Resilience in Glasgow: reflections and connections

On Sunday morning I watched the London Marathon coverage on TV. I can only imagine the discomfort felt by the runners. Blue skies and sunshine led to the highest temperatures ever recorded during a London Marathon and 26.2 miles is a long way. We might say that to cross the finish line, the runners were resilient.

But what do we really mean by this? When are we, as people and communities, resilient? And if we are not able to be, what then?

Last week, the GCPH hosted their 21st Healthier Future Forum supported by a series of blogs, of which this is the final instalment. We heard from Sarah Toy, Chief Resilience Officer for Bristol; Duncan Booker, Chief Resilience Officer in Glasgow and, from the GCPH, Pete Seaman spoke about continuing and emerging challenges that may undermine resilience in the city. From these speakers, and the lively workshop conversations among the participants, connectedness emerged, for me, as the strongest theme. Simply put, to be a resilient population, people need to be and to feel connected to others; as Michael Marmot has told us, “people with stronger networks are healthier and happier” (Fair Society, Healthy Lives, 2010). This is not new or startling, you might say. Here at the GCPH we research and reflect not only to learn, but also to affect change, so what can we do – or do more of – to create the conditions for resilient people and populations to flourish?

Our early research on resilience for public health (2014) has been part of a growing general sense that supporting the resilience concept into practice is a worthy goal. You may have noticed references to resilience popping up in plans, policies and conversations across Glasgow.

In this work, we describe resilience as being simultaneously ‘within us, between us and beyond us’ – and the Forum participants appeared to support this framing of the concept. Our social, physical and economic circumstances strongly influence our inner resources (what is within us), how connected, or isolated, we find ourselves (what is between us) and our links to people and organisations that make decisions that affect our lives (that which is beyond us).

The London Marathon course will have felt longer for some than for others; just as in life, our individual experiences are not equal. Andressa Gadda’s blog explores how early life experiences play a crucial role in our development and health and wellbeing throughout the course of our lives. We must be mindful of these differences in asking a person, or a population, to be resilient. Tackling such inequalities was touched on by Jamie Cooke through the lens of social protection in his blog.

Returning to my marathon metaphor, perhaps in considering the resilience concept we should be feeling uncomfortable, just like Sunday’s runners. We are learning from research about the picture of inequality and population health in Glasgow and Scotland so that we might collectively take positive action. However, exploring resilience as a way of supporting population health has shown us that human relational responses are important to allow the strengths and aspirations of people and populations to be realised. Taking a human perspective in assessing the wide variety of information available to us on poverty and inequality takes us beyond the data to a picture that is moving and emotional.

Promoting resilience as a concept that can support population health is not about recommending a set of actions. (If only it were so simple.) To endure is important, but resilience is also about adapting; supporting moving on and moving up – for which connectedness, often described as ‘social capital’, is imperative.

However, re-framing our existing perspectives may be illuminating. For example, give some thought to the distinction between big systems (our NHS, or local authority) as inanimate organisations, to understanding that people are the essence of all such systems. Professional roles too, are occupied by human beings. The ‘people’ and ‘communities’ we talk and write about are also us. Cathy Sharp, in her blog, asks us to bring a piece of ourselves to the workplace. Related to this, Carnegie UK’s newly established Kindness Innovation Network recognises a role for all of us in protecting each other from loneliness and social isolation to promote resilient and empowered communities. 

As well as individuals, organisations too may become more resilient in creating links with those around them and with the people they serve – but disinvestment and the need (perceived or actual) to compete for funding can undermine efforts to reach out and share. A recently published piece of action research, Weathering Change, demonstrates that supporting local organisations to connect is possible and a shared vision, with people at the centre, is certainly helpful in achieving this aim. Can funders also incentivise community-based organisations that collaborate?  

Lastly, I want to mention measurement. Judging success in terms of building resilience is undoubtedly problematic, both at the individual level and for communities and systems. We need to use carefully selected indicators of change, being wary of the inevitable draw to those that are simplest to measure. Because it is not easily evidenced does not mean that change has not occurred, or that the outcome is any less important. Qualitative methods, alongside quantitative, are often wholly appropriate and just as robust when used well, and in the right circumstances.

The social context is challenging, and we have no reason to believe the pressure will be alleviated. If we take the time and energy to create the conditions that help people, communities and places to flourish, rather than focusing our efforts on creating resilient systems in themselves, we may feel more connected too. After all, building connections and relationships that matter is a marathon, not a sprint.