1. BRIDGING THE GAP BETWEEN EMERGENCY PREPAREDNESS AND RESPONSE 1
The Role of Preparedness and Health Equity in Building Community Health Resilience
Jenna Maloney
University of Rhode Island
Community Health Resilience Project
Rhode Island Department of Health
April 1, 2015

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The intersection of health preparedness and social or environmental justice is particularly
prevalent when factors such as minorities, inequalities and social vulnerabilities are present.
Health preparedness efforts have not been receptive to all populations varying in financial
resources and income. Although environmental justice advocates for equal involvement for all
people in the community, it is nearly impossible for an entire community varying in wealth and
cultural capital to fully participate. To address the issue of heterogeneous demographics in
environmental involvement, environmental educators must first understand the distinct
demographic characteristics of the community. Depending on the demographics, one’s
perception of nature is filtered by realities relative to their socio-economic standing. While those
of higher economic status and affluence have the resources to relocation, access to transportation
and the means to finance insurance in the face of disaster, minorities are left with few resilient
tactics in times of despair. The decision-making processes for those of lower economic or
minority statuses generally have fewer options. Poor households are more likely to be located in
floodplains, to live in standard housing often in disrepair, and thus more vulnerable to natural
hazards (Morrow 2007). Despite the allocation of resources, financial and systematic health
preparedness of a community, health preparedness policies cannot collectively address the issues
related to community disasters. On the organizational level, social and environmental justice can
be addressed in terms of health preparedness through policy implication. The distinct link
between income inequality and reduced resilience rates raise the question to ethics and political
responsibility when strategically planning the promotion of resilient communities. The political
introduction of environmental inequalities among minority social groups and poor communities
peaked in the 1970s. Neoliberalism, the belief that success is dependent on solely individual

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efforts, has been argued to exacerbate environmental injustice. For example, in1982, major
protests dominated North Carolina to over polychlorinated biphenyl (PCB) landfill in
predominately African American communities. The vocal indignation of the affected citizens led
to arrests, which raised the brows of many environmental justice advocates all around the nation
as well as inspiring activism efforts. Efforts escalated yielding a national study by 1987, Toxic
Wastes and Race in the United States, which further proved environmental injustice is related to
race and socio-economic status is used to determine where major waste facilities are located
(Mascarenhas 2008). Following the Alaskan earthquake of 1964, national vulnerability to loses,
both actual and potential from natural hazards were on the rise as a result of suburbanization, an
increase of habitation in unprotected floodplains, seismic zones and costal locations (Cutter et
al., 2008). By offering incentives similar to the US Federal Emergency Management Agency
(FEMA) announced its National Mitigation Strategy- to reduce escalating disaster losses by
fostering public-private partnerships and incentives for migration (Cutter et al., 2008), health
preparedness can attained regardless of one’s socio-economic status and cultural capital while
ensuring environmental and social justice to a community of any caliber of risk.
Efforts to further emphasize the positive correlation between social cohesion and
resilience is crucial for the Community Health Resilience Project to recognize in order to move
forward with the “Rhode Island Roadmap to Health Resilience” project. There is validity to the
public health concern that our naturalized environmental dichotomy has created a strong
disassociation of the self. When one is faced with an environmental crisis, one’s social cohesion
and a community’s willingness can counteract the worsened disaster effects and help to ensure

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environmental safety through collective, cultural efforts. Prevalent economic, demographic and
cultural gaps in our society yield minority community tendencies to disassociate from wealthier,
higher status social groups’ instilled environment-society relationships such as activism or
volunteerism. Considering policy implication cannot alter one’s social capital or directly address
economic inequalities on the individual level, the CHRP should strive to introduce values and
norms to enhance minorities’ perception of the environment through proper education in relation
to their cultural capital. The CHRP should also focus on communal efficacy, the shared sense of
trust and willingness to work for the common good of the neighborhood to yield social capital
for minority population through volunteerism during times of crisis (Sampson et al. 1997). An
understanding of adaptive cycles within the couples human environmental systems, and the scale
at which they occur, is necessary to foster resilience and sustainability (Cutter etal. 2008). In
addition to focusing on the increase of environmental sensitivity through technology, the CHRP
should too, focus on technology’s detrimental effects on the social environment (Marrow 2008).
Public attitudes towards economic insecurities related to minorities and immigrants are difficult
to address through policy development and program initiatives. Environmental education is the
most cohesive to minority inhabitants when organizations fully comprehend the extent of the
environment-society relationships between social capital and social immobility. It has been
argued that the increase of social capital must be assessed on the individual level in hopes to
bring collective, communal change. However, organizations should not strive to address
individualistic efforts but instead, understand environmental symbolic interaction in order to gain
a better understanding of demographics. To socialize future generations in terms of
environmental justice; the fair and equal involvement of an entire community without regards to

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culture, race or income discrimination, accessible programs, information and resources must be
implemented. In highly concentrated disaster inflicted minority areas, collective efficacy bridges
the domains of social capital and community competence. Incorporating efficacy and targeting
minority communities to successfully adopt community vision to bring change can conquer
demographic obstacles conquered to promote resilience.
To bridge the connections between health equity, promotion, preparedness and resilience,
being able to fully anticipate disaster mitigation and rebounds is imperative. Getting community
members to think more about the whole environmental idea of preparedness is key for resilience
and building environmental synergy. The aftermath of Hurricane Sandy in 2012 is still visible
along shores on the northeast of the United States, specifically New Jersey and New York. Thus,
in terms of preparedness and resilience, by spreading awareness through community resilience
efforts, one can better anticipate the core capacities of populations both to mitigate disasters and
rebound from them (Plough et al., 2013). In regards to environmental research and activism, it
has proven that the setting-based approach is overall effective in terms of promoting health and
sustainability. In terms of health equity, activist motivations can be further justified by studying
ecosystems in which it can aid in health and sustainability promotion on the community level.
For example, one can infer socio-ecological elements from features of water, the sole component
to the most increasingly resilient-sensitive area can ironically promote resilience and attempt to
ensure environmental justice. Integrated catchment management (ICM) is important because it’s
approaches entail water resource management and is relevant in terms of socio-economic context
in of poverty in rural areas. By looking into this data and making inferences to our ecosystem

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and it’s relation to resilience, the CHRP can work to improve social determinants, decrease
health inequality and strive for even distribution of resources as well. However, ‘ecological’ and
systematic perspectives, specifically how ecosystem disruption have both direct and indirect
implications for health that tend to exacerbate existing health inequalities whether through
exposure to physical hazards or loss of livelihoods (Corvalan et al., 2005; Marmot, 2007). By
taking a further look into the ecosystem, activists can better understand environmental hazards,
specifically how to respond to potential environmental health inflictions, such as water-related
diseases. Last, thinking about the distribution of resources in a community can drastically
enhance its resilience in certain areas of minority demographics. Social support interventions are
most effective when they build social skills and mutual support (Hogan et al. 2002). In areas
where financial resources are not implemented through policy or technology, services for
temporary relocation such as public transportation and health prevention must be readily
available. In minority communities, it is crucial for affordable and centrally located sources of
transportation as well as persistent public health efforts for alleviation of disease containments in
minority communities. The CHRP can gain further insight to close the gap between health
preparedness and response through education, activism and extensive research of environmental
conditions and community demographics.

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References
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Margot W. Parkes and Pierre Horwitz
Water, ecology and health: ecosystems as settings for promoting health and sustainability
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