1. ITRC 2018 Conference Preparing People for Climate Change in California
ITRC SF Conference Jan 2018
ITRC 2018 Conference Preparing People for Climate Change in California
Building Resilience in the Face
of Climate Change-Related Traumatic Experiences
Sergio Aguilar-Gaxiola, MD, PhD
Professor o Clinical Internal Medicine
Director, Center for Reducing Health Disparities
UC Davis School of Medicine
Oakland, CA
January 25, 2018

7. USGCRP, The Impacts of Climate Change on Human Health in the United States: A Scientific Assessment, 2016

8. ITRC SF Conference Jan 2018
Effects of Disasters
Initial shock and mourning, fear, anxiety, and depression.
Initial sense of being overwhelmed.
A sense that things are not real, are occurring to someone else. Like a bad dream from which one needs to be awoken.
Positive and negative expectations of survival. Depending on the events, people may feel great relief over their own and their family’s survival, but they also frequently experience a sense of guilt over others who have been hurt, perished, or lost homes or property.
The Society for Community Research and Action, 2010

9. Effects of Disasters (2)
ITRC SF Conference Jan 2018
Effects of Disasters (2)
Intense anger at fate, the government, the attackers (if that is the case), or even at God for allowing such things to happen.
Sleep difficulty and troubles eating, particularly healthy foods, often with a risk of trying to self- medicate with alcohol or drugs.
Being consistently reminded in this stage of the original horror or fear. People often report feeling like they can still see the events unfold before their eyes.
The Society for Community Research and Action, 2010

10. Most Common Mental Health Problems
ITRC SF Conference Jan 2018
Most Common Mental Health Problems
74% of 130 distinct samples (>50,000 individuals who experienced different disasters)
Post Traumatic Stress Disorder (65%)
Major Depression (37%)
Non-Specified Stress
Somatic Concerns
Generalized Anxiety Disorder (19%)
Norris, 2005; Wiese, 2005

11. Multiple Risk Factors Extremity of environmental destruction
ITRC SF Conference Jan 2018
Multiple Risk Factors
Extremity of environmental destruction
Increased loss = higher distress/trauma
Loss of family/friends
Injury of life threat
Relocation/displacement
Loss of home/possessions
Exposure of traumas in the past
Preexistent health/mental illness
Chronic poverty, homelessness, unemployment, discrimination, racism—social determinants of health
Recent/subsequent life stressors
e.g., single parenting, loss of job
APA & NCPTSD; Wiese, 2005

12. Tips on Self-Care Find support (family, friends, community group)
ITRC SF Conference Jan 2018
Tips on Self-Care
Find support (family, friends, community group)
Maintain routines
Take a break from news
Be gentle with self—Acknowledge feelings
Find opportunities to help others
Focus on the present
Establish healthy habits—sleep, eat, exercise
Engage in activities that make you feel better
Avoid major life decisions
Wiese, 2005

13. ITRC SF Conference Jan 2018
Resilience defined…
“…a process linking a set of adaptive capacities to a positive trajectory of functioning and adaptation after a disturbance.”
“A majority of individuals psychologically affected by a traumatic event (such as a climate related disaster) will recover over time.”
Norris, 2005; Wiese, 2005; Crimmins et al., 2016

14. How prevalent is resilience
after disasters?

16. Summary and Conclusions
ITRC SF Conference Jan 2018
Summary and Conclusions
Resilience is not a trait that an individual, organization, or community has for all time.
Rather, it is one particularly desirable trajectory of post-event functioning that is influenced both by the severity of the stressor and by resources that can be strengthened via pre- and post-event interventions
There is progress in the areas of individual and community resilience (AND vice versa)
Wiese, 2005

17. The Society for Community Research and Action, 2010

18. Principles that Guide Community Work
ITRC SF Conference Jan 2018
Principles that Guide Community Work
Solid research information promotes good decisions in the real world (and vice versa).
Multiple contexts demand flexibility
Social justice is always at risk in any community under duress
Knowledge is a public private good
Actions should emphasize strengths and solutions, not simply challenges and deficits
The Society for Community Research and Action, 2010

19. Five Essential Elements of Intervention at the Individual Level
ITRC SF Conference Jan 2018
Five Essential Elements of Intervention at the Individual Level
A sense of safety
Calming
A sense of self and collective efficacy
Connectedness
Hope
Hobfall et al., 2007; The Society for Community Research and Action, 2010

20. Resources that Promote Community Resilience to Disasters
ITRC SF Conference Jan 2018
Resources that Promote Community Resilience to Disasters
Resilience is not something intrinsic to a community, but is something that can be developed and encouraged
Resilience is an ongoing process that is achieved over time
Resilience can be cultivated
Skills associated with resilience can be learned and practiced
The Society for Community Research and Action, 2010

21. Increasing Community Resilience in Disaster Recovery
ITRC SF Conference Jan 2018
Increasing Community Resilience in Disaster Recovery
Communities must work to better develop economic resources, reduce risk and resource inequities, and attend to their areas of greatest social vulnerability.
Local people must be engaged meaningfully in every step of the process.
Pre-existing organizational networks and relationships are the key to rapidly mobilizing emergency and ongoing support services for disaster survivors.
Interventions are needed that boost and protect naturally- occurring social supports in the aftermath of disasters.
Communities must plan for the unexpected, focusing on building flexible and trusted information and communication resources that function in the face of unknowns.
The Society for Community Research and Action, 2010