Resilience - public health white paper

Resilience is mentioned several times in the recent public health white paper 'Healthy Lives, Healthy People' (england and wales). What does resilience mean and is it linked with sustainability?

The white paper uses resilience in refering to mental health, but also in connection with emergency preparedness. There will even be Local and National Resilience Forums.

I was intrigued whether we're talking about the same thing in sustainability discussions. For example Rob Hopkin's Blog, at Transition Culture (co-founder of Transition Towns), recently reviewed a film 'ResilientCity' dir. Gregory Greene. I haven't seen the film, but I guess resilience here means community resilience. This has some implications of self-reliance, localisation and some degree of redunancy of roles and systems (compared to modernist specialism).

To find out a little more about the public health sense of resilience I watched a very good youtube panel interview from US government public health emergency dept. This discussion is mainly from the perspective of emergency planning, but it covers a range of perspectives:

• Personal resilience - related to physical health & managing chronic conditions
• Personal resilience - related to mental wellbeing (maybe interpersonal?)
• Community resilience - a preparedness of the community for emergency
• Institutional resilience - non-governmental (NGO) and state organisations - especially how they coordinate

In the discussion there was an opinion that resilience is more positive approach, compared to emergency response. Which would fit with sustainability discussions. Another opinion from a public health professional was that an indicator of resilience was whether NGO's were communicating with local government. I may be reading too much into this, but I detected a power imbalace here - that onus was on the community groups to 'report' to statutory bodies.

These two points are an interesting reflection on UK thinking. Local government is moving towards 'asset-based' approaches, which are intended to be a more positive way of working with community than 'needs-based'. The second point reflects on many unknowns within the white paper - how much capacity do community groups have to deliver public health? How much freedom will they have in how they deliver and how and to whom will they report?

The youtube film was mainly talking about emergency preparedness,and this is indeed an interesting perspective from which to look at the impacts of peak oil on community and public health. However the slow-burn nature of the emergency may limit this approach. On the other hand the economic situation, job losses and potential social unrest may be much more of an emergency situation, both personally and for communities. Will this white paper help us weather the storm?

Waste medicines

I've just come across a report on waste medicines by York Health Economics Consortium and the School of Pharmacy, University of London. They seem to be saying that we've done the easy bit in reducing wasted drugs. Now it's likely to be more expensive to reduce the waste than it's worth - just £300million! This is the economic argument. This is based on clinicians and pharmacists time (£25-100 per hour) required to reduce waste.

Can environmental sustainability have a different view on this. Viewing wasted drugs from an environmental impact rather than just a cost. This includes C-footprint of manufacture, shipping and disposal.

The authors do come up with some recommendations to reduce waste. It would be great if bringing sustainability into the argument could strengthen their case and encourage action. I found the report through commentry on Pharmaceutical Services Negotiating Committee it would be great to find out if anyone in that organisation is championing sustainability?