The relationship between public health system resilience and psychological resilience: multilevel regression study

Objective: This study aims to explore the effect of Public Health System Resilience (PHSR) on the psychological resilience of individuals. To demonstrate this interaction, the study investigated psychological resilience levels of individuals negatively affected by the recently experienced COVID-19 pandemic as a disaster period in the province of Çanakkale. Method: This study was conducted in two stages in April and September 2022. In the first stage, the PHSR Scorecard prepared by the United Nations Office for Disaster Risk Reduction was used to obtain the scores from the Merkez province of Çanakkale and the Bayramiç and Ayvacık districts. In the second stage, a questionnaire for demographic data and the Psychological Resistance Scale was administered to 510 people, including those over 65 years, small business owners, and students (high-school grades 2 and 3). The results were analyzed at two levels and with three different models using the Multilevel Regression analysis. Results: Based on the multilevel regression model formulated for the factors affecting Psychological Resilience, it was found that PHSR was an explanatory or predictor variable for psychological resilience, and a high public health system resilience was associated with a high psychological resilience (Model 1 ß:0,29, p<0,05), (Model 2 ß:0,26, p<0,01) (Model 3 ß:1,05, p<0,01). It was also found that in PHSR interactions, small business owner groups (β =-0,77, t=-2,35, p<0,05) and student groups (β =-1,56, t=4,72, p<0,01) were affected more negatively than the group aged over 65 years. Conclusion: Our study has demonstrated that PHSR effectively enhances individuals’ psychological resilience. © 2025 by the Association of Public Health Specialist.