key: cord-0682665-2v4u26qd authors: South, J; Stansfield, J; Amlôt, R; Weston, D title: Sustaining and strengthening community resilience throughout the COVID-19 pandemic and beyond date: 2020-08-21 journal: Perspect Public Health DOI: 10.1177/1757913920949582 sha: 06d4925f184fcaaa16382f1301fe50d387f8bf3d doc_id: 682665 cord_uid: 2v4u26qd nan The scale of community action in the UK since the start of the COVID-19 pandemic has been significant. Community-based organisations, national charities, mutual aid groups and thousands of individual volunteers, including the 750,000 NHS volunteer responders, have stepped forward to support those made more vulnerable by the pandemic. 1,2 These acts of community and solidarity between people range from practical help with shopping and running food banks, to telephone befriending and staffing helplines. In some areas, volunteers have even mobilised to conduct community-led contact-tracing to support the pandemic response. 3 Community action is a vital part of the public health effort in a pandemic. 4, 5 Fundamentally, it is through the action of community members, via the majority of people adhering to social distancing, respiratory and hand hygiene recommendations, that the spread of a disease is attenuated. 6 It is only through community support that those who are clinically vulnerable and who are required to 'shield' by staying at home for a protracted length of time can successfully self-isolate and maintain social distancing. 6 Community mobilisation in an outbreak can also lead to growth of supportive community networks. 5 The Office for National Statistics (ONS), who are tracking social impacts of COVID-19 in the UK, reported in May 2020 that just under 2 in 3 adults (64%) felt other local community members would support them if they needed help, and more than half (55%) had checked in with their neighbours. 7 As the long-term social, health and economic impacts of COVID-19 are felt throughout the UK, communities and community-based organisations will have a critical role to play in the recovery process. The ability of communities to cope with and recover from large-scale emergencies is often referred to as 'community resilience'. 8 WHO Regional Office for Europe has long argued that building resilient communities and supportive environments is a public health priority. 9 Creating resilient communities is not about preparing them to cope with shocks and their aftermath alone, rather it is about what public health systems can do to strengthen protective factors, such as strong social networks, which will aid people and communities to manage, adapt, and ultimately recover well. 10 Indeed, literature demonstrates that being a member of multiple social networks or groups can have important effects for health and wellbeing, particularly during times of change. 11 It is through the action of community members, via the majority of people adhering to social distancing, respiratory and hand hygiene recommendations, that the spread of a disease is attenuated The UK public health community has a major part to play in strengthening community resilience in the context of COVID-19. We should initially ask two key questions: (1) How can local public health systems support the least advantaged communities to become more resilient?; (2) Who is at risk of being 'left behind'? 4 We know that the economic conditions that drive health inequalities undermine resilience 12 and affect people's ability and resources to cope with emergencies. 13 Not everyone is able to contribute to or benefit equally from community action and the COVID-19 pandemic will have left some more isolated and vulnerable. Voluntary and community sector (VCS) organisations have a public health role here, particularly grassroots organisations that are in touch with groups and individuals who face the greatest risks. The public health workforce who are community based, such as community pharmacists, teachers and community development workers, also hold vital knowledge of local needs and assets and are trusted sources of advice for many individuals and families. 14 Strengthening community resilience in the months and years to come will require a whole system approach working with different sectors. The UK Government Community Resilience Development Framework stresses the importance of enabling spontaneous community-led action alongside the need for public services to work in partnership with voluntary partners to coordinate efforts. 15 Key routes for engagement include parish councils, local businesses, faith organisations, community hubs and resident associations. Public Health England (PHE) recently published guidance for taking a whole system approach to community-centred public health. 16 This draws on international evidence and the experience of local authorities and public health leaders who are changing the way local public health is practised. While this guidance was developed before the pandemic, nonetheless the main elements, values and principles (Figure 1 ) can be used to guide a strategic response to strengthening community resilience in Figure 1 Eleven elements of community-centred public health: a whole system approach. Source: Public Health England. 16 the recovery from the multiple impacts of the COVID-19 pandemic. We have highlighted how these might be applied in Table 1 . A whole system approach to strengthening community resilience should also involve good public health intelligence. A WHO Europe report recommends assessing community vulnerabilities and capabilities across key economic and social indicators in combination with gathering insights from the most marginalised groups. 17 Having a shared understanding of local assets and vulnerabilities will help in planning actions in the recovery period. Looking forward to the recovery from the COVID-19 pandemic, a collaborative approach to rebuilding community health, wealth and wellbeing will be needed; an approach that ensures that the health gap is reduced not widened. Many public health teams will be thinking now of how to build on the current levels of community action in planning for recovery. Many local authorities will have developed partnership arrangements with the voluntary and community sector that have withstood the test of this pandemic, having demonstrated capability to respond quickly to community needs. The potential to learn from these whole system approaches is huge, and work to capture lessons identified will be vital. In addition, those working and volunteering in communities through this outbreak will have gained important insights about what does and does not work when implementing initiatives 'on the ground'. In conclusion, we know that the economic, health and social impacts from the COVID-19 pandemic will be significant and unequally distributed. There is much that the public health community can do to work in solidarity and partnership with communities and community-based organisations to mitigate these impacts and to create the conditions for individuals and communities to thrive post-pandemic. This is an opportunity to create a new way of working and to realise the ambition of a more community-centred system, building upon the community-driven initiatives that Table 1 Applying whole system community-centred public health to the COVID-19 recovery Whole system community-centred public health 16 Potential actions to build community resilience Take a place-based approach to reducing health inequalities, working across neighbourhoods. Starting at a 'hyper-local' level will tap into local community action and resources. Utilise community-centred approaches to provide support, alongside professional-led services. Local services such as social prescribing can offer a flexible, person-centred approach to supporting people during and after the emergency. Maintain two-way communication and decision-making between communities and services, to ensure needs and priorities are understood and addressed. Establish new ways of gathering the insights of people most affected by the COVID-19 pandemic. Use community development methods, especially in marginalised communities, in order to increase people's control over their health and wellbeing. Work in partnership with local VCS organisations who are reaching out to those in need. Find ways to build the capacity of grassroots organisations that have close ties with marginalised and vulnerable groups. Support volunteering, working alongside volunteer-involving organisations to ensure volunteers have the right information, support and training to help people safely in the community. Enhance the skills of the public health workforce in community engagement and using asset and strengthsbased approaches when tackling local priorities. Prioritise meeting basic needs through action on employment, housing, food, income, debt, natural environment and education as building blocks for community resilience. Developing a strategic and long-term ambition for strengthening communities in the recovery from COVID-19. Improve measurement using community outcome frameworks with short-, medium-and long-term indicators on what matters to communities, such as a sense of belonging, or mental wellbeing. Looking forward to the recovery from the COVID-19 pandemic, a collaborative approach to rebuilding community health, wealth and wellbeing will be needed have been so important to the pandemic response to date. The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of OrCID ID Jane South https://orcid.org/0000-0003-1462-7632 Covid-19 voluntary response: a blog from our chief executive. Volunteering Matters Local heroes. How to sustain community spirit beyond Covid-19. London: Power to Change, National Lottery Community Fund UK's first coronavirus contacttracing group warns of difficulties. The Guardian Statement -older people are at highest risk from COVID-19, but all must act to prevent community spread. Copenhagen: World Health Organisation Regional Office for Europe Key experiences of community engagement and social mobilization in the Ebola response How can we involve communities in managing the Covid-19 pandemic? BMJ Opinion What do we mean by 'community resilience'? A systematic literature review of how it is defined in the literature Health 2020: a European policy framework supporting action across government and society for health and well-being. Copenhagen: WHO Regional Office for Europe Strengthening resilience: a priority shared by Health 2020 and the sustainable development goals. Copenhagen: World Health Organization Regional Office for Europe The social cure: identity, health and well-being Moving from understanding to action on health equity: social determinants of health frameworks and THRIVE International Federation of Red Cross Red Crescent Societies (IFRC). IRFC framework for community resilience Rethinking the public health workforce Cabinet Office. Community resilience development framework. London: HM Government Community-centred public health: taking a whole system approach: briefing of research findings What quantitative and qualitative methods have been developed to measure health-related community resilience at a national and local level? Copenhagen: WHO Regional Office for Europe Looking after your self-ie: A guide to finding your balance on and offlineBuilding on the research undertaken for the RSPH Status of Mind and New Filters reports, RSPH has developed a free, open access e-learning resource.The programme aims to reintroduce participants of Scroll Free September, and the wider public, to social media in a healthy way. The programme will focus on awareness-raising; encouraging meaningful use by educating users on the potential harms and benefits of social media. The course is free to access via the e-learning pages of our website.