Resilience thinking in health protection.

BACKGROUND: In recent years, the term 'resilience' has gained increasing currency in discussions of emergency preparedness. This review identifies key concepts and explores the relevance of resilience for disaster planning and public health protection. METHODS: A systematic review of literature on concepts of resilience, with a narrative summary of key relevant concepts for public health. RESULTS: The key concepts identified were community resilience, disaster resilience and social-ecological resilience. Community and disaster resilience describe a community's intrinsic capacity to resist and recover from a disturbance, while the social-ecological interpretation stresses the importance of thresholds in a society's capacity to adapt to crises. Important elements of resilience include communication, learning, adaptation, risk awareness and 'social capital'. CONCLUSIONS: These concepts have clear relevance for public health and emergency planning. Resilient communities should be less dependent on external help in times of disaster. Many features of resilience also encompass the wider social and economic determinants of public health. Difficulties remain in defining and measuring resilience in the population health context.