THRIVE: COMMUNITY TOOL FOR HEALTH & RESILIENCE IN VULNERABLE ENVIRONMENTS

submitted by Jeffrey Stiefel

THRIVE: A Community Approach to Address Health Disparities

Prevention Institute has updated its Community Approach to Addressing Disparities in Health with the revision of THRIVE: Toolkit for Health and Resilience in Vulnerable Environments.  A centerpiece of THRIVE is a set of community level factors that are linked to Healthy People 2010 Leading Health Indicators.  It now features a simplified list of thirteen factors to facilitate use of the tool at the local level.

THRIVE Executive Summary (PDF)

THRIVE Expert Panel

Advancing a Community Resilience Approach to Improve Health Outcomes

Poor health and safety outcomes, including chronic disease, traffic-related injuries, mental illness, substance abuse, teen pregnancy, and violence, are disproportionately high among low-income people and people of color in the United States. In addition, the impact of racism and oppression increases numerous risk factors for illness and injury, including reduced access to fresh nutritious foods, fewer opportunities for physical activity, greater exposure to environmental toxins, and substandard housing and neighborhood conditions.

With the increased recognition of existing health disparities in the United States, there has been an emphasis on treatment and intervention. However, there is also a need to prevent health disparities before the onset of injury, illness, or death. Focusing on underlying factors, both risk and resilience, can save lives and money and reduce suffering. Resilience, defined here as the ability to thrive and overcome risk factors, merits attention in order to achieve health and safety outcomes. Studies show that resilience factors can counteract the negative impact of risk factors and that effective approaches need to include attention to both. Given the preponderance of attention to risk factors, this project will highlight resilience factors that support health and safety outcomes.

Resilience approaches have tended to focus on individual measures; attention to community-level factors is also important. For example, the building blocks of healthy communities include marketing and availability of healthy foods as opposed to fast food and tobacco, safe parks, effective education, health and social services, community gathering places, and locally owned businesses. Research confirms the relationship between such factors and health and safety outcomes. For instance, social cohesion corresponds with significant increases in physical and mental health, academic achievement, and local economic development, as well as lower rates of homicide, suicide, and alcohol and drug abuse. Other examples of community resilience factors include environments that promote walking, bicycling, and other forms of incidental or recreational activity, jobs, a willingness to take action for the common good, positive intergroup relations, and positive behavioral norms. By strengthening such factors, communities have significant capacity to enhance health and safety.

Measuring Community Resilience

The goal of this project was to develop a tool to assess community-level resilience factors that serve as benchmarks for the Leading Health Indicators of Healthy People 2010. The tool, which is informed by research, included an environmental scan and piloting in Del Paso Heights, California; Hidalgo County, New Mexico; and East Harlem, Central Brooklyn, and the South Bronx in New York City. A diverse, national expert panel provided guidance throughout the process. The pilot process confirmed the tools utility in rural and urban settings and for community members as well as practitioners and local policy makers. This tool can help local decision-makers close the health gap. It includes collateral materials such as training materials and preliminary guidelines to translate the THRIVE results into concrete changes in local policies, programs and priorities.

http://thrive.preventioninstitute.org/thrive.html