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Article

Jeanette C. Takamura

Public policy advances in the field of aging in the United States have lagged compared to the growth of the older adult population. Policy adjustments have been driven by ideological perspectives and have been largely incremental. In recent years, conservative policy makers have sought through various legislative vehicles to eliminate or curb entitlement programs, proposing private sector solutions and touting the importance of an “ownership society” in which individual citizens assume personal responsibility for their economic and health security. The election of a Democratic majority in the U.S. House and the slim margin of votes held by Democrats in the U.S. Senate may mean a shift in aging policy directions that strengthens Social Security, Medicare, and Medicaid, if the newly elected members are able to maintain their seats over time. The results of the 2008 presidential election will also determine how the social, economic, and other policy concerns will be addressed as the baby boomers join the ranks of older Americans.

Article

Dementia is not a disease, but a group of symptoms so severe that they inhibit normal functioning. Alzheimer’s disease is the most common type of dementia in older persons, impacting not only the person with the illness but also the entire family. Obtaining an accurate diagnosis is essential to assure appropriate and timely care and to exclude reversible causes of dementia. Social workers can play key roles throughout the course of the illness as educators, therapists, supporters, and advocates for improved policies and services.

Article

Ellen Fink-Samnick

The past two decades have witnessed a surge in the growth of initiatives and funding to weave physical and behavioral health care, particularly with identification of the high costs incurred by their comorbidity. In response, a robust body of evidence now demonstrates the effectiveness of what is referred to as collaborative care. A wide range of models transverse the developmental lifespan, diagnostic categories, plus practice settings (e.g., primary care, specialty medical care, community-based health centers, clinics, and schools). This article will discuss the foundational elements of collaborative care, including the broad sweep of associated definitions and related concepts. Contemporary models will be reviewed along with identified contextual topics for practice. Special focus will be placed on the diverse implications collaborative care poses for the health and behavioral health workforce, especially social workers.

Article

Dawn Apgar

Characteristics associated with contemporary definitions of disabilities have existed in the human population from earliest recorded history. However, societal views on disability and those who have them have varied greatly over time. Disability has been viewed as a blessing from deity or the deities, a punishment for sin, or a medical condition. Social workers have worked with people with disabilities from the inception of the profession and have critical roles in the prevention and treatment of disabilities. Practice is driven by the promotion of the core values of the profession, including the dignity and worth of all people. Social workers recognize that variability in physical and cognitive abilities should not compromise access to opportunities and human rights. Social and political action focused on people with disabilities aim to promote inclusion, foster self-determination, and fight discrimination. Despite increasing services and policies to promote the well-being of people with disabilities, significant income, employment, housing, and quality of life issues still exist for those with disabilities. Macro social work practice is greatly needed to ensure that laws, organizations, and policies do not marginalize or oppress based on varying physical and/or intellectual abilities. Social work’s focus on policy and community development is well suited for reforming existing structures that prevent people with disabilities from achieving full integration within schools, work settings, and community living. Macro social work methods are needed to ensure that quality supports are provided to those with disabilities, to maximize their well-being and participation in all aspects of society.

Article

Maryah Stella Fram

This entry provides an overview of current knowledge and thinking about the nature, causes, and consequences of food insecurity as well as information about the major policies and programs aimed at alleviating food insecurity in the United States. Food insecurity is considered at the nexus of person and environment, with discussion focusing on the biological, psychological, social, and economic factors that are interwoven with people’s access to and utilization of food. The diversity of experiences of food insecurity is addressed, with attention to issues of age, gender, culture, and community context. Finally, implications for social work professionals are suggested.

Article

Sandra Wexler and Valire Carr Copeland

Despite technological advances and changes in healthcare delivery, some groups in the United States continue to have better health-related outcomes than others. This article discusses health disparities and inequities—differences in health status and healthcare utilization that are influenced by complex social, structural, economic, and cultural factors. It begins by exploring the “problem” with health disparities—what makes them problematic and for whom they are problematic. Factors contributing to health inequities, commonly referred to as social determinants, are then reviewed. Finally, the article considers early 21st-century policy and programmatic responses as well as future directions, including social workers’ role as macro practitioners.

Article

Larry D. Icard, Jacqueline J. Lloyd, and Gisoo Barnes

HIV/AIDS has introduced an array of issues and needs for children, youth, and their families. Family-focused interventions have emerged as a viable strategy for researchers and practitioners seeking effective and appropriate responses for the prevention, treatment, and care of children, youth, and families affected by HIV/AIDS. This discussion provides an overview of the epidemiology of HIV infection among children and youth, and highlights common elements and trends in the development, implementation, and testing of family-focused interventions. The discussion concludes with a commentary on areas for future attention.

Article

Goldie Kadushin

Home health care is professional medical and non-medical care delivered in the home (home refers to a private residence, an assisted living facility, or a group home) to assist ill, injured, or disabled seniors or adults remain safely at home for as long as possible. As the population ages, and the numbers of Baby Boomers age 85 and older increases, it is likely that there will be a growing need for long-term care, including home health care. In this article, the role of social work in home health care is reviewed as it is impacted by sources of payment and demographic characteristics of home care users. Social work assessment and intervention in home health care is also discussed with a focus on effective referral practices.

Article

Indigenous populations have experienced hundreds of years of historical trauma, systemic racism, and oppression since colonization began in the Americas, Australia, and New Zealand. Settler colonialism has created and continues to perpetuate historical and ongoing trauma and systemic racism in Indigenous populations. Despite considerable diversity and resilience among Indigenous populations globally, there is a clear pattern of significant disparities and disproportionate burden of disease compared to other non-Indigenous populations, including higher rates of poverty, mortality, substance use, mental health and health issues, suicide, and lower life expectancy at birth. Substantial gaps related to access to healthcare and service utilization exist, particularly in low-income Indigenous communities. Implementation and sustainment of White dominant-culture frameworks of care in Indigenous communities perpetuate these systems of oppression. Development and implementation of culturally informed services that address historical trauma and oppression, and systematically integrate concepts of resiliency, empowerment, and self-determination into care, are issues of policy as well as practice in social work. The co-creation and subsequent implementation, monitoring, and sustainment of effective systems of care with Indigenous populations are essential in addressing health disparities and improving outcomes among Indigenous populations globally.

Article

The World Health Organization defines interprofessional collaborative practice (IPCP) as when multiple health workers from different professional backgrounds provide comprehensive health services working with patients/clients, families, caregivers, and communities to deliver quality health care across settings. IPCP has long been considered a best practice model to improve effective health-care delivery; however, implementation of collaborative practice models and evidence to support their efficacy have been relatively slow to develop. IPCP is inextricably linked to interprofessional education and practice (IPEP), which brings together students and practitioners across disciplines and practices, and includes direct care workforce, people/patients/clients, families, and communities to learn with, from, and about each other to prepare them for integrated workplace practice. The article will explore national and global interprofessional collaborative practice initiatives; outline core competencies and evidence for collaborative practice; provide examples of IPCP implementation; and discuss the role social work plays in the development and leadership of collaborative practice.

Article

As a result of rising life expectancies, America’s older population is itself aging. The U.S. Census Bureau projections suggest that, by the middle of the 21st century, more than 40% of Americans aged 65 and older can expect to live to at least the age of 90. Although the oldest-old (often defined as persons ages 80 and older or those ages 85-plus) is a diverse population, advanced old age is associated with a greater risk of experiencing economic hardship, disabling illnesses or health conditions, and social isolation. A growing public policy challenge will be ensuring the economic well-being, the health, and the dignity of society’s very oldest citizens.

Article

Valire Carr Copeland and Daniel Hyung Jik Lee

Social reform efforts of the settlement-house movement have provided, in part, the foundation for today’s Maternal and Child Health Bureau’s policies, programs, and services. Planning, implementing, and evaluating policies and programs that affect the health and well-being of mothers and children require a multidisciplinary approach. Social workers, whose skills encompass direct services, advocacy, planning and research, community development, and administration, have a critical role to play in improving the health outcomes of maternal and child populations.

Article

Julianne S. Oktay and Bradley Zebrack

Oncology social work researchers have made (and continue to make) important contributions to the knowledge base that supports the profession. This article discusses the profession of oncology social work, its roots in medical social work in the United States, the development of cancer treatment, and the body of research that informs its art and practice. Oncology social work research is placed in the broader contexts of the social work profession, the field of oncology, and the specific field of oncology social work. Through the decades, the profession of oncology social work has grown, gained stability and legitimacy. Oncology social work itself, along with oncology social work research, have made rapid strides in the 21st century and accelerating in impact and relevance. Oncology social work research is stronger now than ever. Recent developments, such as the addition of a research institute at the annual AOSW conference and initiatives to establish a “practice-based research network” are expanding capacity in the field. Oncology social work researchers bring a unique perspective to their research. Social work’s patient-centered perspective is reflected in research that explores the cancer experience of patients and family members and leads to new interventions based on that experience. Social work’s focus on human development over the life course results in research that reflects a developmental framework or focuses on specific age groups, such as children, adolescents, young adults, or the elderly. Social work’s conceptual model of “Person-in-Environment” is reflected in research on cancer patients in the context of their interpersonal relationships. The values of social justice and cultural competence are reflected in research on health disparities, minority populations, and multicultural perspectives. Finally, the field of oncology social work itself has been the focus of recent research on distress screening and its implementation. In the 21st century, oncology social work research stands in a pivotal position. Although this type of research is now widely recognized as important, it is still a challenge to access the level of support from major funders of cancer research required to establish and reinforce a strong and vibrant knowledge base for the profession.

Article

Vimla Nadkarni and Roopashri Sinha

The entry outlines a historical and global overview of women’s health in the context of human rights and public health activism. It unravels social myths, traditional norms, and stereotypes impacting women’s health because social workers must understand the diverse factors affecting women’s health in a continually changing and globalized world. There is need for more inclusive feminist and human rights models to study and advocate women’s health. There is as much scope for working with women in a more holistic manner as there is for researching challenging issues and environments shaping women’s health.