Unraveling the complexities of disaster management: A framework for critical social infrastructure to promote population health and resilience

TLDR

Disaster management is best understood through a complexity lens that highlights interdependencies between health care and broader social systems, yet empirical evidence on how micro‑level critical social infrastructure shapes community capacity remains limited. The study aims to empirically investigate disaster complexity, identify actionable levers for collaborative health promotion among high‑risk populations, and construct a framework and model for critical social infrastructure interventions. Using community‑based participatory research, nine focus groups (n = 143) across five Canadian communities employed a Structured Interview Matrix, and open coding grounded in complexity theory produced four core themes—dynamic context, situational awareness and connectedness, flexible planning, and collaboration—that structure the framework. Findings reveal that micro‑level interconnected hard and soft systems, framed by culture, underpin community resilience, and the study proposes seven actionable recommendations to strengthen population health and resilience.

Abstract

Complexity is a useful frame of reference for disaster management and understanding population health. An important means to unraveling the complexities of disaster management is to recognize the interdependencies between health care and broader social systems and how they intersect to promote health and resilience before, during and after a crisis. While recent literature has expanded our understanding of the complexity of disasters at the macro level, few studies have examined empirically how dynamic elements of critical social infrastructure at the micro level influence community capacity. The purpose of this study was to explore empirically the complexity of disasters, to determine levers for action where interventions can be used to facilitate collaborative action and promote health among high risk populations. A second purpose was to build a framework for critical social infrastructure and develop a model to identify potential points of intervention to promote population health and resilience. A community-based participatory research design was used in nine focus group consultations (n = 143) held in five communities in Canada, between October 2010 and March 2011, using the Structured Interview Matrix facilitation technique. The findings underscore the importance of interconnectedness of hard and soft systems at the micro level, with culture providing the backdrop for the social fabric of each community. Open coding drawing upon the tenets of complexity theory was used to develop four core themes that provide structure for the framework that evolved; they relate to dynamic context, situational awareness and connectedness, flexible planning, and collaboration, which are needed to foster adaptive responses to disasters. Seven action recommendations are presented, to promote community resilience and population health.