Lastly, we provide a series of recommended actions for improving health sector resilience at the local level. The recommended actions emphasize those items that individuals who experienced Hurricane Sandy deemed to be most important. The recommendations are presented as a checklist that can be used by a variety of interested parties who have some role to play in disaster preparedness, response, and recovery in their own communities. Following a general checklist are supplemental checklists that apply to specific parts of the larger health sector.
Objective
Dispositional optimism, a stable expectation that good things will happen, has been shown to improve health outcomes in a wide range of contexts, but very little research has explored the impact of optimism on post-disaster health and well-being.
Design
Data for this study come from the Centers for Disease Control and Prevention’s Public health systems and mental health community recovery (PHSMHCR) Survey. Participants included 3216 individuals living in counties affected by the April 2011 tornado outbreak in Mississippi and Alabama.
Main outcome measures
This study assesses the effect of dispositional optimism on post-disaster recovery and mental health.
Results
Dispositional optimism was found to have a positive effect on personal recovery and mental health after the disaster. Furthermore, it moderated the relationship between level of home damage and personal recovery as well as the relationship between home damage and post-traumatic stress disorder (PTSD), with stronger effects for those with increased levels of home damage.
Conclusions
The utility of screening for optimism is discussed, along with the potential for interventions to increase optimism as a means of mitigating adverse mental health effects and improving the recovery of individuals affected by disasters and other traumatic events.
Findings provided the basis for an evidence-informed checklist outlining specific actions for public health authorities to take to strengthen public health resilience to future high-consequence infectious disease events.
A significant proportion of people entering the military are discharged within the first 6 months of enlistment. Mental health related problems are often cited as the cause of discharge. This study evaluated the utility of stress inoculation training in helping reduce the attrition of a sample of Air Force trainees at risk for discharge from basic military training. Participants were 178 trainees referred for a psychological evaluation from basic training. Participants were randomly assigned to a 2-session stress management group or a usual-care control condition. Compared with past studies that used less rigorous methodology, this study did not find that exposure to stress management information increased the probability of graduating basic military training. Results are discussed in terms of possible reasons for the lack of treatment effects and directions for future research. The Department of Defense must annually recruit approximately 200,000 young adults for the activeduty armed forces to sustain the United States' ability to effectively pursue national security interests, A number of trends are evident suggesting that meeting this requirement has become more difficult in the 1990s. The proportion of young men and women who express an intention to serve on active duty in one of the military services has declined across the past decade (Cohen, 1998). The percentage of military recruits who score in the top half of the Armed Forces Qualification Test has dropped from 86% in 1990 to 79% in 1997 (McGinty, 1998). In recent testimony to Congress, the Chairman of the Joint Chiefs of Staff reported that the strong economy in the United States is draining the military of its most talented workforce ("Joint Chiefs," 1998). Studies conducted by the U.S. General Accounting Office in the last 2 years have focused attention on the high attrition rate of young people who do choose to enlist in the military (Scarborough, 1998; U.S. General Accounting Office, 1997). Results showed that approximately one third are discharged before completing their first tour of duty. These observations underscore the considerable
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