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THRIVE: Community Tool for Health & Resilience In Vulnerable Environments

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A Community Approach to Address Health Disparities
Prevention Institute has updated its Community Approach to Addressing Disparities in Health with the revision of THRIVE: Toolkit for Health and Resilience in Vulnerable Environments. A centerpiece of THRIVE is a set of community level factors that are linked to Healthy People 2010 Leading Health Indicators. It now features a simplified list of twelve factors to facilitate use of the tool at the local level.

NNPHI and Prevention Institute Partner to Address Social Determinants of Health
In 2010, the National Network of Public Health Institutes (NNPHI), in partnership with Prevention Institute (PI), was awarded a five-year cooperative agreement by the Office of Minority Health (HHS) to further develop and disseminate PI's Tool for Health and Resilience in Vulnerable Environments, or THRIVE. By building on the original tool, NNPHI and PI will increase the capacities of local PHIs to address social determinants of health. Currently in our final year of the cooperative agreement, PI and NNPHI are rounding out our training and technical assistance with the last three of a total of 16 Public Health Institutes.

This project is made possible by funding from the Office of Minority Health, U.S. Department of Health and Human Services.

To access information about our partnership with the National Network of Public Health Institutes, click here.

A Community Resilience Approach to Improve Health Outcomes

THRIVE (Tool for Health and Resilience in Vulnerable Environments) was created to answer the question, "What can communities do to improve health and safety and reduce inequities?" THRIVE is: a process for engaging community members and practitioners in changing community conditions to achieve better health and safety outcomes; and, a tool for assessing the status of community conditions and prioritizing them for action to improve health, safety, and health equity. Prevention Institute recently updated THRIVE which now features a simplified list of twelve factors to facilitate use of the tool at the local level.

For the updated, interactive tool, click here.

For an overview of THRIVE, click here.

Poor health and safety outcomes, including chronic disease, traffic-related injuries, mental illness, substance abuse, teen pregnancy, and violence, are disproportionately high among low-income people and people of color in the United States. In addition, the impact of racism and oppression increases numerous risk factors for illness and injury, including reduced access to fresh nutritious foods, fewer opportunities for physical activity, greater exposure to environmental toxins, and substandard housing and neighborhood conditions. To date, resilience approaches have tended to focus on individual measures and we know that attention to community-level factors is also important. THRIVE focuses on community level resilience factors so that communities can increase their capacity to improve health and safety.

Advancing a Community Resilience Approach to Improve Health Outcomes

With the increased recognition of existing health disparities in the United States, there has been an emphasis on treatment and intervention. However, there is also a need to prevent health disparities before the onset of injury, illness, or death. Focusing on underlying factors, both risk and resilience, can save lives and money and reduce suffering. Resilience, defined here as the ability to thrive and overcome risk factors, merits attention in order to achieve health and safety outcomes. Studies show that resilience factors can counteract the negative impact of risk factors and that effective approaches need to include attention to both. Given that the bulk of attention has gone to risk factors, this project will highlight resilience factors that support health and safety outcomes.

The building blocks of healthy communities include marketing and availability of healthy foods as opposed to fast food and tobacco, safe parks, high quality education, health and social services, community gathering places, and locally owned businesses. Research confirms the relationship between such factors and health and safety outcomes. For instance, social cohesion corresponds with significant increases in physical and mental health, academic achievement, and local economic development, as well as lower rates of homicide, suicide, and alcohol and drug abuse. Other examples of community resilience factors include environments that promote walking, bicycling, and other forms of incidental or recreational activity, jobs, a willingness to take action for the common good, positive intergroup relations, and positive social norms. By strengthening such factors, communities have significant capacity to enhance health and safety.

Under this cooperative agreement, NNPHI and PI updated the research from the original tool, developed a training manual, trained 80 trainers at Public Health Institutes, and enabled 16 sites to integrate THRIVE into their approaches to address the social determinants of health and reduce inequities.

For more information on the development of THRIVE, click here.


Associated File(s) (click to download):


Prevention is Primary


Read Chapter One here

Book cover photo credit G.Meyer(c)2006