The health care environment remains in a state of flux, impacts of climate change continue to advance, the long economic expansion is coming to an end and, on a national level, identity politics are as divisive as ever. The institutions of liberal democracy that inform the cultural fabric of a free society are under threat.

It is now more important than ever to build resilience on a personal and community level. How?

First, keep those disaster kits supplied with sufficient food, water, first aid, extra medicine, flashlights, fuel and emergency plans. My spouse has taken disaster preparedness courses to help ensure there are enough of us in the community to come together to optimize health, food, water and energy security should we take a direct hit from a hurricane or tsunami. To the extent possible, we also must take measures to harden our residential structures, which could make the difference between getting through a Category 1 versus a Category 3 hurricane.

For energy, Hawaii continues to lead in photovoltaic roof systems, and more homes are also acquiring battery storage so as to remain viable should the grid go down. Many of the new PV (photovoltaic) inverters have a regular plug that can be used during daylight hours. At a minimum, try to acquire a generator.

Resilience also requires us to keep our personal health as fine-tuned as possible. Many people keep a tight maintenance schedule for our vehicles. Why not for our bodies and minds as well? In addition to regular attention to diet and exercise, it is essential to secure health insurance and maintain an active relationship with a primary care provider.

Open enrollment for the Hawaii Medical Service Association starts Oct. 15, and for the Affordable Care Act, otherwise known as Obamacare, on Nov. 1. Take the time and effort to think about whether you feel well served by your existing insurance company and the team of health care providers you’ve been seeing for care. Open enrollment offers the annual opportunity to make changes if you think you can do better. Bear in mind that there remains a severe physician shortage in Hawaii. For that reason, Manakai o Malama continues expand its medical care team so there is always room for new patients.

Stay connected. Resilience also can be developed simply by strengthening our relations with our ohana, neighbors and co-workers. No amount of wealth or material possessions can replace committed, caring human relationships where we live and work, especially during trying times.

Above all, resilience is the result of our own internal perspective. Having a sense of trust, faith, flexibility and connection is the ultimate way to counter fear, overly rigid thinking and divisive relationships. Learning how to react thoughtfully and without malice when confronted with seemingly unkind or uncaring behavior in life can be a huge blessing. So often, a simple smile can help to turn the tide. At Manakai we remind our staff that we never know what kind of health or life issues someone may be dealing with. They may be in pain, or broke, or subject to abuse by a family member.

Finally, committing ourselves to forging long-term solutions to those issues that will affect generations to come is also part of being resilient. With the enormity of challenges we face, we have the responsibility to look both at the present and into the future and determine our individual role in building a safer, more connected world.

Ira Zunin, MD, MPH, MBA, is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center. His column appears the first Saturday of every month. Submit any questions to info@manakaiomalama.com.