Resilience: A new definition of health for people and communities

Abstract

Beginning with the Framingham Study (Dawber, Meadors, & Moore, 1951), risk factor research has a long and successful history of identifying biological and psychosocial vulnerabilities to chronic, as well as acute, illness. How do people sustain themselves while ill, and how do so many who are ill recover? In this chapter we offer resilience as an integrative construct that provides an approach to understanding how people and their communities achieve and sustain health and well-being in the face of adversity. Our aim is to define resilience based on current thinking in biopsychosocial disciplines, to outline key research methods employed to study resilience, and to suggest how this approach may further the development of public health and other intervention programs designed to promote health and well-being. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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Resilience: A New Definition of Health for People and Communities
Alex J. Zautraa*, John S. Hallb, and Kate E. Murraya,
of the Resilience Solutions Group
Psychology Department, Arizona State University, Tempe, USA.; bSchool of Public Affairs, Arizona State
University, Tempe, USA
Full Citation: Zautra, A.J., Hall, J.S., & Murray, K.E. (2010). Resilience: A new definition of
health for people and communities. In J.R. Reich, A.J. Zautra, & J.S. Hall (Eds).
Handbook of Adult Resilience (pp. 3-30). New York: Guilford.
This article may not exactly replicate the final version published in the book published by
Guilford. It is not the copy of record.
Title Page Footnote:
_____________________
*The first two authors contributed equally to this work. They wish to thank Billie Sandberg and
members of the Resilience Solutions Group. The members of the Resilience Solutions Group
(RSG) in addition to the authors of this article are, in alphabetical order: Leona Aiken, Felipe
Castro, Mary Davis, Roger Hughes, Martha Kent, Rick Knopf, Kathy Lemery, Linda Luecken,
Morris Okun, and John Reich. This work is supported in part by a grant from the National
Institute on Aging (R01 AG 026006), Alex. Zautra (PI), John Hall (Co-PI). In addition, the
authors are grateful to St. Luke’s Charitable Trust and the Arizona State University Office of the
Vice President for Research for invaluable support of the RSG.

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Resilience: A New Definition of Health for People and Communities
Beginning with the Framingham studies (Dawber, Meadors, & Moore, 1951), risk factor
research has a long and successful history of identifying biological and psychosocial
vulnerabilities to chronic as well as acute illness. By age 65, most if not all Americans will
harbor some significant risk for a life-threatening illness. Yet, those who live that long may be
expected to live an average of 20 more years. In addition, the National Academy of Sciences
finds a decrease in disability rates—falling under 20% for the first time in 2000—among elders
citing education, diet, exercise, medical and public health advances all leading to a more
vigorous and healthy old age (National Research Council, 2001). Even centenarians profess a
level of happiness that rivals that of younger groups and laugh at least as often (Jopp & Smith,
2006). How do these people sustain themselves while ill, and how did so many who were ill,
recover?
The pursuit of knowledge about these capacities is not just about those individuals who beat
the odds. There are also considerable anomalies in the community health data (Evens, Barer, &
Marmor, 1994)—levels of illness and disablement that cannot be accounted for in the
accumulation of risk indices, and surprisingly high levels of functional health in the face of
physical illness that cannot be explained by risk factor research. Social status, for example,
confers health advantage even after the calculation of multivariate risk ratios between risk and
poor health (Marmot & Fuhrer, 2004). Further, there are apparent paradoxes in the findings for
some groups that cut against the social gradient (Heidrich & Ryff, 1993). The best known among
them is the Hispanic paradox. Even at high risk on the standard indicators, those with strong
attachment to their Hispanic heritage appear healthier as a group than their social status would
warrant (Fuentes-Afflick, Hessol, & Perez-Stable, 1999; Gould, Madan, Qin, & Chavez, 2003).

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These anomalies may be due to a matrix of factors woven within the fabric of the lives of
people and their communities that confer resilience. Indices of this capacity for resilience may be
found within the person, his/her primary network of kith and kin, and the sociocultural profiles
of the neighborhood and community settings. In this article we offer resilience as an integrative
construct that provides an approach to understanding how people and their communities achieve
and sustain health and well-being in the face of adversity. Our aim is to define resilience based
on current thinking in biopsychosocial disciplines, outline key research methods employed to
study resilience and suggest how this approach may further the development of public health
and other intervention programs designed to promote health and wellbeing.
What is resilience?
We begin with definitions of the term. The need for clarity here is made all the more
important by its popularity in everyday discourse, becoming what Rutter (1999) has called the
“millennium Rorschach.” Until recently, scholarly work on resilience was the sole province of
developmental psychology (Luthar, 2006). In that arena, resilience has been studied as a dynamic
process of successful adaptation to adversity revealed through the lens of developmental
psychopathology. Across research and practice, there has been considerable debate over the
definition and operationalization of resilience (Luthar, Cicchetti, & Becker, 2000). Is resilience
best categorized as a process, an individual trait, a dynamic developmental process, an outcome,
or all of the above? In addition, where does one draw the line at successful and resilient
adaptation versus non-resilient responses?
In our view, resilience is best defined as an outcome of successful adaptation to adversity.
Characteristics of the person and situation may identify resilient processes, but only if they lead
to healthier outcomes following stressful circumstances. Two fundamental questions need to be

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asked when inquiring about resilience. First is Recovery, or how well do people bounce back and
recover fully from challenge (Masten, 2001; Rutter, 1987)? People who are resilient display a
greater capacity to quickly regain equilibrium physiologically, psychologically, and in social
relations following stressful events. Second, and equally important, is Sustainability, or the
capacity to continue forward in the face of adversity (Bonanno, 2004). To address this aspect of
resilience we ask, how well do people sustain health and psychological well-being in a dynamic
and challenging environment?
Definition One: Recovery: From risk to resilience
One of the problems we have in understanding the processes of recovery from stressful
events is that most models of health and mental health have not developed an adequate
understanding of the meaning of recovery. This problem is made even more apparent by the
frequency with which people and communities actually recover from adversity. Masten (2001),
in referring to the many children who survive difficult even abusive home environments, called it
“ordinary magic.” It would be most consistent with what we observe in human communities to
see resilience as a natural capacity to recover and perhaps even further one’s adaptive capacities.
In fact, the modal response to calamity in our community studies has not been despair but “to see
the silver lining.” People report they “discovered what really mattered in life,” “found out how
much others cared,” and “uncovered hidden strengths within (or hidden capacities for generosity
in others)” (Zautra, 2003). Researchers who have focused narrowly on developmental risks often
see resilience in response to adversity as the exception rather than the rule (Luthar, 2006).
However, people are extraordinary, and it is common, not rare, to observe these feats of
resilience in children (Garmezy, 1991) and across the life span (Bonanno, 2004; Greve &
Staudinger, 2006). Some initial psychological distress following stressful experiences is

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expected, and may even be potentially beneficial to adaptation. From a resilience perspective,
speed and thoroughness of recovery from harm are the key outcomes to observe. A resilient
“recovery” may not be without some remaining emotional “scars” but the return to health is
often well beyond what our models of psychopathology would have predicted. A broader and
more differentiated view of health and mental health would be a place to start to capture these
resilience experiences.
Though the resilience response may be nearly universal, it is likely that we are not all the
same in this capacity, nor are the environmental forces that strengthen or weaken resilience to
stress distributed equally in the population. People differ in their inner strength, flexibility, and
“reserve capacity” (Gallo, Bogart, Vranceanu, & Matthews, 2005) just as communities differ in
resources and overall resilience capacities. Further, the responsiveness of the social and physical
environment differs from one family to another and from one community to the next (Garmezy,
1991). Some resilience researchers have focused on personality features (e.g. Friborg, Barlaug,
Martinussen, Rosenvinge & Hjemdal, 2005), and have given relatively short shrift to the social
environmental determinants of response capacities of individuals. Yet, without attention to social
as well as psychological capital within our communities, models of resilience may have limited
applicability. A social and community psychology of resilience is needed if we are to understand
why many of us are not always able to preserve well-being and sustain our progress toward the
goals we have set out for ourselves and those we care for (Cowen, 1994). In addition, attention to
the social and contextual factors may provide greater insights into differences in resilient
processes across cultures; an area which requires greater theoretical and empirical interrogation.
We often fail to recognize that communities recover as well, albeit in potentially different
ways across cultures and countries. In fact, recovery from horrific devastation is one of the most

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important themes of the history of cities. As chronicled in The Resilient City (Vale &
Campanella, 2005) cities have been destroyed throughout history, “sacked, shaken, burned,
bombed, flooded, starved, irradiated, and poisoned.” Only 42 cities worldwide were permanently
abandoned (Chandler & Fox, 1974), and all others have recovered, rising like the mythic
phoenix. As Kelly (1970) has reminded us, adaptation principles apply as much to human
communities as they do to other eco-systems. It is frequently observed that in the process of
recovery from devastation, most members of affected communities demonstrate unusually high
levels of cooperation and bonding. Alas, these changes in behavior may not last. Whether it be
dramatic examples such as New York City following 9-11, or more frequent natural disasters
such as floods or hurricanes, people often tend to return to business as usual once the sandbags
are removed, the debris cleared, insurance claims filed, and so forth. For many communities,
“community resilience” ends with immediate recovery. “Social resilience” may partially result
from crises, but lasting sustainable resilience capacities would seem to require purposeful
intervention in multiple aspects of community and there are unique approaches to recovery
enacted by different systems of governance around the globe. Communities clearly recover; how
they do so, and with what implications for future resilience capacity, deserve our attention.
Definition two: Sustaining pursuit of the positive
The second major definition of resilience is adopted from the field of ecology, and is linked
directly to the concept of reserve capacity. Holling, Schindler, Walker, and Roughgarden (1995)
define the resilience of an ecosystem as its capacity to absorb perturbations/disturbances before
fundamental changes occur in the state of that system. By changes in state, Holling et al. (1995)
and others (Adger, 2000) do not mean a change in the level of a given profile of interactions, but
a dynamic non-linear change in the nature of the relationships among the constituent parts of the

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system. When people reach and go beyond their capacities to cope with events, we observe not
simply a change in levels of cognition, affect and behavior, but a change in the nature of the
relationship among these core elements of the human response.
The study of chronic pain patients provides one illustration. During episodes of pain and
stress, there are changes not only in level of negative emotion but also changes in the relation
between positive and negative states revealing a reduction in the complexity of a person’s
affective experiences (Zautra, 2003; Zautra et al., 2005). Based on these findings, it seems that
heightened stress and pain lower the capacity of the person to distinguish positive from the
absence of negative emotion, lowering the sustainability of positive affective engagement.
Kelly (1955) was among the first to point out that the constructs we use to understand
ourselves are oriented to the prediction and control of future events. We follow his lead in
proposing that the natural course of one’s life has a forward lean toward engagement, purpose,
and perseverance. Mind-body homeostasis is not sustained by emotional neutrality, but by
ongoing, purposeful, affective engagement. From this perspective, resilience is expected to
extend beyond the boundaries of a person’s capacity to stave off pathological states or a
community’s ability to recover from a disaster, and thus it includes sustaining pursuits of the
positive. In this sense, individual resilience may be defined by the amount of stress that a person
can endure without a fundamental change in capacity to pursue aims that give life meaning. The
greater a person’s capacity to stay on a satisfying life course, the greater their resilience.
Whereas resilient “recovery” focuses on aspects of healing of wounds, “sustainability” calls
attention to outcomes relevant to preserving valuable engagements in life’s tasks at work, play
and in social relations.

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Behavioral scientists as well as clinicians, unaware of the shortcomings of their conceptual
models of health and mental health, have difficulty understanding the discontinuities between a
person’s level of suffering and their capacity for psychological growth. Attributes of the positive
like “satisfying life course” are often left undefined, or, defined based on the absence of some
negative attribute. Yet we all know people and communities who appear perfectly adjusted to
their circumstances but who have not the capacity to plan for them. Their ship is still in the
harbor. We know of people who carry full diagnoses of illness, even mental illness, who yet
show spark and wit and perseverance remarkable for even the healthiest of us. The absence of
illness and pain is no guarantee of a good life. Some paradigms within the clinical sciences have
focused much on revealing hidden pathologies within us but have often appeared blind to the
natural capacities of people, even those ill, to resolve problems, bounce back from adversity, and
find and sustain energy in the pursuit of life’s goals.
There are parallels in the study of communities. We often define the quality of life within a
community by the absence of crime, the safe streets, the convenience to stores selling everyday
commodities, and a relatively unfettered path from home to work, and back again. If this were all
that attracted us to community, though, no one would bother with Manhattan, San Francisco, or
Los Angeles. These very diverse, vibrant places prosper because they attend to the basics as well
as provide high levels of stimulation and opportunity even though they may introduce more
hazards into everyday life (Florida, 2004). People need the structure of a coherently organized
physical environment that affords them basic goods. They also benefit from communities that
support their needs for social connection and psychological growth. Resilient community
structures build on peoples’ hopes as well as provide a means of circling the wagons to provide a
“defensible space.” We need definitions that go beyond the absence of problems: not just risk,

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but also capacity, thoughtfulness, planning, and a forward-leaning orientation including
attainable goals and a realistic vision for the community as a whole.
How does our focus on sustainability of the positive as resilient compare in saliency to
recovery? The capacity to mount effective responses to stress and resist illness is a fundamental
imperative. But survival is not enough for resilience. A fulfilling life is also fundamental to well-
being, so changes that affect our plans and goals for ourselves, our families, and our
communities need attention as well.
The Role of Awareness in Resilient Lives
Recovery and sustainability are different in one critical respect. For recovery, homeostasis is
the fundamental principle: a return to a former, more balanced, state. Sustainability, on the other
hand, is not based on push and pull mechanisms of action and reaction. This condition depends
on unique human capacities for appraisal, planning, and intentional action. Whereas
automaticity characterizes homeostatic processes, awareness and choice characterize the
development of sustainable human values and purposes.
The implications of this distinction are profound. First, it seems possible, even likely, that
many people recover from adversity without giving the experience much thought at all.
Physiological systems are built to bounce back. Our blood pressure will rise under stress, even
‘boil” when we are angry, but return to resting levels without any special work on our part.
Psychological levels of well-being and distress and social perceptions like interpersonal trust will
show changes in response to adversity only within a range of values, returning to pre-adversity
levels except under the most extraordinary of circumstances. Loss naturally leads to sorrow. For
some the grief is remarkably understated, and for some others, the grief seems so strong as to be
frightening. At the time we are faced with grief at its peak levels, it may appear that we will

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never recover. But just as we say that to ourselves, a light appears at the end of the tunnel and we
begin to move toward it.
There are cultural differences in how people rebound from adversity. David Brooks (2008)
noted how little trauma and grief there was among the survivors of an earthquake that struck
China’s Sichuan Province in 2008 killing 70,000 people. Instead of sorrow, he observed a
pragmatic mentality: “Move on, don’t dwell, look to the positive, fix what needs fixing, and
work together.” But even in Western nations, quick recovery is the rule. Bonnano (2004) found
a high proportion of those who lost a close family member showed no grief reaction, and another
significant number showed rapid recovery following the death.
Individuals may differ in the extent to which they are able to rebound fully and rapidly.
McEwen (1998) introduced the idea of allostatic load to describe elevations in physiological
indicators that appear to defy homeostatic principles: Cortisol levels and blood pressure that do
not go lower during the day, for example. Depression and anxiety may be added to the list of
indicators of load that, once elevated, do not fall back to normal levels for some people. But
these are exceptions to the principle of recovery. The science and practice of psychosomatic
medicine arose to address just these kinds of abnormal “heterostatic” patterns.
The normal course of human response is to return to baseline. Interventions are not needed to
coax most people back to health unless there are other problems. A physiological propensity
toward auto-immunity, for example, might lead to rheumatoid arthritis for those suffering from
episodes of major depression. Some people have great difficulty admitting to suffering, and
deny painful experiences, even to themselves. In psychoanalytic frameworks denial can turn
ordinary experiences into nightmares; a dynamic that influences our emotional lives in
unpredictable ways, sometimes leaving us more troubled than we were by the original

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experience.
The young are without the means to fully comprehend a highly threatening experience. Often
unprepared to cope with implications of highly stressful events, emotional wounds may be left
unhealed. Abuse and early trauma can invade awareness years later, disrupting homeostatic
processes and chronically elevating psychological and physiological processes central in
homeostatic regulation (e.g. Luecken & Appelhans, 2006; Luecken, Appelhans, Kraft & Brown,
2006). Researchers in behavioral medicine have verified these kinds of costs of early trauma, but
even here, not every child is distressed. If we look, we see plenty of the “ordinary magic” of
resilience (Masten, 2001) throughout development.
Sustainability and Awareness
Sustainability of purpose invites consideration of existential questions more than recovery
does. How do we want to live, what do we wish to accomplish, which voice within do we listen
to most fervently? This is the world of choice and value, and it is surprising how little time most
of us spend in this world. Nevertheless, sustainability is a moot point unless we are aware
enough to have pursuits that give our lives meaning beyond recovery and survival (Ryff &
Singer, 1998 Without a sense of purpose, there is no purpose to sustain, and without a sense of
value there is no meaning that can lengthen the life of the emotions that accompany a positive
experience. We are willows in the wind without a direction of our own.
Awareness is a prerequisite to these higher-order processes, and it is only logical to extend
this discussion to include levels of awareness. Some forms of consciousness are more likely than
others to yield a rich bounty of meaning and value. Tolle (2005) and others talk about differences
in types of awareness. Here it is possible to introduce a range of possible definitions of the
quality of the conscious experience. Different cultures have different ways to order the quality of

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conscious experiences as well (e.g. Diener & Suh, 2000). Western and Eastern philosophies, for
example, offer contrasting views on the nature of conscious experience most likely to sustain
wellbeing. Western views focus on choice and mastery over the environment, whereas Eastern
philosophies emphasize full awareness and acceptance of experience, however painful, to gain an
enlightened and “joyous” view of the world. These cultural differences underscore that there is
more than one way to be resilient and greater understanding of resilient processes across cultures
is needed.
When thinking of a community’s resilience, this distinction between recovery and
sustainability is all the more apparent. However, “awareness” is not a property typically ascribed
to communities, so, at first glance, it would appear irrelevant. For many, an effectively managed
community would be one that operates as clockworks. The trains run on time, regardless of what
is happening, and people shuffle forward, as expected, undeterred by calamity. Indeed, an
effective future plan for recovery for a community following a natural disaster is one that
arranges resources in such a way that the response is as swift and automatic as possible.
Emergency deployments are thoughtfully planned before the fact. During the disaster, the
community hopes everyone knows what they are to do without question. They may be guided to
safety by set programs, modified in process by only a select few engineers with authority at the
top. Yet from experience we know that a substantial transfusion of cooperation as a result of
disaster can sometimes be the key ingredient in community recovery. Two key research
questions remain: 1. Why is it that increased cooperation and bonding occurs in some
communities but not in others despite similarity of the event?; and 2. Why is it that immediate
cooperative responses often dissipate and do not lead to continued collaboration after immediate
recovery?

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Sustainability of community life requires thinking and planning of a different kind, one that
relies on raising awareness and participation of the whole, not just investment in the skills of a
few. Fundamental to elevation of awareness to purposeful collective action are processes which
promote awareness, social cohesion and connectedness, and participation by all in the
functioning of a healthy community system. Here is where Sarason’s concept “sense of
community” is most applicable (Sarason, 1974). Without a shared sense of purpose within the
community, there may not be much of a community to sustain anyway. There may be “bricks
and mortar,” to be sure, but for purposes not defined by those who live and work there. Just as
there are levels of awareness and conscious engagement within individuals, communities vary in
the quality of citizen awareness, contribution, and commitment to its goals. We believe the
sustainability of a community’s future is in direct proportion to the quality and extent of
collective awareness and direction for growth and development.
What contributes to these capacities, and how to foster these processes within people and
their communities are the key questions that need to be addressed by resilience researchers. New
innovative programs focused on resilience are underway and would benefit from paradigm
guidance and a better articulated and integrative set of methodologies. Next, we examine
measures and methods that may be useful in the study of resilience within people and across
communities. We propose one important distinction to keep in mind: Resilience is an outcome of
successful adaptation to adversity revealed by either sustainability, recovery or both. Resilient
processes are those that have garnered empirical support as variables that increase the likelihood
of those outcomes. For the field to advance it is essential to keep the processes and outcomes
distinct. Doing so allows us to develop ways to examine the evidence for resilience processes
without confusing independent with dependent variables (see also Greve & Staudinger, 2006).

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Identifying Indicators of Resilience Processes
At this stage of resilience research, social scientists have advanced the field with propositions
regarding the key biopsychosocial processes that further recovery and sustainability (e.g.
Hawkley et al., 2005; Ong, Bergeman, & Bisconti, 2004). Reliable measures of core aspects of
positive mental health (Ryff & Keyes, 1995), personal agency, emotional maturity, and
subjective well-being (Vaillant, 2003) have provided substantive means of evaluating those
propositions. Further, Charney (2004) and Curtis and Cicchetti (2003) have reviewed potential
neuro-hormonal and genetic processes that may yield physiological markers of resilience.
Greater specificity in reliable measurement is increasingly available across the levels of inquiry.
A key question for resilience research is how new indicators of resourcefulness differ from
established ones of vulnerability. Table 1 illustrates how such indices of resilient processes
( Call out here for Table 1)
compare to more conventional indices of risk across different levels of analysis. On the left
side are examples of risk factors culled from studies of health risk beginning with Framingham
(Dawber, Meadors, & Moore, 1951). These “usual suspects” are well-established markers of
high risk for a number of health problems as people age. On the right side of the graph is a
contrasting set of variables that identify biopsychosocial and community resources. Many of
these indices have been associated with better psychological and physiological functioning, but
many fewer studies have been conducted on the positive side of the ledger.
Resilience Processes as a Separate Dimension
The evidence to date indicates that resilience resources illustrated in Table 1 are not qualities
found at the positive end of a single continuum of risk, but as a separable factor of well-being
altogether, which confer unique health and mental health advantages not accounted for by

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assessments of relative risk (e.g. Steptoe, Wardle, & Marmot, 2005). To characterize the nature
of risk and resilience we need models that contain at least two separate factors: One that
estimates vulnerabilities and one that estimates strengths (Zautra, 2003). Resilience depends as
much on keeping separate that which is different as it depends on the integration of parts that fit
together to make a congruent whole. A psychological economy that equates the positive with the
absence of the negative is a model for simplicity within the mind, not growth.
One reason we need to distinguish factors is that they address two fundamentally different
motivational processes: The need to protect and defend against harm, and the need to move
forward, and to extend one’s reach toward positive aims (Bernston, Caccioppo, & Gardner,
1999). These processes infuse a two-factor meaning structure to emotion, cognition, and
behavioral intention. Indeed, neurophysiological responses, including both EEG and fMRI data,
support distinct neural structures for the regulation of positive as opposed to negative emotive
responses (Canli et al., 2001; Watson, Wiese, Vaidya, & Tellegen, 1999). Underlying cognitions
of personal control and mastery show two factors (Reich & Zautra, 1991): One of agency,
optimism and hope, and another of helplessness, pessimism and despair. Social relations have
similar differentiated structures. The extent of negative social ties does not predict the extent of
positive social ties (Finch, Okun, Barrera, Zautra, & Reich, 1989). Even within intimate spouse
relations, the extent of negative social interaction does not account for the extent of positive
exchanges between partners (Stone & Neale, 1982).
When investigators have constructed separate indices of positive and negative aspects of the
person and/or social relations, they have uncovered surprising currency for positive aspects in
prediction of health and illness unaccounted for in measures taken of negative affective factors
(Cohen, Doyle, Turner, Alper, & Skoner, 2003; Moskowitz, 2003; Pressman & Cohen, 2005;

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Russek & Schwartz, 1997; Seeman et al., 1995). Laughter, positive affect, optimism, emotional
range as well as maturity (Vaillant & Mukamal, 2001), the capacity for empathy and support for
others all may infuse people with potentially life-sustaining resources even in the face of
considerable distress (Zautra, Johnson, & Davis, 2005). It is important not to overstate the
amount of psychological muscle it might take to be resilient. Resilient actions often start just
with a smile or a moment for reflection that welcomes a broader perspective and encourages a
thoughtful optimism about events.
In collaboration with other investigators, we have conducted three studies of risk and
resilience with patients challenged by chronic pain disorders (Furlong, Zautra, Puente, López, &
Valero, in press; Johnson-Wright, Zautra, & Going, in press; Smith & Zautra, 2008). Each of
these studies examined whether measures of resilient resources formed separate factors and
predicted health outcomes over and above risk factors with patients with rheumatic conditions,
including rheumatoid arthritis, osteoarthritis and fibromyalgia. Although each study relied on
somewhat different predictors and different health outcomes, each found evidence of separate
but inversely correlated factors of resilience and risk, and in each case the resilience factors
predicted key health outcomes after controlling for risk. The Smith & Zautra (2008) study of
rheumatoid arthritis patients, for example, identified a resilience factor comprised of measures of
active coping, acceptance, positive reinterpretation and growth, purpose in life and optimism that
had a modest negative correlation (r = -.31) with a vulnerability factor containing scales
measuring anxiety, depression, interpersonal sensitivity, and pessimism. Scores on vulnerability
(but not resilience) predicted daily fluctuations in negative affect, including elevations in
negative emotion on days of elevated pain. Those participants high on resilience reported more
everyday positive interpersonal events, more positive emotion, and greater responsivity to daily

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positive interpersonal events. Vulnerability scores were unrelated to those positive affective
outcomes.
Indicators of Individual Resilience: Resources and Outcomes
At the level of the individual, resilience concepts have led researchers to develop indices of
positive adaptation, with items like, “I tend to bounce back quickly after hard times” (e.g.,
Smith, et al, in press). They constitute self-report measures of resilient outcomes. In child
development, this research has focused on competence and adaptation, stating that adaptation is
identified by successfully meeting developmental criteria (Luthar, 2006). For adults and elderly,
preservation of health and well-being in the face of adversity provide key resilience outcomes.
Here we urge further work to distinguish between the resilience outcomes of recovery and
sustainability. Speed with which a person regains physiological homeostasis following
inflammation from an autoimmune flare is one example of Recovery aspects of resilience. The
length of time to return to pre-stress levels of depression is an example of recovery in mental
health. In contrast, Sustainability in mental health would be revealed by the preservation of
energy and commitment to purposeful engagements in work and family life under the adaptation
challenges imposed by psychosocial distress. For example, resilience may be examined through
estimates of sustainability of daily physical functioning under the stress of an episode of chronic
pain. In a recent public health study, retention of 20 or more teeth was used as the primary index
of resilience to urban poverty (Sanders, Lim, & Sohn, 2008).
To assess resilience resources, the researcher needs to be guided by theoretical models of
how people adapt successfully to stressful events. To date emphasis has been placed on variables
linked by theory and/or data to greater endurance. Investigators have begun to examine several
key variables of this capacity including measures of coping, flexibility, personal agency, sense of

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purpose, positive emotional engagement in daily life at home, work, and at play, emotion
regulation, and indicators of physiological buoyancy such as heart rate variability (Connor &
Davidson, 2003; Keyes, 2004; Masten & Powell, 2003; Ryff & Singer, 1998; Seligman &
Csikszentmihalyi, 2000). Theoretical models, research and interventions must also take into
account cultural values, beliefs and norms to increase understanding of resilience resources in the
experiences of individuals around the globe.
Public health researchers have studied related processes for some time as antidotes to stress
and vulnerability. Two examples of this emphasis are the study of social support (Berkman &
Glass, 2000) and personal control (Pearlin & Schooler, 1978; Reich & Zautra, 1990; Schulz,
1976), both seen as resources that promote adaptation to stressful situations. Indeed, concepts of
personal mastery and social support are among the most thoroughly conceptualized, researched,
and applied concepts in all the social sciences (Coyne & Downey, 1991; Skinner, 1996). The
perception that one can achieve desirable goals and retain a sense of mastery when life events
threaten one’s personal control beliefs defines the resilient individual. Further, the person’s
social world provides the meaning structures and supportive resources that enable individuals to
meet adaptation challenges. A science of resilience utilizes the best of these approaches in the
development of indices of that promote recovery and/or sustainability.
Some Candidate Indicators of Community Resilience
Work with communities should also take into account a two-factor model of resilience in
developing indicators. As with individual research, examination of community-level variables
has grown out of a risk-based tradition. There are numerous assessments that focus on
community risk such as crowded housing, poverty, high school drop out rates, and income
inequality promoted by the urban “Hardship Index,” now in its third edition (Montiel, Nathan, &

Page 19
Wright, 2004). Other indices and models that focus on community and neighborhood stress such
as the Community Stress Index (CSI, Ewart & Suchday, 2002) and measures of neighborhood
problems (Steptoe & Feldman, 2001) have also been developed to examine psychosocial effects
of environmental stress. Links between neighborhood stress and deprivation and individual
mortality and illness constitute an important field of inquiry in public health (e.g., Tonne et al.,
2005).
As Beck (1992) has noted, we tend to focus on living in a “risk society” where our public
policies, social services, non-profit and other organizations work to identify problems and areas
of weakness in our communities and in turn attempt to alleviate those symptoms. In fact, studies
of neighborhood crime and safety, poverty alleviation, welfare reform, economic development of
poor inner-city neighborhoods, and so forth represent a virtual subfield of urban inquiry. Even
former Senator Daniel Patrick Moynihan, remembered in part for his famous critique of the
poverty industry-complex, accepted the risk society model: “Well, life really is about risk and it
ends badly.” Such attitudes and beliefs trickle down from policies and community leaders to
color the way people construe their life experiences, and their motivations.
However, the last two decades have given way to an outcropping of research on community
resources that foster resilience. At the forefront of this research, extensive examinations of social
capital have underscored the importance of social trust, reciprocity, neighborhood efficacy, and
civic engagement in many aspects of community life (Coleman, 1990; Portes, 2000; Putnam,
2000; Putnam, Felstein, & Cohen, 2003; Putnam, Leonardi, & Nanetti, 1993). Not surprisingly
given the importance of social support and personal mastery as resources that promote adaptation
to the most stressful situations, social connectedness and cohesion have been shown to be linked
to greater vitality and stability in communities (Langdon, 1997). Studies probing the link

Page 20
between different indicators of social capital and health outcomes (Kawachi, Kennedy, Lochner,
& Prothrow-Stith, 1997; Veenstra et al., 2005) and research empirically examining the “mosaic”
of community risk and protective factors continue to highlight the critical influence of place on
individuals (Fitzpatrick & LaGory, 2003). These studies help us understand the complex and
variable matrix of capacities that communities rely on to enhance the physical, mental and
financial outcomes of its constituents and the individual consequences of developing greater
social and human capital.
Just as some individuals appear more resilient than others, similar variation in resilience
capacity has been found among communities (Vale and Campanella, 2005; Pelling, 2003;
Chaskin, Brown, Venkatesh, & Vidal, 2001), with some communities better able to maintain
healthy growth and development and to respond to stressors such as economic downturns or
natural disasters. This general finding raises profoundly important questions about the nature of
the relationship between individual and community resilience and the community role in crafting
deeper wells of resilience. To what extent do communities teach, or instill resilience in people as
opposed to either nurturing or blunting resilience tendencies that people bring to a situation?
How much of the variation in community resilience can be manipulated by community
programs, resource and activities versus variance that is more pre-determined ranging from
genetic determinants to some social, economic, and educational factors that are difficult to
change?
Previous research has developed several hypotheses and potential advances in identifying
key factors of community resilience capacity, but less hard data with which to discern how best
to conceptualize and assess these qualities (Flower, 1994; National Civic League, 1999). These
questions call for thorough empirical study grounded in theory and guided by advanced methods

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of inquiry that rely on multi-level framework for conceptualizing and evaluating the relationships
between indices of social, community and personal capacity. We suggest attention to distinctions
between recovery and sustainability may add clarity to research linking social worlds to health
outcomes. Wen, Browning, & Cagney (2007), for example studied neighborhood correlates of
physical exercise, a good indicator of sustainability of health. Other researchers may attend to
neighborhood rates of recovery following illness. Different community factors may be
responsible for sustainability versus recovery outcomes.1
A working hypothesis that guides current research on community resilience is that
communities like people can be taught to be resilient. But we are learning that this is not an
endeavor of quick and easy fixes. Communities must also nurture and build resilience from
existing natural relationships and among existing institutions. For communities as well as
individuals, sustainable resilience capacities are built over time, require a focus (often a re-focus)
on strengths not weaknesses, and rest on improved self-organization, self control (mastery), and
social connection.
The bridge from culture to health is built across neighborhoods and communities that connect
individuals who share common space as well as common ground to support a collective hope and
efficacy (Duncan, Duncan, Okut, Strycker, & Hix-Small, 2003). Research on racial segregation
and health disparities has shown how neighborhood resources can profoundly influence
individual health outcomes (e.g. St. Luke’s Health Initiatives, 2003). These research efforts
indicate that communities vary dramatically in their capacity to promote and sustain health and
healthy communities (Kretzmann & McKnight, 1993).Yet, studies that have examined the
relations between community-level factors like social capital and person-level variables like
health have had mixed results (Carpiano, 2006; Portes, 2000; Ziersch, Baum, Macdougall, &

Page 22
Putland, 2005), suggesting we have only begun to understand the boundaries of influence of the
social domain on individuals
Inconsistencies are not surprising given that different variables have been used in each study
to describe community capacity, resilience, health, and well-being. In addition, many questions
remain in community research, such as how to define communities, and isolate their effects
beyond that of individual variables. Communities are complex, as are the few partial theories
explored by analyses of these variables (Bourdieu, 1986; Coleman, 1990; O’Campo, 2003;
Portes, 2000; Szreter & Woolcock, 2004). Broad descriptive analyses of community factors that
range from socio-economic to environmental, from crime statistics to educational outcomes are
now available, but they lack integrative focus. Research papers are brimming with hypotheses
identifying key factors of community capacity, but little hard data with which to discern how
best to conceptualize and assess these qualities (Flower, 1994; Hall, 2002; National Civic
League, 1999). Both individual and community inquiry would benefit from integrative theory
and multi-level approach to this research.
In Table 2 we illustrate how measures of resilient resources may be paired with the resilient
(put the callout for Table 2 here)
outcomes of recovery and sustainability across three levels of inquiry: individual, family, and
community. These pairs represent hypothesized relationships between resilient resources and
outcomes, and may serve as a guide to building a science of resilience over the next decade of
research. For example, under individual resources we list “efficacy expectations” and pair that
resource with prevention of chronic disablement following injury or illness. There is evidence of
this relationship already in the literature (Bodenheimer,Lorig, Holman, & Grumbach (2002), but
we do not know the full extent of that relationship, nor do we know for whom this connection is

Page 23
more/less likely. The resilient outcomes for sustainability are different than those designated as
“recovery.” These outcomes fall within the realm of positive mental health (Ryff & Singer, 1998;
Zautra, 2003) and more generally, positive psychology identifying the growth and maturation of
some of the best qualities of the human experience.
In family/community levels we propose links between attributes of group relations and
outcomes favorable to community resilience like rapid recovery following a natural disaster and
trust. We include these kinds of hypotheses to encourage greater attention to the broader social
context, and the role of “community” in sustaining wellbeing for populations. Often, researchers
only study characteristics of the person and their “perceived” social worlds to test predictions of
individual wellbeing. The role of social relations is too fundamental to sustaining health and
recovery from illness to be ignored any longer by research.
Methods of Inquiry and Resilience Outcomes
Longitudinal design
To develop the appropriate technologies for the study of resilience we need to follow a few
basic principles. First, we need to study resilience over time. People develop themes in their lives
that offer them hope, optimism, purpose, emotional clarity and a wisdom built on a complex and
accepting view of their social relationships. But they do not do so all at once. Resilience as we
see it takes time to unfold. Further, there are many bumps along the way, periods of life when
many people look anything but resilient. If we fail to keep the cameras rolling past the point of
an illness episode we miss capturing the evidence we seek. A focus on the presence or absence of
the episode leads us to see people as healthy only until they exhibit signs of illness; then they are
sick. This way of thinking places enormous constraints on the development of constructs that can
inform our understanding of adaptation across the life span. For example, a person may be

Page 24
nourished by awareness of complex and, at times, painful emotions; a benefit not always
immediately apparent. Only through longitudinal observation and carefully conducted birth
cohort studies (e.g. Silva & Stanton, 1996) peppered with qualitative evidence from life-
changing narratives do we discover how the person has been and can yet be resilient (McAdams,
2006).
Developmental tasks are natural challenges to resilience that come about across the life-span,
identifying problems as well as revealing hidden capacities within. People who look resilient in
youth may not retain their resilient capacities in later life, though we suspect that the qualities
that make one resilient do tend to generalize to other situations and continue to support
successful adaptation and recovery later in life. The degree of cross-situational consistency and
stability of resilience over time are important to further develop in future studies. Both the
development of these capacities and their sustainability requires us to understand the trajectories
of the resilient mind and body over the life course.
Several longitudinal studies within developmental psychology provide a starting point for
such inquiry. A seminal study by Werner and Smith (2001) followed children on the island of
Kauai from infancy through adulthood with the initial sample targeting all pregnancies on the
island in a given year. Through data collection and analysis spanning forty years, this research
has been able to identify key risk and protective factors that influence outcomes across child
development and into adulthood. Findings have emphasized several key factors influencing
resilient outcomes, including: (1) individual characteristics such as self-esteem and purpose in
life; (2) characteristics of their families such as maternal caregiving and extended family support;
and, (3) the larger social context, especially having adult role models who provide additional
support (Luthar, Cicchetti, & Becker, 2000; Werner & Smith, 2001). This study along with other

Page 25
major longitudinal studies within child development (see Luthar, 2006 for a review) provide a
framework for tracking resilient development among children and adolescents over time and in
their transitions into adulthood. Although resilience research in child development provides a
critical foundation, longitudinal inquiries of health and wellbeing across adulthood introduce
unique challenges (Ong, Bergeman, Bisconti, & Wallace, 2006). The specific risk and protective
factors, and their salience to the desired goals for competence and adaptation will vary across the
life-span, influenced by culture and context.
Resilience research with adults must also address physical health, a domain diminished in
the child literature due to difficulty in detection of physiological processes in the early years of
life that increase risk for illness later. To fully understand resilience in adults, we advocate a
mind-body approach that incorporates both physical and mental health, and the interactions
between the two. The Framingham study (Dawber, Meadors, & Moore, 1951) has identified
many critical risk factors for illness and pathology over the course of adulthood, such as the role
of cigarette smoking and unhealthy diet on physical health outcomes. The next question is then,
what are the predictors of continued good health and functioning throughout life? Antonovsky
(1987) identifies “generalized resistance resources (GRR)” as the attributes and resources that
help individuals to maintain homeostasis and maintain optimal health. Others too (Evans &
Stoddart, 1990; Singer & Ryff, 2001) have recognized the need to examine not only trajectories
of illness but also trajectories of health. Resilience theories that provide coherent and integrative
biopsychosocial models of adaptation would provide this type of inquiry.
Multi-level Analysis
We define the content of inquiries into resilience as, (1) the study of the processes of
recovery from adversity, and (2) the processes underlying sustainability of purpose. The best

Page 26
methods to advance these inquiries are multi-level: The examination of resilience capacities at
the levels of the biological, psychological, social and organizational-community. Though any
one study may focus on core manifestations of resilience at one or two levels, a full
understanding of resilience requires methods that can examine how levels interact in the
prediction of resilience in the face of adversity.
The examination of resilience at the level of community poses formidable challenges to
researchers. Yet, communities of location (Black & Hughes, 2001) provide the context in which
all individuals, spanning life cycles, income brackets and cultural heritage, work, love and live.
The complexity of communities provides considerable methodological challenges, demanding
multi-level analyses that examine the richness of individual experiences as well as the
cumulative effects of environmental variables. The bi-directional influences of environmental
and individual characteristics raises questions of causality, highlighting the importance of
feedback loops, cascading effects and the endless interaction between levels of analysis.
Researchers across fields recognize the challenges of understanding, measuring and evaluating
the interplay between individuals and communities (Macintyre, Ellaway, & Cummins, 2002;
Rappaport & Seidman, 2000; Sampson, Morenoff, & Gannon-Rowley, 2002; Subramanian,
2004; Subramanian, Jones, & Duncan, 2003).
The “place effects” that were once considered a black box (Macintyre, Ellaway, & Cummins,
2002) may now be more clearly delineated with advances in analysis methods that do justice to
the many layers of influence on individual lives. Statistical analyses are now better able to tease
apart the differences between and within individuals and communities allowing us to examine
the diversity within our samples rather than look solely at aggregated data (Subramanian, 2004).
The increases in predictive power obtained permit an understanding of the richness of

Page 27
individuals and communities, and tests of the independent impact of risk and resilience factors
(Zautra, Hall, & Murray, in press).
Knowledge of core ingredients of resilience within the person shapes the agenda for insights
at the community-level, but awareness of ecological forces at work changes and extends the
metaphor of recovery and sustainability to include relational constructs like leadership,
reciprocity, and culture. With this greater understanding comes the “opportunity for
simultaneous pursuit of new knowledge and more effective practice” (Price & Behrens, 2003).
The use of multi-level modeling permits us to better estimate the influence of community-level
variables and examine variability both within and across communities, allowing us to inquire, for
example, about the determinants of and influence from the average level of “trust” within a
neighborhood, over and above the influence of the individual (Subramanian, Lochner, &
Kawachi, 2003). Improved research design and analysis can aid in identifying the short- and
long-term effects, from behaviors and attitudes to the accumulated stress and environmental
impact, of a neighborhood on individual outcomes (Ellen, Mijanovich, & Dillman, 2001). These
analyses provide the rich opportunity to look at different layers of effects over time and have
been recognized by community researchers as an essential tool in carrying out macro-level
research.
However, different levels of analysis often require attention to ecological influences, raising
fundamental questions about the resilience process under study as well. The study of trust is a
case in point (See Table 3). Trust is best understood at the level of the person, and his or her
(put the callout for Table 3 on this line)
social interactions. However, it can also be examined at a biological level as a “safety
response” with physiological markers of parasympathetic activation, and with neurohormones

Page 28
like oxytocin, which has been associated with trusting others with personal resources (Kosfeld,
Heinrichs, Zak, Fischbacher, & Fehr, 2005). Mutuality and cohesiveness characterize trusting
family networks. At the level of community, this quality may be best characterized as
collaborative ties, and fairness in the distribution of resources, measured through indicators that
can detect evidence of reciprocity in institutional relationships, neighborhoods, and
municipalities. Personal income is a valuable resource for resilience, but at the community level,
high levels of income disparity among groups within the community (Wilkinson, 1996) may
undermine processes of reciprocity and cooperation that permit the expression of trust in
interactions among members of those groups thereby weakening the psychological sense of
community (Brodsky, O'Campo, & Aronson, 1999). Resilience researchers need to be mindful of
the shifts in meaning of constructs like trust across levels of analysis. Measurement properties of
the variable and how that variable is related to other key aspects of adaptation may change
dramatically from the level of the person to that of community.
Studying Resilience in Action
Resilience scholars shift the focus of research on health and well-being through their
emphasis on processes that aid in the restoration of well-being following stressful experiences.
Stress reactivity research has correctly emphasized the need to examine responses close in time
to the occurrence of the stressor (Linden, Rutledge, & Con, 1998; Lovallo & Gerin, 2003;
Treiber et al., 2003). Only when the organism is challenged are its capacities fully tested and its
vulnerabilities revealed (Light, et al., 1999; Matthews, Woodall, & Allen, 1993). An important
area of research concerns the identification of genes that promote resilience under stress. Caspi et
al. (2003) reported that a functional polymorphism in the promoter region of the serotonin
transporter gene protects individuals from depression following stressful life events. Young

Page 29
adults homozygous for the long allele had fewer depressive symptoms, diagnoses of depression
and suicidality than individuals with one or two copies of the short allele. Some researchers ask
whether we can identify genetic factors in neural plasticity that can shape development of
resilience (Curtis & Cicchetti, 2003), and whether we can identify factors that slow the effects of
age on the decay of resilience (Hawkley et al., 2005).
A stress-diathesis approach that focuses solely on amplitude of the stress response is not
sufficient, however. To fully estimate success of psychophysiological adaptation to stress,
researchers need to assess both initial reaction and recovery (McEwen, 1998; Sapolsky, 1998).
Frankenhauser (1983) has shown that heart rate increases during the workday at all occupational
levels, but down-regulates more rapidly afterwards for those in higher status occupations. A
focus on resilience calls attention to the effect of time in the restoration of homeostasis. The
failure to down regulate following a stress response and to restore homeostasis both
physiologically and psychologically is the central contributor to allostatic load (McEwen, 1998;
Seeman, Singer, Ryff, Dienberg Love, & Levy-Storms, 2002). To study resilience properly, we
need to identify the critical factors within the person and their social situation that preserve
health and well-being by promoting restoration of homeostasis.
Advanced field methods offer ways to study resilience processes as they unfold in everyday
life. Electronic diaries may be used to monitor affects, cognitions and behaviors thought to be
sources of resilience as well as those thought to place the person at risk. These methods can be
used to record resilient responses and also failures of resilience day-to-day or even minute-to-
minute, or hour-to-hour, if you want to be this precise. Ambulatory recording devices permit
examination of physiological processes within days that may underlie recovery following stress
as well (Almeida, 2005).

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The resilience capacities of individuals and their families may be further tested through
longitudinal research following major life crises. Bonanno (2005), for example, has developed a
model of resilience built upon observations of how people respond to the loss of a loved one.
Chronic burdens in family life pose special challenges to adaptive capacities. Most people have
suffered through at least one highly stressful circumstance, and to understand resilience requires
a careful assessment of the variables which contribute to emotional, cognitive, and behavioral
changes that facilitated their recoveries.
The interpersonal contributions to resilient outcomes are likely substantial. Most stressors are
shared: Family and friends are involved, directly and indirectly, in the paths to recovery for
people in crisis. Homelessness, divorce, chronic mental and physical illnesses are examples of
situations that recruit whole families into them. To understand resilience requires us to advance
our methods as well as our concepts to evaluate the capacities of families to rebound when faced
with stressful circumstances. At the level of the individual, we may focus on a person’s capacity
for optimism, but at the family level, emotional leadership and a climate of acceptance may be
the critical features that hold the families together during a crisis. Family interaction research can
be used to characterize the behavior of resilient families, and social climate measures can add an
emotional profile.
Advances in neuroscience have permitted investigations of how family members exchange
biological goods as well as social ones, reacting to and sharing experiences are revealed in
changes in neurohormones, the heart and gut, as well as behavior (Charney, 2004; Craig, 2009).
Anxiety, hope, trust and attachment are shared qualities of families that are observable, in
principal at least, at the level of genes, neurophysiology, behavior, cognition and emotion. The

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dynamic changes in these family qualities in response to stress across levels and over time would
be needed to capture resilience processes underway at home.
Communities also respond to a broad range of stressful events, some acute, others chronic
disruptions. Some of these stressors, like discrimination based on income and race, lack of
affordable housing and/or jobs for residents, are deeply significant, yet often partially hidden or
denied. Others are relatively straightforward: A road closure, salmonella poisoning at the local
elementary school, an acute shortage of gasoline. There can also be catastrophic threats to public
health such as a terrorist threat aimed at the water supply, or the sustained failure of the electric
power grid during hot summer months. The survival and well-being of individuals and their
families depends not only on the resourcefulness of the people themselves, but also on the
responsiveness of the community. Community responsiveness in turn can be impacted by deep
and unresolved fissures of the types mentioned above.
As columnist Neal Peirce (2005) noted in his article about intergovernmental response to
Hurricane Katrina, spending billions on recovery can be viewed as an enormous opportunity if
the best minds are brought to the table to develop scenarios for public debate, if desirable
community goals and visions are derived from this process, and if long-term, effective
community-wide investments are made. These natural experiments may lead us to uncover the
best ways to assess and strengthen community capacity.
Examining Sustainability
Our second definition of resilience shifts our attention to those factors that preserve ongoing
goal-related and highly-valued activities that are keys sources of psychological and community
well-being. Ecologists remind us that time is a central factor in sustainability. Some systems and
societies survive well in the short term only to collapse later (Diamond, 2005). So too do some

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people appear unaffected by stressors, only to develop illness and emotional disturbance later.
Most research examining the person’s affective responses to stress focus on the extent of
negative affects provoked. However, other outcomes may be more central to preservation of
functioning long-term: The degree to which positive engagements continue uninterrupted, the
maintenance of broad affective range, and evidence of clear purposeful steps forward,
unimpeded by stress, even if taken only one at a time (Ong, Bergeman, & Bisconti, 2004).
However, with some notable exceptions (e.g., Bonanno, 2004; Bonanno et al., 2002; Ong et al.,
2004, 2006), studies of sustainability are rare when compared to the rich literature on stress and
recovery.
The adoption of a two-factor approach allows us the conceptual space needed to develop
methods of inquiry into the processes of sustainability of goals, purpose, and life satisfaction
independent of the study of the negative affective reactions to stressful change. Although
stressors may increase psychological distress, they may have little or no effect on how much
hope the person sustains for the future, personal efficacy expectations, and trust in social
relationships. Similarly, hope, efficacy and trust are also central to community health and at least
partially independent of collective stress. In fact the role of crisis and disaster in forging positive
public policy for the future is a frequent theme of the public policy literature (Vale &
Campanella, 2005). A prominent American historian Kevin Rozario (2005) writes:
Dominant colonial traditions encouraged a remarkably constructive approach to
calamity, leading settlers on a constant search for silver linings. Disaster
narratives became self-fulfilling prophecies, inspiring a faith in betterment, and
generating the energy, will and capital commitment that made reconstruction

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viable—ultimately turning calamities into opportunities and thereby…making
progress. (p. 34)
Communities have recently developed additional tools to use in building resilience while
enhancing the quality of community life. Substantial progress in collaborative leadership and
community efforts to develop community-wide goals and indicators of progress toward those
goals in a range of community domains can be observed in projects across the United States. The
best of these projects are inclusive longitudinal efforts that rest on the contributions of a diverse
array of community stakeholders, institutions and sectors (e.g., Sustainable Seattle Regional
Indicator Program http://www.sustainableseattle.org). These community efforts typically aim to
enhance some combination of community social, educational, economic, physical,
environmental, health and quality of life domains. As such, these projects are inherently geared
to build connections among people across central areas of community life and promote
interdisciplinary and cross-sector collaboration. An interdisciplinary focus on resilience offers
additional insight when examined at the level of neighborhood and community.
Fostering Individual Resilience
When applying themes of resilience in the design of interventions, we sharpen the saw of
current approaches, and also encourage new frameworks that take as their principal aim the
development of personal and community resources. For individuals there are many useful
prevention programs, and many valuable therapies, but few interventions that have articulated a
focus on resilience per se. Nevertheless, the skills and ingenuity of consulting and clinical
practitioners have led to many methods that are likely to be proven highly successful in boosting
individual capacity to recover from difficult times and sustain positive engagements.

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One change is apparent with a focus on resilience: A shift away from exclusive attention on
therapeutic methods and the endorsement of a broader scope of interactions designed to further
strengthen existing talents. Alongside psychotherapy are a host of other potentially valuable
interventions including “coaching” (Hart, Blattner, & Leipsic, 2001), life course review (Viney,
1993), exercise, and mindful meditation, to name a few. Snyder (2002) advocated workshops to
encourage pathways that strengthen the person’s capacity for hope. With a resilience framework,
the targets for lifting demoralization are made more explicit. From a two-factor framework, we
know, for instance, that restoring hope does not demand exclusive attention to alleviation of
psychological distress. A person can be hopeful even when still anxious. Optimism can be urged
even for those who cannot (or will not) give up their fundamentally pessimistic outlooks.
Attention to emotion regulation that includes an embrace of the positive extends the metaphor of
the therapeutic beyond that of coping and adjustment to include encouragement of feelings of
joy, pleasure and exhilaration that come from pursuits of core values.
Reich (2006) identified three core principles to follow in developing resilience interventions
following catastrophic events: Sense of control, coherence, and connectedness. There is broad
applicability of these three “C’s” to which we might add a fourth: Culture. The social context as
well as the interior of the mind shape what constitutes a positive experience and distinguishes it
from that which is negative. We assert that resilience can be a universal outcome, with multiple
methods and interventions which may be more or less effective depending on the challenges
faced and individual, family, community and cultural influences. Many of the interventions
proposed and tested to date emphasize Western theories and values and further development of
interventions to foster resilience across cultures is needed.

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A number of interventions have been proposed in the last decade within the positive
psychology framework (see Snyder & Lopez, 2002). These interventions have focused
specifically on fostering positive engagement with attention to constructs like “flourishing”
rather than psychopathology and the alleviation of distress (e.g. Keyes & Haidt, 2002). Another
recent approach has been to encourage methods of “forgiveness” thereby releasing restraints on
the positive feelings that family members with a history of conflict still may have toward one
another (e.g. McCullough, Pargament, & Thoresen, 2000). In a large internet-based study of
positive psychology interventions, Seligman et al. (Seligman, Steen, Park, & Peterson, 2005)
found that when individuals wrote about three good things that happened each day and used their
identified signature strengths in new ways each week, the people reported higher ratings of
happiness and lower ratings of depression up to six months post-intervention. These techniques
are not new. Effective interventions for depression have often included positive activity
“homework” for those suffering from major depression (Lewinsohn & Graf, 1973). What is new
is the paradigm: An attention to the positive for the explicit purpose of enhancing well-being and
not as a salve for troubled states of mind. When seen with a two-factor lens, this approach is not
simply compensatory or even rehabilitative in nature, but a means to further human
development, along independent trajectories. Thus, the key to resilience is not only the capacity
for calm, but the development of greater self-awareness, resulting in the attainment of personal
hopes and social purposes.
Fostering Community Resilience
Resilience themes can be applied to the development of social and community interventions
as well. Here, the focus is on furthering the expansion of social capital and strengthening
connectivity by the reorganization of social exchange. Individual capacity to learn, achieve, and

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excel at work is strengthened by organizational reforms that shift responsibility (and
accountability) for complex tasks downward. Programs in job enrichment (Herzberg, 1966), built
upon an understanding of personal needs for mastery and growth on the job, can be highly
beneficial to the company profits as well, building greater collective capacity as well as
furthering the firm’s social capital. These efforts are examples of effective resilience solutions in
which personal development and organizational capacity are threaded together as a long-term
investment strategy for a healthy and energetic organization.
A broad systemic view of intervention is often not taken. For a host of reasons, interventions
often "morselize" (Lane, 1962) instead. They focus on narrow dimensions of “the problem” and
immediate achievable measures of outcomes such as quarterly profits or election validations
rather than building system-wide capacity for the long-term. This is particularly evident in the
proliferation of community activities designed to help people cope with problems in living.
Marginal tinkering with programs, and minor investments in neighborhoods, are unlikely to
foster resilient communities. In fact, many limited and targeted grant efforts do just the opposite
and reinforce separation and segregation, and in some cases even destroy communities (Chaskin,
Brown, Venkatesh, & Vidal, 2001; Churchill, 2003; Peirce, 2005).
Wildavsky (1988) explores the public policy implications of the fact that risk (danger) and
safety are inextricably intertwined and should be viewed in a systems context. Wildavsky points
to the danger of thinking in terms of “all good” and “all bad” and counsels a search for safety
and development of the whole which involves reduction but not elimination of risk overall. In
advocating resilience over resistance as a central organizing theme for city planning and
management, Churchill (2003) advises: “conserving and investing in the human, social,

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intellectual and physical capital which constitutes its protective factors, rather than expending a
large part of the energy of its leadership in short-term efforts.” (p. 357).
Innovative resilience programs can change the structure of social exchange within our
communities. The “Experience Corps” (Fried et al., 2004) is one example. This program engages
retired senior citizens to advance the chances of young children within inner-city schools. The
seniors are provided a way to participate meaningfully in bettering the lives of children in their
community. In turn, the children have a surrogate, caring grandparent who watches over them
during part of the school day. Success is measured by markers of well-being among the seniors
as well as retention rates of the children in high school.
St. Luke’s Health Initiatives (2008), a public foundation in Phoenix, Arizona, has launched a
five year, multi-million dollar program that blends the authors’ resilience model together with
strength-based community development as a key to resilience (Kretzmann & McKnight, 1993).
Called “Health in a New Key (HNK),” this intervention awards community organizations that
develop new partnerships to implement resilience-based interventions that focus on assets, not
deficits. The effort is defined as “a way of identifying, framing and responding to issues that
focuses first on existing strengths and assets…and avoids the pervasive culture and model of
deficits and needs” (Saint Luke’s Health Initiatives, 2003). This initiative marks an important
step in providing funds to move beyond threat and response paradigms to funding resilience and
assets-based research and interventions that can be sustained within communities.
HNK is based on a redefinition of health and measures of progress in that domain.
According to the designers of HNK, in the traditional definition of health (“health in the standard
key”): “Health proceeds through diagnosis and treatment based on science, evidence and best
practices. Illness, pathology, needs and deficiencies are identified. Treatment and services are

Page 38
provided. Patients and communities are ‘restored to health’ ” (St. Luke’s Health Initiatives,
2003). Juxtaposed to this definition is Health in the New Key: “Health is the harmonious
integration of mind, body and spirit within a responsive community. Diagnosis and treatment,
yes, but the focus shifts to strengths and assets first, not just deficits” (St. Luke’s Health
Initiatives, 2003). By providing financial support in the form of nine 5-year partnership grants to
collaborations of public and private nonprofit organizations throughout the vast Phoenix
metropolitan areas, St. Luke’s Health Initiatives hopes to promote resilience and better
community health by nurturing exiting organizations, instilling a new approach to health in the
region and developing “stronger and more pervasive formal/informal community networks
focused on improving health outcomes” (St. Luke’s Health Initiatives, 2008).
Examples from current funded partnerships include collaborative efforts designed to foster
broad goals of community building and resilience while meeting important targeted objectives
such as:
1. Develop sustainable asset mobilization that improves community response to health
challenges
2. Increase the number of Phoenix Hispanic families willing and able to provide foster
and/or adoptive homes for Hispanic children
3. Identify promotoras to serve as leaders addressing community health priorities to
measurably improve maternal and infant outcomes in South Phoenix and Maryvale (Phoenix
communities with large poverty populations) (St. Luke’s Health Initiatives, 2008)
Other examples include the Healthy Communities Initiatives by the World Health
Organization (WHO, 1997), as well as the National Civic League’s All-American Cities awards
and its development of the Civic Index (National Civic League, 1999). The Resilience Alliance

Page 39
is an international network of institutions and agencies that focuses on social-ecological systems,
promoting adaptability and sustainability surrounding developmental policy and practice. The
Community Resilience Project based in British Columbia has developed manuals and guides to
enhance the capacity of individuals and communities in responding to change. These programs
and many more, represent a new era of public policy and programming that attend to both the
needs and the deficits within our communities. Future efforts must strive to continue to unify
theory and integrate social activism with models of health and well-being built upon a solid
empirical foundation.
Resilience: More than a Metaphor
Resilience has become a powerful metaphor for human endurance in a wide array of
literature, ranging from scholarly articles about ecology and urban affairs, to the financial and
sports pages of the daily newspaper. We hope we have shown that there is now substantial if not
universal evidence of its paradigm-building strength among social scientists interested in models
of health and well-being across the life span. As metaphor, resilience exerts a powerful influence
on how we think about physical health, psychological well-being and community functioning. In
this paper, our aim has been to develop resilience as more than a metaphor by providing
guidance to scientific inquiry. We have advocated measurement methods, multilevel designs, and
a two-factor approach to modeling health and well-being for individuals and their communities.
In our view, only by gathering longitudinal data in studies of the turning points in the trajectory
of an individual or a community, along with contemporaneous assessments of everyday life, and
conducting controlled laboratory studies that provoke challenges to adaptation will we begin to
specify the mechanisms that underlie resilience. By establishing urban observatories to mark
progress along dimensions of resilience for collectivities, and testing the efficacy of interventions

Page 40
that seek to strengthen resilience for people and their social worlds we may arrive at the point to
declare, as Edward Jenner (1801) did with the smallpox vaccine, that the evidence favoring this
approach to health was “too manifest to admit of controversy.” Meanwhile, there will be plenty
of criticism of resilience concepts, and much healthy debate about measures, and methods of
change. In science, that is as it should be.

Page 41
Table 1. Risk and Resilience Resource Indices
Risk factor index
Resilience resource index
Biological
Blood pressure: diastolic >90, systolic >140
Heart rate variability
Cholesterol >240 mg, resting glucose >124,
BMI >25
Regular physical exercise
Genetic factors associated with anxiety
Genetic factors associated with stress resilience
High C-reactive protein and/or other
elevations in inflammatory processes
Immune responsivity and regulation
Individual
History of mental illness
Positive emotional resources
Depression/helplessness
Hope/optimism/agency
Traumatic brain injury
High cognitive functioning, learning/memory &
executive functioning
Interpersonal/family
History of childhood trauma/adult abuse
Secure kith/kin relations
Chronic social stress
Close social ties
Community/organizational
Presence of environmental hazards
Green space and engaging in the natural
environment through community gardening
Violent crime rates
Volunteerism
Stressful work environment
Satisfying work life

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Table 2. Illustrations of Resilience Resources and Hypothesized Resilient Outcomes
Resources
Hypothesized outcomes
Individual recovery
Heart rate variability
Physiological recovery following stress
Supportiveness of social network
Low depression and anxiety following loss
Coping capacity/efficacy expectations
Prevention of disablement following injury
TH1/TH2 balance of immune response
Rapid immune response to acute illness/injury
Individual sustainability
Sense of purpose
Sustained elevations in positive emotion, and hope
Emotional awareness and clarity
High levels of emotion differentiation/complexity
Social connection/affiliation
Social meaning and value sustained under stress
Family/community recovery
Empathetic concern for
family/neighborhood/ community
Rapid return to normal pace of community life
following disaster
Rapid response crisis training
Fairness in allocation of local resources
Absence of collateral damage during recovery
Minimal “place” clustering of chronic illness
Family/community sustainability
Leadership fostering citizen participation
Vitality/Enthusiasm for living shared by members
Culture of democratic decision making
Lasting trust in governance of community resources
Reciprocity and mutual respect in
community relations
High levels of well-being shared by those in the
family/community

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Table 3. The Study of. Trust Across Multiple Levels of Analysis
Level of analysis
Sample constructs
Research approaches
Biological Basis
Oxytocin
Experimental designs, lab
assessments
Individuals
Interpersonal trust
Cross-sectional studies,
daily diary studies
Families
Family cohesion, mutuality,
and trust
Cross-sectional, family and
genetic studies
Communities
Collaborative ties,
reciprocity, fairness
Epidemiological
/community samples, social
indicator research

Page 44
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1 To develop specific answers to these questions, The Resilience Solutions Group of Arizona
State University (www.asu.edu/resilience) has begun a comprehensive five year study of
residents of forty diverse “social worlds” in greater Phoenix, Arizona. Results from that study
and related research may provide empirical evidence to support a community resilience index
and a menu of most effective options for building resilience in communities.