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Article

Education is strongly associated with better health and longer lives. However, the extent to which education causes health and longevity is widely debated. We develop a human capital framework to structure the interpretation of the empirical evidence and review evidence on the causal effects of education on mortality and its two most common preventable causes: smoking and obesity. We focus attention on evidence from randomized controlled trials, twin studies, and quasi-experiments. There is no convincing evidence of an effect of education on obesity, and the effects on smoking are only apparent when schooling reforms affect individuals’ track or their peer group, but not when they simply increase the duration of schooling. An effect of education on mortality exists in some contexts but not in others and seems to depend on (i) gender, (ii) the labor market returns to education, (iii) the quality of education, and (iv) whether education affects the quality of individuals’ peers.

Article

Starting in the 1920s, the first initiatives to organize the control of cancer in Argentina soon revealed the presence of different actors and interests, a specialized cancer institute, a women’s voluntary organization, state authorities, university departments, cancerologists, and gynecologists. Initially concentrated around the activities of the Institute of Experimental Medicine for the Study and Treatment of Cancer in Buenos Aires, cancer interventions expanded in the following decades through university departments and gynecology services, which outlined a decentralized approach for reining in the centralized efforts from the institute. While a therapeutic-based approach with substantial funding for research institutes characterized industrialized countries’ initiatives until the end of World War II, in Argentina it was within the field of cancer diagnosis where specialists sought to create the foundational structures of cancer organization. Early detection of tumors, it was argued, favored a good prognosis with surgical treatment, placing the burden of cancer control on public education, the availability of diagnostic services, and doctors’ knowledge of cancer identification. From the 1920s to the early 1980s, three distinct periods can be identified: first, an institutional approach, where the first cancer institute attempted to concentrate all the activities related to the control of cancer, that is, lay education, scientific research, diagnosis and treatment, patients’ support, and cancer statistics; second, a state approach, inaugurated by the arrival of Juan Domingo Perón to government, where the centralization of cancer initiatives became a state affair; and third, a long period characterized by the retirement of the state—marked by political unrest and a succession of military governments until the return of democracy in 1983—informed by decentralizing policies, the prominent role of civil society actors, such as voluntary organizations and medical societies, and the relative sway of the Pan American Health Organization. Throughout these three periods, all these actors played a role, and their ambivalent relationship and, often poor, interaction shaped the country’s efforts to control and prevent a disease that, since the 1940s, has steadily occupied the second cause of death. As the early detection strategy prevailed, responsibility for cancer control and prevention was constantly redistributed among the public, doctors, educators, and those who financed cancer services. The national state emerged as a feeble agent in cancer governance and, as discussed in the final section, this legacy is still felt today.

Article

The prevention of communicable diseases, the containment of epidemic disorders, and the design of programs and the implementation of public health policies went through important transformations in Mexico, as in other Latin American nations, between the final decades of the 19th century and first half of the 20th century. During that period not only did the advances in medical science make possible the identification and containment of numerous contagious diseases; it was also a time when the consolidation of formal medical institutions and their interaction with both national and international actors contributed to shape the definitions and solutions of public health problems. Disease prevention strategies were influenced by medical, scientific, and technical innovations and by the political values and commitments of the period, and Mexico experienced profound and far-reaching political, economic, and social transformations: the apogee, crisis, and downfall of the long Porfirio Díaz regime (1876–1910), the armed phase of the Mexican Revolution (1910–1920), and the period of national reconstruction (1920–1940). Thus, during the period under consideration, and alongside the consolidation of an official medical apparatus as an integral part of public power, the promotion of public health became a crucial element to reinforce the political unification and the social and economic strength of the country.

Article

Dennis Myers, Terry A. Wolfer, and Maria L. Hogan

A complex web of attitudinal, cultural, economic, and structural variables condition the decision to respond to communications promoting healthy behavior and participation in risk reduction initiatives. A wide array of governmental, corporate, and voluntary sector health-related organizations focus on effective messaging and health care options, increasing the likelihood of choices that generate and sustain wellness. Researchers also recognize the significant and multifaceted ways that religious congregations contribute to awareness and adoption of health-promoting behaviors. These religiously based organizations are credible disseminators of health education information and accessible providers of venues that facilitate wellness among congregants and community members. The religious beliefs, spirituality, and faith practices at the core of congregational cultural life explain the trustworthiness of their messaging, the health of their adherents, and the intention of their care provision. Considerable inquiry into the impact of religion and spirituality on health reveals substantive correlations with positive psychological factors known to sustain physical and psychological health—optimism, meaning and purpose, hope, well-being, self-esteem, gratefulness, social support, and marital stability. However, the beliefs and practices that create receptivity to health-related communications, care practices, and service provision can also be a deterrent to message impact and participation in healthy behaviors. When a productive relationship between spirituality and health exists, congregational membership offers rituals (e.g., worship, education, mission) and relationships that promote spiritual well-being. Research demonstrates increased life satisfaction and meaning in life, with health risk reduction associated with a sense of belonging, enriched social interactions, and shared experiences. Congregations communicate their commitment to wellness of congregants and community members alike through offering a variety of congregationally based and collaborative wellness and risk reduction programs. These expressions of investment in individual and community health range across all age, gender, and ethnic demographics and address most of the prominent diagnostic categories. These programs are ordered along three dimensions: primary prevention (health care messaging and education), secondary prevention (risk education), and tertiary prevention (treatment). Applying the dimensions of sponsorship, goal/mission, focus, services, staffing, and intended outcome highlights the similarities and differences among them. Several unique facets of congregational life energize the effectiveness of these programs. Inherent trust and credibility empower adherence, and participation decisions and financial investment provide service availability. These assets serve as attractive contributions in collaborations among congregations and between private and public health care providers. Current research has not yet documented the best practices associated with program viability. However, practice wisdom in the planning, implementation, and evaluation of congregationally based and collaborative health-related programs suggests guidelines for future investigation. Congregational leaders and health care professionals emphasize well-designed needs assessment. Effective congregational health promotion and risk reduction may be linked to the availability and expertise of professionals and volunteers enacting the roles of planner/program developer, facilitator, convener/mediator, care manager/advocate, health educator, and direct health care service provider.

Article

Ruth Irelan Knee

Milton Wittman (1915–1994) was a social worker, writer, and leader in social work, public health, and mental health. He played a key role in the expansion of opportunities for social work education and for the involvement of social workers in the provision of mental health services.

Article

Edward Pecukonis

The concept of health profession centrism and its effects on interprofessional education is important to Social Work practice. Profession centrism is concerned with a student’s professional socialization and their ability to work effectively with other health professionals and clients. This cultural frame determines the salience of curriculum content, core values, practice rituals and customs. It determines the meaning and etiology of symptoms and what constitutes health and treatment success. The interprofessional education (IPE) agenda is often seen as “soft curriculum” content and put to the side for the rigors of health sciences. Paradoxically, it is these issues of communication, ethics, role definition, and working as a team that creates problems among health professionals which compromise safety and efficiency in patient/client care. Learning to minimize profession centrism is a critical education and training objective for health social workers.

Article

Richard Hoefer

Understanding both public and private welfare expenditures is necessary to appreciate the full scope of a social welfare system. This entry examines spending in four major areas of social welfare policy (health, medical, and nutrition; retirement and disability insurance; income maintenance and welfare; and education), comparing the public and private sectors. While expenditures for both sectors are increasing, private expenditures are not increasing as a percentage of total costs, despite efforts to privatize social welfare. This may change in the future if military costs continue to siphon governmental costs away from social welfare expenditures.

Article

Jo Holliday, Suzanne Audrey, Rona Campbell, and Laurence Moore

Addictive behaviors with detrimental outcomes can quickly become embedded in daily life. It therefore remains a priority to prevent or modify these health behaviors early in the life course. Diffusion theory suggests that community norms are shaped by credible and influential “opinion leaders” who may be characterized by their values and traits, competence or expertise, and social position. With respect to health behaviors, opinion leaders can assume a variety of roles, including changing social norms and facilitating behavioral change. There is considerable variation in the methods used to identify opinion leaders for behavior change interventions, and these may have differential success. However, despite the potential consequences for intervention success, few studies have documented the processes for identifying, recruiting, and training opinion leaders to promote health, or have discussed the characteristics of those identified. One study that has acknowledged this is the effective UK-based ASSIST smoking-prevention program. The ASSIST Programme is an example of a peer-led intervention that has been shown to be successful in utilizing opinion leaders to influence health behaviors in schools. A “whole community” peer nomination process to identify opinion leaders underwent extensive developmental and piloting work prior to being administered in a randomized trial context. Influential students were identified through the use of three simple questions and trained as “peer supporters” to disseminate smoke-free messages through everyday conversations with their peers. In response to a need to understand the contribution of various elements of the intervention, and the degree to which these achieve their aim, a comprehensive assessment of the nomination process was conducted following intervention implementation. The nomination process was successful in identifying a diverse group of young people who represented a variety of social groups, and whom were predominantly considered suitable by their peers. The successful outcome of this approach demonstrates the importance of paying close attention to the design and development of strategies to identify opinion leaders. Importantly, the involvement of young people during the development phase may be key to increasing the effectiveness of peer education that relies on young people taking the lead role.

Article

Shirley Otis-Green

Health social work is a subspecialization of social work concerned with a person's adjustment to changes in one's health and the impact this has on that person's social network. Social workers in every setting must be ready to assist individuals and families adjusting to illness and coping with medical crises. This entry provides a brief overview and history of health social work and describes the settings and roles where this work is practiced. Significant challenges and opportunities in clinical care, research, education, and policy are discussed. Standards and guidelines for quality practice are then noted.

Article

Suruchi Sood, Amy Henderson Riley, and Kristine Cecile Alarcon

Entertainment-education (EE) began as a communication approach that uses both entertainment and education to engender individual and social change, but is emerging as a distinct theoretical, practice, and evidence-based communication subdiscipline. EE has roots in oral and performing arts traditions spanning thousands of years, such as morality tales, religious storytelling, and the spoken word. Modern-day EE, meanwhile, is produced in both fiction and nonfiction designs that include many formats: local street theater, music, puppetry, games, radio, television, and social media. A classic successful example of EE is the children’s television program Sesame Street, which is broadcast in over 120 countries. EE, however, is a strategy that has been successfully planned, implemented, and evaluated in countries around the world for children and adults alike. EE scholarship has traditionally focused on asking, “Does it work?” but more recent theorizing and research is moving toward understanding how EE works, drawing from multidisciplinary theories. From a research standpoint, such scholarship has increasingly showcased a wide range of methodologies. The result of these transformations is that EE is becoming an area of study, or subdiscipline, backed by an entire body of theory, practice, and evidence. The theoretical underpinnings, practice components, and evidence base from EE may be surveyed via the peer-reviewed literature published over the past 10 years. However, extensive work in social change from EE projects around the world has not all made it into the published literature. EE historically began as a communication approach, one tool in the communication toolbox. Over time, the nascent approach became its own full-fledged strategy focused on individual change. Backed by emerging technologies, innovative examples from around the globe, and new variations in implementation, it becomes clear that the field of EE is emerging into a discrete theoretical, practice, and evidence-based subdiscipline within communication that increasingly recognizes the inherent role of individuals, families, communities, organizations, and policies on improving the conditions needed for lasting social change.

Article

Tanya Smith Brice

Jay Carrington Chunn, II, (1938–2013), was a leader in social work education, a professor, and an author who focused on public health and policy within urban populations.

Article

Explanations designed to teach, rather than to support scientific claims in scholarly works, are essential in health and risk communication. Patients explain why they think their symptoms warrant medical attention. Clinicians elicit information from patients and explain diagnoses and treatments. Families and friends explain health and risk concerns to one another. In addition, there are websites, brochures, fact sheets, museum exhibits, health fairs, and news stories explaining health and risk to lay audiences. Unfortunately, research on this important discursive goal is less extensive than is research on persuasion, that is, efforts to gain agreement. One problem is that explanation-as-teaching has not been carefully conceptualized. Some confuse this communication goal and discursive type with its frequent verbal and visual features, such as simple wording or diagrams. Others believe explanation-as-teaching does not exist as a distinctive communication goal, maintaining that all communication is solely persuasive: that is, designed to gain agreement. Explanation-as-teaching is a distinct and important health communication goal. Patient involvement in decision making requires that both clinicians and patients understand options underlying health-care choices. To explore types of explanation-as-teaching, research provides (a) several ways of categorizing health and risk explanations for lay audiences; (b) evidence that certain textual and graphic features overcome predictable confusions, and (c) illustrations of each explanation type. Additionally, explanation types succeed or fail in part because of the social or emotional conditions in which they are presented so it is important to note research on conditions that support patients, families, and clinicians in benefiting from explanations of health and risk complexities and curricula designed to enhance clinicians’ explanatory skill.

Article

Gloria Hegge

Rene Sand (1877–1953), Belgian social worker and physician, was best known in the field of social work for being co-founder of the International Association of Schools of Social Work (IASSW) in 1928, and serving as its president from 1946 to 1953.

Article

James Midgley

Lord William Beveridge (1879–1963) was one of the founders of the British welfare state. His report of 1942 formed the basis for the Labour Government's social policies between 1945 and 1950 and fostered the creation of Britain's national health services.

Article

María Rosa Gudiño Cejudo

In August 1940, President Franklin D. Roosevelt, concerned with Nazi infiltration in the Americas and continental defense, created the Office of Inter-American Affairs (OIAA) and appointed Nelson Rockefeller coordinator. To strengthen ties between the United States and Latin America, including Mexico, Rockefeller implemented cultural programs that included Health for the Americas and Literacy for the Americas to teach illiterate rural inhabitants to read and write in Spanish, and to inform them about health, prevention, and hygiene. Both programs used educational cinema as their main teaching tool, and the OIAA hired filmmaker Walt Disney to produce the films. The health series included thirteen animated cartoons with an average duration of ten minutes, dubbed in Spanish and Portuguese. The themes were drawn in part from the guidelines set out at the XI Conferencia Sanitaria Panamericana (Eleventh Pan-American Health Organization Conference; Rio de Janeiro, Brazil, 1942) to address health care and sanitation. A group of psychologists, cartoonists, health authorities, teachers, and OIAA representatives carried out surveys and field work in various countries before production and test screening began. In this process, Mexico differed from the other countries involved because of Walt Disney’s connections with Mexican schools. Eulalia Guzmán, representative of the Secretaría de Educación Pública (Secretary of Public Education), led in reviewing the educational films, and Disney attended classes with local teachers to discuss the use of film as a teaching tool. In 1943, through the Programa Cooperativo de Salubridad y Saneamiento (Health and Sanitation Cooperative Program) of the Secretaría de Salubridad y Asistencia (Ministry of Health and Assistance, the films were shown in health campaigns throughout Mexico.

Article

Ndola Prata and Karen Weidert

Adolescence, spanning 10 to 19 years of age, begins with biological changes while transitioning from a social status of a child to an adult. For millions of adolescents in low- and middle-income countries (LMICs), this is a period of exposure to vulnerabilities and risks related to sexual and reproductive health (SRH), compounded by challenges in having their SHR needs met. Globally, adolescent sexual and reproductive ill-health disease burden is concentrated in LMICs, with sexually transmitted infections and complications from pregnancy and childbirth accounting for the majority of the burden. Adolescents around the world are using their voices to champion access to high-quality, comprehensive SRH information and services. Thus, it is imperative that adolescents’ SRH and rights be reinforced and that investments in services be prioritized.

Article

Sebastian E. Bartos

Both academic and lay definitions of sex vary. However, definitions generally gravitate around reproduction and the experience of pleasure. Some theoretical approaches, such as psychoanalysis and evolutionary psychology, have positioned sexuality at the center of psychological phenomena. Much research has also linked sex to health and disease. On the one hand, certain sexual thoughts, feelings, behaviors, and identities have been described as pathological. Over time, some of these have been accepted as normal (especially homosexuality), while new forms of pathology have also been proposed (e.g., “porn addiction”). On the other hand, some aspects of sexuality are being researched due to their relevance to public health (e.g., sex education) or to counseling (e.g., assisted reproduction). Sex research has always been controversial, paradoxically receiving both positive attention and disdain. These contradictory social forces have arguably affected both the content and the scientific quality of sex research.

Article

Laura Sokal and Jennifer Katz

Inclusive classrooms provide new opportunities for group membership and creation of effective learning environments. In order to facilitate the success of inclusion as an approach and philosophy, it is important that all class members as well as their teachers develop the skills to understand one another, and to communicate and work together effectively. Social emotional learning (SEL) is aimed at developing these skills and is generally defined to involve processes by which individuals learn to understand and moderate their own feelings, understand the feelings of others, communicate, resolve conflicts effectively, respect others, and develop healthy relationships. These skills are important to both children with disabilities and to those without, in terms of overall social development, perceptions of belonging, and promotion of overall mental wellness, as well as mitigation of the development of mental illness. Research suggests that SEL programming has the potential to effectively enhance children’s academic, social, and relational outcomes. Moreover, teachers who teach SEL in their classrooms have also demonstrated positive outcomes. Despite these encouraging findings, implementation of SEL has been hampered by some limitations, including the lack of a consistent definition—a limitation that in turn affects research findings; lack of teacher education in SEL, which erodes confidence in the fidelity of implementation; and concerns that current SEL programs are not sensitive to cultural differences in communities. Together, the strengths and limitations of SEL illuminate several policy implications regarding the most advantageous ways for SEL to contribute to the success of inclusion in classrooms and schools.

Article

Obesity is widely recognized as a chronic disease characterized by an elevated risk of adverse health conditions in association with excess body fat accumulation. Obesity prevalence reached epidemic proportions among adults in the developed world during the second half of the 20th century, and it has since become a major public health concern around the world, particularly among children and adolescents. The economics of childhood and adolescent obesity is a multi-faceted field of study that considers the numerous determinants, consequences, and interventions related to obesity in those populations. The central economic framework for studying obesity is a life-cycle decision-making model of health investment. Health-promoting investments, such as nutritional food, healthcare, and physical activity, interact with genetic structure and risky health behaviors, such as unhealthy food consumption, to generate an accumulation or decumulation of excess body fat over time. Childhood and adolescence are the primary phases of physical and cognitive growth, so researchers study how obesity contributes to, and is affected by, the growth processes. The subdiscipline of behavioral economics offers an important complementary perspective on health investment decision processes, particularly for children and adolescents, because health investments and participation in risky health behaviors are not always undertaken rationally or consistently over time. In addition to examining the proximate causes of obesity over the life cycle, economists study obesity’s economic context and resulting economic burden. For example, economists study how educational attainment, income, and labor market features, such as wage and work hours, affect childhood and adolescent obesity in a household. Once obesity has developed, its economic burden is typically measured in terms of excess healthcare costs associated with increased health risks due to higher obesity prevalence, such as earlier onset of, and more severe, diabetes. Obesity among children and adolescents can lead to even higher healthcare costs because of its early influence on the lifetime trajectory of health and its potential disruption of healthy development. The formulation of effective policy responses to the obesity epidemic is informed by economic research. Economists evaluate whether steps to address childhood and adolescent obesity represent investments in health and well-being that yield private and social benefits, and they study whether existing market structures fail to appropriately motivate such investments. Potential policy interventions include taxation of, or restricting access to, obesogenic foods and other products, subsidization of educational programs about healthy foods and physical activity inside and outside of schools, ensuring health insurance coverage for obesity-related preventive and curative healthcare services, and investment in the development of new treatments and medical technologies.

Article

Media literacy describes the ability to access, analyze, evaluate, and produce media messages. As media messages can influence audiences’ attitudes and behaviors toward various topics, such as attitudes toward others and risky behaviors, media literacy can counter potential negative media effects, a crucial task in today’s oversaturated media environment. Media literacy in the context of health promotion is addressed by analyzing the characteristics of 54 media literacy programs conducted in the United States and abroad that have successfully influenced audiences’ attitudes and behaviors toward six health topics: prevention of alcohol use, prevention of tobacco use, eating disorders and body image, sex education, nutrition education, and violent behavior. Because media literacy can change how audiences perceive the media industry and critique media messages, it could also reduce the potential harmful effects media can have on audiences’ health decision-making process. The majority of the interventions have focused on youth, likely because children’s and adolescents’ lack of cognitive sophistication may make them more vulnerable to potentially harmful media effects. The design of these health-related media literacy programs varied. Many studies’ interventions consisted of a one-course lesson, while others were multi-month, multi-lesson interventions. The majority of these programs’ content was developed and administered by a team of researchers affiliated with local universities and schools, and was focused on three main areas: reduction of media consumption, media analysis and evaluations, and media production and activism. Media literacy study designs almost always included a control group that did not take part in the intervention to confirm that potential changes in health and risk attitudes and behaviors among participants could be attributed to the intervention. Most programs were also designed to include at least one pre-intervention test and one post-intervention test, with the latter usually administered immediately following the intervention. Demographic variables, such as gender, age or grade level, and prior behavior pertaining to the health topic under study, were found to affect participants’ responses to media literacy interventions. In these 54 studies, a number of key media literacy components were clearly absent from the field. First, adults—especially those from historically underserved communities—were noticeably missing from these interventions. Second, media literacy interventions were often designed with a top-down approach, with little to no involvement from or collaboration with members of the target population. Third, the creation of counter media messages tailored to individuals’ needs and circumstances was rarely the focus of these interventions. Finally, these studies paid little attention to evaluating the development, process, and outcomes of media literacy interventions with participants’ sociodemographic characteristics in mind. Based on these findings, it is recommended that health-related media literacy programs fully engage community members at all steps, including in the critical analysis of current media messages and the production and dissemination of counter media messages. Health-related media literacy programs should also impart participants and community members with tools to advocate for their own causes and health behaviors.