Conference Presentation, Panel, Fireside Chat
Resilient Communities, Successful Disaster Recovery
Milken InstituteLynn Goldman, Elizabeth Disco-Shearer, Nancy Knight, Robert Ottenhoff, Umair A. Shah, John Balbus
- Public health systems face escalating risks from disasters with projected increases in frequency, intensity, and severity driven by climate change, necessitating long-term shifts from infrastructure to human capital resilience.
- Economic and social impacts are expected to persist for years, involving billions in real estate and commercial losses, potential community tax base erosion, and deep disruptions including mental health struggles, domestic violence, and situational poverty for displaced families.
- Future health risks include prolonged mortality and morbidity due to facility failures, infectious disease outbreaks, and unvetted volunteer activities, highlighting a need for improved surveillance, diagnostics, and coordination between public and private healthcare sectors.
- Federal public health funding trends show specific allocations, such as $620 million for state preparedness in the past fiscal year and $50 million annual commitments for global health security in FY18-20, though previous five-year global security resources have expired and HPP grant funding has declined.
- Current philanthropic patterns are criticized for being reactionary, with 50-70% of funds directed to immediate response versus only 10% to mitigation, and donations peaking three to four weeks post-event before diminishing, creating a funding gap for work that often extends into the third month and beyond.
- Recovery efforts face challenges including an "invisibility crisis" where public health work is overlooked until disease rates rise, disconnects between federal/state planning and local execution, and the need for voluntary organizations to coordinate within formal incident command systems to avoid safety risks.
- Strategic plans emphasize community-level preparedness, including individual 72-hour survival capabilities, digital access to records, and the cultivation of community champions to articulate needs and secure pro-health policies and sustained funding.
- Specific organizations and regions are targeted for intervention, with CDC deployments planned for global crises like Ebola and cyclones, while the Center for Disaster Philanthropy and voluntary groups in Texas and Puerto Rico focus on long-term rebuilding and case management for up to two years.