Current approaches to health system resilience tend to prioritize system-level outcomes (e.g. functionality) while overlooking key underlying social processes, contexts, and power-laden interactions through which resilience is produced. When community resilience is subsumed under health system resilience, without attending to distinct contextual factors, it can lead to fragmented approaches or maladaptive outcomes that misalign with the resilience of communities. Therefore, resilience approaches need to include additional methods that incorporate analyses of power structures and context. We propose intersectionality theory as a methodological lens to investigate the underlying social processes and power dynamics that shape community resilience and health system resilience interactions. An intersectionality approach prompts researchers to distinguish how resilience capacity is derived through the involvement of community actors, their unique intersecting social identities, and their lived experiences. Including an intersectional lens in resilience approaches provides researchers with the tools to identify points of practical constraints that arise at the intersection of communities and health systems, with particular attention on the burdens that are placed on community actors.

(1) Background: Health disparities across the United States (U.S.) are increasing. Large variations in risk factors and health outcomes have been described among states from the U.S. (2) AIM. This study aims to describe health trends in morbidity, mortality, and risk factors from 1990 to 2019 in the State of Colorado. (3) Methods: We describe the measures of health loss for 286 causes of death, 369 diseases and injuries, and 87 risk factors for the state of Colorado from the Global Burden of Disease project estimates between 1990 to 2019. (4) Results: We found that 21,171 and 40,724 deaths were estimated in 1990 and 2019, respectively, in Colorado. The leading cause of death, in both sexes, in 1990 and 2019 was ischemic heart disease (IHD). The top leading disability-adjusted life years (DALY) diagnoses were IHD, followed by low back pain, chronic obstructive pulmonary disease, and opioid use disorder. In 2019, the top risk factors by DALYs in Colorado were smoking, drug use, high body mass index (BMI), alcohol use, high fasting plasma glucose, and high systolic blood pressure. (5) Conclusion: Non-communicable diseases and their related risk factors are the top leading causes of DALYs in Colorado. Findings support the need for policies to prevent non-communicable diseases, with special attention to musculoskeletal disorders and interventions to reduce tobacco, alcohol, and drug use.