Unraveling the complexities of disaster management: A framework for critical social infrastructure to promote population health and resilience

Abstract

Complexity is a useful frame of reference for disaster management and understanding population health. An important means to unraveling the complexities of disaster management is to recognize the interdependencies between health care and broader social systems and how they intersect to promote health and resilience before, during and after a crisis. While recent literature has expanded our understanding of the complexity of disasters at the macro level, few studies have examined empirically how dynamic elements of critical social infrastructure at the micro level influence community capacity. The purpose of this study was to explore empirically the complexity of disasters, to determine levers for action where interventions can be used to facilitate collaborative action and promote health among high risk populations. A second purpose was to build a framework for critical social infrastructure and develop a model to identify potential points of intervention to promote population health and resilience. A community-based participatory research design was used in nine focus group consultations (n = 143) held in five communities in Canada, between October 2010 and March 2011, using the Structured Interview Matrix facilitation technique. The findings underscore the importance of interconnectedness of hard and soft systems at the micro level, with culture providing the backdrop for the social fabric of each community. Open coding drawing upon the tenets of complexity theory was used to develop four core themes that provide structure for the framework that evolved; they relate to dynamic context, situational awareness and connectedness, flexible planning, and collaboration, which are needed to foster adaptive responses to disasters. Seven action recommendations are presented, to promote community resilience and population health.

An Agenda to Advance Integrative Resilience Research and Practice: Key Themes From a Resilience Roundtable

“…Emergency management started with a focus on hazard and vulnerability assessments and tended to emphasize traditional top-down and government-led approaches (Fields, Wagner, & Frisch, 2015). But, with the introduction of various national strategies (e.g., National Disaster Recovery Framework, National Health Security Strategy, National Security Strategy) as well as international frameworks [e.g., Sendai Framework, Hyogo Framework for Action (United Nations Office for Disaster Risk Reduction, 2005Reduction, , 2015], these approaches have evolved to use risk analysis to identify, assess, and address a range of social, behavioral, and ecological factors that not only contribute to vulnerability but can be leveraged to mitigate or adapt to those stresses (O'Sullivan, Kuziemsky, Toal-Sullivan, & Corneil, 2013;Paton, Parkes, Daly, & Smith, 2008). These fields of emergency management and disaster risk reduction also began to embrace a fuller appreciation of the range of actors involved in response and recovery, namely civil society organizations working alongside government stakeholders (Eikenberry, Arroyave, & Cooper, 2007;Patterson, Weil, & Patel, 2010).…”

“…Achieving lasting change on a wide scale will require these systems, not just independently but as a dynamic whole, to become more resilient (Chandra et al, 2011;O'Sullivan et al, 2013). While the capacity to prevent, withstand, and mitigate the stress of an incident may already exist across some social networks, a set of networked adaptive capacities is needed to build full community resilience (Norris et al, 2008).…”

Conceptualizing Dimensions and Characteristics of Urban Resilience: Insights from a Co-Design Process

“…As can be seen from Table 1, the Structured Interview Matrix (SIM) fulfills these requirements and, therefore, was selected to structure the discussions. The SIM sessions were conducted according to the methodology outlined in O'Sullivan and Kuziemsky [23] and O'Sullivan and Corneil [24]. Although this method has previously been used mostly for community asset mapping, in this study SIM was used as a technique to facilitate discussions between several groups of experts and to elicit knowledge from them.…”

Adaptation to extreme weather events in complex health and social care systems: The example of older people’s services in England

“…Wilson & Holt, 2001;Curtis & Riva, 2010;Klijn & Snellen, 2010;O'Sullivan et al 2013, Boyd & Folke, 2012Lega & Calciolari , 2012) comprising 'agents' that are variably configured in different settings. These services and supporting infrastructures are impacted by 'extreme weather events' including heatwaves, floods and cold weather, (Oven et al 2012 ;DEFRA, 2012;Hames et al, 2012;IPCC, 2014;Plsek & Greenhalgh, 2001;Department of Health, 2011;Hames et al, 2012), in ways that depend upon their complex characteristics (Lanham et al, 2013;Joseph et al 2013), and vary due to local diversity in physical, social and institutional conditions (Dominelli, 2012;Carr-West et al 2011).…”