IDRC14-ppp-Gowan_Monica

5th
International Disaster and Risk Conference IDRC 2014
‘Integrative Risk Management - The role of science, technology & practice‘ • 24-28 August 2014 • Davos • Switzerland
www.grforum.org
Integrative Disaster Resilience:
bringing well-being to self-management
of disaster risk and uncertainty
Monica E. Gowan, PhD, MS, Mayo Clinic, USA
Ray C. Kirk, PhD, University of Canterbury, New Zealand
Jeff A Sloan, PhD, Mayo Clinic, USA

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For detailed results, see
www.hqlo.com/content/12/1/85
"Building resiliency: a cross-sectional study
examining relationships among health-related
quality of life, well-being, and disaster
preparedness" (Gowan, Kirk & Sloan, 2014)

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bringing well-being to self-management of disaster risk and uncertainty
Evidence-based Training
• 2014 – Results published
www.hqlo.com/content/12/1/85
• 2014 – Postdoctoral research
fellowship completed
• 2012 – PhD awarded
• 2010—2014 Canterbury
Earthquake Sequence
• 2008—2009 PhD data collection
• 2006—2007 PhD study proposal
• 2004—2006 Postgrad Certificate
in Public Health Preparedness
• Pre-2004—Earth Science career
Acknowledgments
• Mayo Clinic Division of
Emergency Management (USA)
• Mayo Clinic Department of
Health Sciences Research (USA)
• University of Canterbury Health
Sciences Centre (NZ)
• GNS Science (NZ)
• Earthquake Commission (NZ)
• Scholarships
– University of Canterbury
– NZ Ministry of Education

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Part I.
HAZARDS AND RISKSCAPES

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The Seismic Hazardscape - Tsunamis
Trans-Pacific (distant) + Regional + Local Earthquakes + Submarine Landslides
Image credit: US NWS Tsunami Warning Center

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Subduction Zone + Transform Plate Boundary + Regional + Local Faulting + Volcanic Activity
Image credit: public domain
The Seismic Hazardscape - Earthquakes

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Wellington Fault (GNS Science) Wellington M7+ Scenario (MCDEM)

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Study Area (Statistics NZ) Tsunami Inundation Map (GNS)

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Survey Distribution
• Self-complete
questionnaire posted to
households
• Sampling Frame
n = 6312
• Sample Size
n = 2451
• Response Rate
n = 695 (28.5%)
• Margin of error + 3.8%
• 80% power r > 0.11

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Part II.
THEORY, RESEARCH QUESTIONS, AND INSTRUMENTS FOR
EXPLORING INTEGRATIVE DISASTER RESILIENCE

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“Health is the extent to which an individual or group is able…to change
or cope with the environment. Health is therefore…a positive
concept emphasising social and personal resources, as well as
physical capacities.”
WHO Ottawa Charter, 1986
“Research and case studies from around the world provide convincing
evidence that health promotion is effective."
WHO Jakarta Declaration, 1997
“The Bangkok Charter identifies actions, commitments and pledges
required to address the determinants of health in a globalised world
through health promotion.”
WHO Bangkok Charter, 2005

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Integrative Disaster
Resilience: bringing well-
being to self-management
of disaster risk
and uncertainty
Concept
Operational
Definition Construct
Indicator or
Domain
Measure or
Specific Aspect
Survey
Question
Social
Well Being
FS (Hawthorne, 2006) Q14
Emotional
Well Being
SOC13
(Antonovsky, 1987)
Q16
Spiritual
Well Being
SS20
(Boyd-Wilson et al.
2004, 2006)
Q17
Physical
Health Status
SF12(v1)
(Ware et al. 1996)
Health-related
Quality of Life
Mental Health
Status
SF12(v1)
(Ware et al. 1996)
Q19-28
Health-
Protective
Attitudes
(Personal
Health and
Well-Being/
Quality of Life)
Global Quality
of Life
Global Life
Satisfaction/
Subjective
Well Being
SWLS
(Diener et al. 1985)
Q29
Q35.1Discussing
Preparedness
With Social Network
With Neighbourhood Q35.2
Q35.3
Q35.4
Q35.6
Seeking
Preparedness
Information
Risks & Consequences
How to Prepare
How to Respond
How to Evacuate Q35.7
Q35.8Taking
Preparedness
Actions
Earthquake
Tsunami Q35.9
Q35.10
Q35.11
Evacuation
Planning
Survival/Escape
Evacuation/Dislocation
Communications Q35.12
Q35.13
Q35.14
Evacuation
Plan Testing
Evacuation Route
Assembly Area
Participated in Drill Q35.15
Q35.16
Q35.17
Q35.18
Health
Management
Resources
(Protective
Factors)
Health-
Protective
Behaviours
(Personal
Disaster
Preparedness)
Earthquake
and Tsunami
Preparedness
Evacuation
Kit Readiness
Survival/Escape
Communications
Kit Accessible Q35.19
Multidimensional
Health-Related QoL
- Physical well-being
- Mental well-being
- Emotional well-being
- Spiritual well-being
- Social well-being
Global QoL
- Global well-being
- Subjective well-being

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of disaster risk
and uncertainty
Concept
Operational
Definition Construct
Indicator or
Domain
Measure or
Specific Aspect
Survey
Question
Social
Well Being
FS (Hawthorne, 2006) Q14
Emotional
Well Being
SOC13
(Antonovsky, 1987)
Q16
Spiritual
Well Being
SS20
(Boyd-Wilson et al.
2004, 2006)
Q17
Physical
Health Status
SF12(v1)
(Ware et al. 1996)
Health-related
Quality of Life
Mental Health
Status
SF12(v1)
(Ware et al. 1996)
Q19-28
Health-
Protective
Attitudes
(Personal
Health and
Well-Being/
Quality of Life)
Global Quality
of Life
Global Life
Satisfaction/
Subjective
Well Being
SWLS
(Diener et al. 1985)
Q29
Q35.1Discussing
Preparedness
With Social Network
With Neighbourhood Q35.2
Q35.3
Q35.4
Q35.6
Seeking
Preparedness
Information
Risks & Consequences
How to Prepare
How to Respond
How to Evacuate Q35.7
Q35.8Taking
Preparedness
Actions
Earthquake
Tsunami Q35.9
Q35.10
Q35.11
Evacuation
Planning
Survival/Escape
Communications Q35.12
Q35.13
Q35.14
Evacuation
Plan Testing
Evacuation Route
Assembly Area
Participated in Drill Q35.15
Q35.16
Q35.17
Q35.18
Health
Management
Resources
(Protective
Factors)
Health-
Protective
Behaviours
(Personal
Disaster
Preparedness)
Earthquake
and Tsunami
Preparedness
Evacuation
Kit Readiness
Survival/Escape
Communications
Kit Accessible Q35.19
Health-protective
behaviours
- Talking about disaster
- Seeking preparedness
information
- Taking preparedness
action
- Making evacuation
plans
- Testing plans
- Making disaster kits

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The Transtheoretical Model (TTM) of Behaviour Change
(Velicer, Prochaska, Fava, Norman, & Redding, 1998)

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Part III.
RESULTS

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• Regression analyses
– Overall health and well-
being explains 4.6-6.8% of
the variance in evacuation
preparedness behaviour
– Spiritual well-being is the
only QoL variable that
significantly and uniquely
explained variance in
preparedness
• Correlational analyses
– No associations with
evacuation preparedness:
• Mental health status
• Social well-being
• Gender
– Negative associations:
• Physical health status
– Positive associations:
• Spiritual well-being
• Emotional well-being
• Global well-being
• Increasing age (?)

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Perceived value of personal resources
for coping with evacuation

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Level of concern for required evacuation

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Level of engagement in disaster preparedness,
stratified by intention vs action

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Part IV.
FINAL THOUGHTS

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• Discussion
– We observed complex, deeply
personal relationships between well-
being and preparedness
• Well-being matters, measurably
• Spiritual & emotional well-being; life
satisfaction are strongest indicators
• Meaningfulness uniquely important
– Perceptual errors are common
• Risks of disaster underestimated
• "Preparedness" not well understood
• "Readiness" for disaster focused
more on on shelter-in-place and
home mitigation
• "Strengths/Assets" for resilience not
fully recognised
Strengths
- Data set is robust,
reliable, representative,
and generalisable
Limitations
- Correlation does not
imply causation
- Response rate requires
prudent interpretation
- Results time-delimited
- QoL not a strong barrier
or predictor
of disaster risk
and uncertainty

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Risk perception
Is highly variable
Evacuation priorities are
Strongly individualistic

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Nothing is permanent Everything is temporary

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Conclusion 1: Everyone is vulnerable
 Risk biases are universal; resilience is fluid and frequently situational
 Broad-brush messages for the general population are thus important
Conclusion 2: Living with risk can be expansionary
 Meaningful actions empower and strengthen people to self-manage
their own unique circumstances and the uncertainties they face
 Adding resilience awareness to risk awareness can improve readiness
 A strong, multidimensional health identity can promote integrative
disaster resilience and translate to a resilient community
Conclusion 3: Preventive health models have a place in
promoting day-to-day and disaster resilience
 Incorporating D3R into preventive timeframes is imperative

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Added value for the Post 2015 Framework for
Disaster Risk Reduction
• How did your work support the implementation of the Hyogo
Framework for Action:
– Used knowledge, novelty/innovation, and education to build a culture
of safety and resilience
– Identified and reduced underlying risk factors
– Strengthened disaster preparedness for effective intervention and
response
• From your perspective what are the main gaps, needs and
further steps to be addressed in the Post 2015 Framework for
Disaster Risk Reduction in
– Research: Support long-haul research that generates reliable data
– Education & Training: Preparedness is more than surviving 72 hours
– Implementation & Practice: Integrate risk management & resilience
– Policy: Prepare people to be ready for change & suspend expectations

IDRC14-ppp-Gowan_Monica

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