In the devastation that follows a major disaster, there is a need for multiple sectors to unite and devote new resources to support the rebuilding of infrastructure, the provision of health and social services, the restoration of care delivery systems, and other critical recovery needs. In some cases, billions of dollars from public, private and charitable sources are invested to help communities recover. National rhetoric often characterizes these efforts as a “return to normal.” But for many American communities, pre-disaster conditions are far from optimal. Large segments of the U.S. population suffer from preventable health problems, experience inequitable access to services, and rely on overburdened health systems. A return to pre-event conditions in such cases may be short-sighted given the high costs-both economic and social-of poor health. Instead, it is important to understand that the disaster recovery process offers a series of unique and valuable opportunities to improve on the status quo. Capitalizing on these opportunities can advance the long-term health, resilience, and sustainability of communities-thereby better preparing them for future challenges.

Healthy, Resilient, and Sustainable Communities After Disasters identifies and recommends recovery practices and novel programs most likely to impact overall community public health and contribute to resiliency for future incidents. This book makes the case that disaster recovery should be guided by a healthy community vision, where health considerations are integrated into all aspects of recovery planning before and after a disaster, and funding streams are leveraged in a coordinated manner and applied to health improvement priorities in order to meet human recovery needs and create healthy built and natural environments. The conceptual framework presented in Healthy, Resilient, and Sustainable Communities After Disasters lays the groundwork to achieve this goal and provides operational guidance for multiple sectors involved in community planning and disaster recovery.

Healthy, Resilient, and Sustainable Communities After Disasters calls for actions at multiple levels to facilitate recovery strategies that optimize community health. With a shared healthy community vision, strategic planning that prioritizes health, and coordinated implementation, disaster recovery can result in a communities that are healthier, more livable places for current and future generations to grow and thrive-communities that are better prepared for future adversities.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON POST-DISASTER RECOVERY OF A COMMUNITY'S PUBLIC HEALTH, MEDICAL, AND SOCIAL SERVICES
• Reviewers
• Preface
• Acronyms and Abbreviations
• Glossary
• Abstract
• Summary
  • STUDY CHARGE AND SCOPE
  • AUDIENCES FOR THIS REPORT
  • A FRAMEWORK FOR INTEGRATING HEALTH INTO DISASTER RECOVERY
  • A HEALTHY, RESILIENT, SUSTAINABLE COMMUNITY RECOVERY VISION
  • A HEALTH IN ALL POLICIES APPROACH TO DISASTER RECOVERY
  • SECTOR-SPECIFIC STRATEGIES
  • CONCLUSION
  • REFERENCES
• I. A HEALTHY COMMUNITY APPROACH TO DISASTER RECOVERY
  • 1. Introduction
    • CHARGE TO THE COMMITTEE
    • APPROACH TO ADDRESSING THE CHARGE
    • DISASTER RECOVERY IN THE CONTEXT OF COMPREHENSIVE RISK MANAGEMENT
    • THE CURRENT POLICY CONTEXT FOR HEALTH-FOCUSED RECOVERY: WHY NOW
    • HOW THIS REPORT IS INTENDED TO BE USED
    • REFERENCES
  • 2. Post-Disaster Opportunities to Advance Healthy, Resilient, and Sustainable Communities
    • WHAT IS A HEALTHY COMMUNITY
    • EQUITY, RESILIENCE, SUSTAINABILITY, AND HEALTH IN THE POST-DISASTER CONTEXT
    • THE NEED FOR AN INTEGRATED APPROACH
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS
    • REFERENCES
  • 3. A Framework for Integrating Health into Recovery Planning
    • THE STRATEGIC PLANNING PROCESS AS A FRAMEWORK
    • A HEALTHY, RESILIENT, SUSTAINABLE COMMUNITY VISION FOR DISASTER RECOVERY
    • ASSESSMENTS TO INFORM RECOVERY PLANNING
    • PLANNING FOR RECOVERY
    • IMPLEMENTATION
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS AND RECOMMENDATIONS
    • REFERENCES
  • 4. Leveraging Recovery Resources in a Coordinated Manner to Achieve Healthier Post-Disaster Communities
    • RESOURCE IMPLICATIONS OF DISASTER DECLARATIONS
    • FEDERAL RECOVERY PROGRAMS AND THEIR APPLICATIONS TO HEALTH RECOVERY
    • NONFEDERAL RESOURCES FOR RECOVERY
    • FUNDING PATHWAYS
    • CHALLENGES IN APPLYING FUNDING TO THE CREATION OF HEALTHY COMMUNITIES
    • OVERCOMING BARRIERS TO COORDINATION OF FUNDING TO SUPPORT A HEALTHY COMMUNITY APPROACH TO RECOVERY
    • SUMMARY OF FINDINGS AND RECOMMENDATION
    • Annex 4-1 Funding for Disaster Recovery
    • REFERENCES
• II. OPERATIONAL GUIDANCE TO SUPPORT A HEALTHY COMMUNITY APPROACH TO DISASTER RECOVERY
  • 5. Public Health
    • PUBLIC HEALTH IN THE CONTEXT OF A HEALTHY COMMUNITY
    • DISASTER-RELATED PUBLIC HEALTH CHALLENGES
    • PUBLIC HEALTH SECTOR ORGANIZATION AND RESOURCES
    • PRE-DISASTER PUBLIC HEALTH SECTOR PRIORITIES
    • THE CONTINUUM OF POST-DISASTER PUBLIC HEALTH RESPONSE AND RECOVERY PRIORITIES
    • EARLY POST-DISASTER PUBLIC HEALTH RECOVERY PRIORITIES
    • INTERMEDIATE- TO LONG-TERM RECOVERY: OPPORTUNITIES TO ADVANCE HEALTHIER AND MORE RESILIENT AND SUSTAINABLE COMMUNITIES
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS AND CONCLUSIONS
    • PUBLIC HEALTH SECTOR RECOVERY CHECKLIST
    • Pre-Event
    • Short-Term Recovery
    • Intermediate- to Long-Term Recovery
    • REFERENCES
  • 6. Health Care
    • HEALTH CARE IN THE CONTEXT OF A HEALTHY COMMUNITY
    • DISASTER-RELATED HEALTH CARE CHALLENGES
    • HEALTH CARE SECTOR ORGANIZATION AND RESOURCES
    • PRE-DISASTER HEALTH CARE SECTOR PRIORITIES
    • EARLY POST-DISASTER HEALTH CARE RECOVERY PRIORITIES
    • INTERMEDIATE- TO LONG-TERM RECOVERY: OPPORTUNITIES TO ADVANCE HEALTHIER AND MORE RESILIENT AND SUSTAINABLE COMMUNITIES
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS AND RECOMMENDATION
    • HEALTH CARE SECTOR RECOVERY CHECKLIST
    • Pre-Event
    • Short-Term Recovery
    • Intermediate- to Long-Term Recovery
    • REFERENCES
  • 7. Behavioral Health
    • BEHAVIORAL HEALTH IN THE CONTEXT OF A HEALTHY COMMUNITY
    • DISASTER-RELATED BEHAVIORAL HEALTH CHALLENGES
    • BEHAVIORAL HEALTH SECTOR ORGANIZATION AND RESOURCES
    • PRE-DISASTER BEHAVIORAL HEALTH SECTOR PRIORITIES
    • THE CONTINUUM OF POST-DISASTER BEHAVIORAL HEALTH INTERVENTIONS
    • SPECIAL CONSIDERATIONS FOR VULNERABLE POPULATIONS
    • BUILDING A MORE RESILIENT AND SUSTAINABLE BEHAVIORAL HEALTH SECTOR
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS AND RECOMMENDATION
    • BEHAVIORAL HEALTH SECTOR RECOVERY CHECKLIST
    • Pre-Event
    • Short-Term Recovery
    • Intermediate- to Long-Term Recovery
    • REFERENCES
  • 8. Social Services
    • SOCIAL SERVICES IN THE CONTEXT OF A HEALTHY COMMUNITY
    • DISASTER-RELATED SOCIAL SERVICES CHALLENGES
    • SOCIAL SERVICES SECTOR ORGANIZATION AND RESOURCES
    • PRE-DISASTER SOCIAL SERVICES SECTOR PRIORITIES
    • THE CONTINUUM OF POST-DISASTER SOCIAL SERVICES INTERVENTIONS
    • EARLY POST-DISASTER SOCIAL SERVICES RECOVERY PRIORITIES
    • INTERMEDIATE- TO LONG-TERM RECOVERY PRIORITIES
    • SPECIAL CONSIDERATIONS FOR CHILDREN AND THE ELDERLY
    • BUILDING A MORE RESILIENT AND SUSTAINABLE SOCIAL SERVICES SECTOR
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS AND RECOMMENDATION
    • SOCIAL SERVICES SECTOR RECOVERY CHECKLIST
    • Pre-Event
    • Short-Term Recovery
    • Intermediate- to Long-Term Recovery
    • REFERENCES
  • 9. Place-Based Recovery Strategies for Healthy Communities
    • A SYSTEMS VIEW OF A HEALTHY COMMUNITY
    • DISASTER IMPACTS ON COMMUNITY SYSTEMS: IMPLICATIONS FOR HEALTH AND RECOVERY
    • ORGANIZATIONAL STRUCTURES AND RESOURCES FOR HEALTHY COMMUNITY PLANNING AND REDEVELOPMENT
    • PRE-DISASTER PRIORITIES
    • EARLY POST-DISASTER RECOVERY PRIORITIES
    • INTERMEDIATE- TO LONG-TERM RECOVERY: OPPORTUNITIES TO ADVANCE HEALTHIER AND MORE RESILIENT AND SUSTAINABLE COMMUNITIES
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS AND RECOMMENDATIONS
    • PLACE-BASED RECOVERY STRATEGIES CHECKLIST
    • Pre-Event
    • Short-Term Recovery
    • Intermediate- to Long-Term Recovery
    • REFERENCES
  • 10. Healthy Housing
    • HOUSING IN THE CONTEXT OF A HEALTHY COMMUNITY
    • DISASTER-RELATED HOUSING CHALLENGES
    • HOUSING SECTOR ORGANIZATION AND RESOURCES
    • PRE-DISASTER HOUSING SECTOR PRIORITIES
    • EARLY POST-DISASTER HOUSING RECOVERY PRIORITIES
    • SPECIAL CONSIDERATIONS FOR VULNERABLE POPULATIONS
    • INTERMEDIATE- TO LONG-TERM RECOVERY: OPPORTUNITIES TO ADVANCE HEALTHIER AND MORE RESILIENT AND SUSTAINABLE COMMUNITIES
    • RESEARCH NEEDS
    • SUMMARY OF FINDINGS AND RECOMMENDATION
    • HOUSING SECTOR RECOVERY CHECKLIST
    • Pre-Event
    • Short-Term Recovery
    • Intermediate- to Long-Term Recovery
    • REFERENCES
• III. APPENDIXES
  • A. The Federal Policy Environment Influencing Disaster Recovery
    • ROBERT T. STAFFORD DISASTER RELIEF AND EMERGENCY ASSISTANCE ACT, MOST RECENTLY AMENDED BY THE SANDY RECOVERY IMPROVEMENT ACT OF 2013
    • DISASTER MITIGATION ACT OF 2000
    • HOMELAND SECURITY ACT OF 2002
    • THE POST-KATRINA EMERGENCY REFORM ACT OF 2006 AND THE NATIONAL DISASTER RECOVERY FRAMEWORK
    • PANDEMIC AND ALL-HAZARDS PREPAREDNESS ACT, PANDEMIC AND ALL-HAZARDS PREPAREDNESS REAUTHORIZATION ACT OF 2013 AND NATIONAL HEALTH SECURITY STRATEGY
    • PRESIDENTIAL POLICY DIRECTIVE 8: NATIONAL PREPAREDNESS
    • HURRICANE SANDY REBUILDING STRATEGY
    • REFERENCES
  • B. Disaster Recovery Funding: Achieving a Resilient Future?
    • PURPOSE OF REPORT
    • INTRODUCTION
    • TIMING OF ASSISTANCE
    • HORIZONTAL AND VERTICAL INTEGRATION
    • PRE- AND POST-DISASTER RECOVERY FUNDING ACROSS THE DISASTER RECOVERY ASSISTANCE NETWORK
    • DISASTER RECOVERY FUNDING PROVIDERS AND RECIPIENTS
    • A TEMPORAL REVIEW OF DISASTER RECOVERY FUNDING
    • KEY CHALLENGES AND OPPORTUNITIES TO ACHIEVING DISASTER RESILIENT OUTCOMES
    • RECOMMENDATIONS
    • ENHANCE THE INTEGRATION OF HEALTH CARE ORGANIZATIONS AND PROVIDERS IN THE DISASTER RECOVERY ASSISTANCE NETWORK
    • DISASTER RECOVERY IN THE AGE OF CLIMATE CHANGE
    • REFERENCES
  • C. Additional Resources
    • BUILDING SOCIAL COHESION
    • DISASTER BEHAVIORAL HEALTH, EMOTIONAL, AND SPIRITUAL CARE
    • DISASTER CASE MANAGEMENT
    • HEALTH CARE SYSTEM RECOVERY
    • MEASURING AND ASSESSING COMMUNITY HEALTH STATUS
    • MODEL POST-DISASTER RECOVERY PLANS AND PLANNING GUIDES
    • PLANNING FOR VULNERABLE POPULATIONS, INCLUDING CHILDREN
    • POST-DISASTER RECOVERY TOOLS
    • PROMOTING INDIVIDUAL AND COMMUNITY PREPAREDNESS
    • WORKER AND HOMEOWNER HEALTH PROTECTION RESOURCES
  • D. Measures and Tools for Healthy Communities
    • AMERICA'S HEALTH RANKINGS^®
    • COUNTY HEALTH RANKINGS
    • SUSTAINABLE COMMUNITIES INDEX
    • HEALTHY COMMUNITIES TRANSFORMATION INITIATIVE
    • LIVABILITY INDEX
    • SOCIAL VULNERABILITY INDEX
    • REFERENCES
  • E. Committee-Identified Research Needs
    • OVERARCHING RESEARCH NEEDS
    • PUBLIC HEALTH RECOVERY
    • HEALTH CARE RECOVERY
    • BEHAVIORAL HEALTH RECOVERY
    • SOCIAL SERVICES RECOVERY
    • PLACE-BASED STRATEGIES FOR RECOVERY
    • HEALTHY HOUSING RECOVERY
  • F. Key to Select Terms Used to Describe Primary Actors and Key Partners in Chapter 5–10 Checklists
  • G. Public Committee Meeting Agendas
    • AGENDA
    • AGENDA
    • AGENDA
    • AGENDA
    • Agenda
    • AGENDA
  • H. Committee Biosketches

This study was supported by contracts between the National Academy of Sciences and the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response (Contract No. HHSO100201200037A and Contract No. 1 HITEP130013-01-00); the U.S. Department of Housing and Urban Development (Contract No. 1 HITEP130013-01-00); and the Robert Wood Johnson Foundation (Contract No. 71003 and Contract No. 72398). Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.

Suggested citation:

IOM (Institute of Medicine). 2015. Healthy, resilient, and sustainable communities after disasters: Strategies, opportunities, and planning for recovery. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.