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Article

Health Care Reform  

Cynthia Moniz, Stephen H. Gorin, and Terry Mizrahi

National health care reform in the United States, from its introduction into the public policy agenda at the turn of the 20th century through policy debates and legislative proposals more than a century later, has achieved limited success with universal coverage for health and mental health services. Opposition to government-sponsored health care has always been present. The extent of the opposition has depended on the type of reform proposed and the era in which it occurred. Medicare and Medicaid reform in the 1960s greatly expanded access and coverage for older adults and low income individuals and families. But, the first true effort to reach universal coverage occurred with the passage of the Affordable Care Act in 2010.

Article

Health Policy Overview  

Heather A. Walter-McCabe

This article describes the complex healthcare policy and financing systems in the US within a historic and political context for how the US arrived at these systems. It also provides an overview of frameworks useful for articulating how social work may have an increased influence on policies impacting the healthcare system along with specific arenas ripe for social work interventions towards healthcare system improvements. Social workers have the obligation, through the National Association of Social Workers Code of Ethics, and the requisite skills, to participate in the healthcare policy process ensuring that they not only have a place at policy making tables, but that members of communities impacted by these policies have an opportunity to assist in setting the healthcare policy agenda and programs to best serve them.

Article

Historical and Intergenerational Trauma  

Laurie A. Walker and Turquoise Skye Devereaux

Historical trauma originated with the social construction of subordinate group statuses through migration, annexation of land, and colonialism. The consequences of creating subordinate group statuses include genocide, segregation, and assimilation. Settler colonialism takes land with militaristic control, labels local inhabitants as deviant and inferior, then violently confines and oppresses the original occupants of the land. Confinement includes relocation, restriction of movement, settlement of lands required for sustenance, as well as confinement in orphanages, boarding schools, and prisons. Historical trauma includes suppression of language, culture, and religion with the threat of emotional, physical, and sexual abuse. Original inhabitant abuse often results in issues with health, mental health, substance abuse, and generational emotional, physical, and sexual abuse. Culturally safe (engagement that respects identity) and trauma-informed social work practices acknowledge the systemic causes of disparities in groups experiencing marginalization and oppression and focus on healing and addressing systemic causes of disparities.

Article

Homelessness and Macro Interventions  

Eva M. Moya, Amy Joyce-Ponder, Jacquelin I. Cordero, Silvia M. Chávez-Baray, and Margie Rodriguez LeSage

The emergence of social work and macro practice is often associated with the eradication of poverty and prevention of homelessness through the efforts of 19th century settlement houses. Structural violence and social determinants of homelessness are often grounded in unequal social, political, and economic conditions. Health and mental health were affected by the lack of stable housing, causing and increasing the complexity of health and human service needs and services. Furthermore, due to inequities, some populations are inadvertently more likely to face chronic homelessness, which can be mitigated through the role community-engagement and macro practice interventions.

Article

Housing  

Anita Zuberi, Gale Schwartz, and Tracy M. Soska

Housing remains foundational to the American Dream, but it is also among our most challenging social issues. The collapse of the housing market in the early 21st century, along with the persistent challenges of affordable housing access, funding, and instability, continue to shape housing issues today. These housing issues are inextricably linked to both national economic disparities and wavering social policies. Housing is symptomatic of and a catalyst for overarching social and economic issues, including racial disparities; economic, educational, and health inequalities; and poverty. It remains an unmet need for a significant portion of our population, such as the working poor, elderly people, those living with a disability, victims of abuse, those aging out of child welfare, veterans, those involved with the justice system, and others who encounter unique difficulties and lack supportive services and service coordination. Advancing comprehensive and coordinated housing policies and programs remains important for social work and to ensure decent and affordable housing for all.

Article

Human Resource Management  

Michàlle E. Mor Barak and Dnika J. Travis

Human resource management (HRM) refers to the design of formal systems that ensure effective and efficient use of human talent and serves as a vehicle for achieving organizational mission and goals. Effective HRM requires applying the same person-in-environment value orientation that guides client services to managing human resources and is critical in today’s economic, legal, cultural, and technological landscape. We are experiencing unparalleled change, uncertainty, and, in some contexts, upheaval in communities locally, nationally, and across the globe. These challenges create demands on the social service workforce to adeptly and rapidly innovate, provide quality services, and meet client and community needs. Centered on promoting diversity, equity, and inclusion, we have developed an organizing HRM framework in three areas: (a) employee development, (b) employee value proposition and experience, and (c) future directions for inclusive and equitable workplaces.

Article

Human Rights and Social Work  

Obie Clayton and June Gary Hopps

The National Association of Social Workers affirms a social worker’s responsibility to social change and social justice on behalf of vulnerable and oppressed peoples. Because of this directive around social justice, it is the profession’s responsibility to make connections among individual human rights issues within the broader social, economic, and cultural contexts that create conditions where injustice can take place. Social workers in the 21st century, especially those working at the policy or macro level, must be able to recognize and emphasize human rights in their practice and policy recommendations on local, national, and international levels. Social workers can bring attention to the need to craft solutions to human rights violations that take into account global human rights standards.

Article

Human Rights Overview  

Joseph M. Wronka

At the heart of social work, human rights is a set of interdependent and indivisible guiding principles with implications for meta-macro (global), macro (whole population), mezzo (at risk), micro (clinical), meta-micro (everyday life), and research interventions to eradicate social malaise and promote well-being. Human rights can be best understood vis-à-vis the UN Human Rights Triptych. This consists of the Universal Declaration of Human Rights, increasingly referred to as customary international law; the guiding principles, declarations, and conventions following it, such as the Guiding Principles to Eradicate Extreme Poverty, Declaration on the Rights of Indigenous Peoples, the Convention on the Rights of the Child, the Convention the Elimination of Racial Discrimination, and the Convention on the Elimination of All Forms of Discrimination Against Women; and implementation mechanisms, such as the filing of country reports on compliance to conventions, the Universal Periodic Review, thematic and country reports by special rapporteurs, and world conferences. This powerful idea, which emerged from the ashes of World War II, emphasizes five crucial notions: human dignity; nondiscrimination; civil and political rights; economic, social, and cultural rights; and solidarity rights. The hope is that every person, everywhere, will have their human rights realized. Only chosen values endure. The challenge is the creation of a human rights culture, which is a lived awareness of these principles in one’s mind, spirit, and body, integrated into our everyday lives. Doing so will require vision, courage, hope, humility, and everlasting love, as the Indigenous spiritual leader Crazy Horse reminded us.

Article

Human Trafficking Overview  

Fariyal Ross-Sheriff and Julie Orme

Human trafficking (HT), also known as modern-day slavery, has received significant emphasis since the early 21st century. Globalization and transnational migration trends continue to amplify economic disparities and increase the vulnerability of oppressed populations to HT. The four major forms of exploitation are labor trafficking, sex trafficking, state-imposed forced labor, and forced marriage. Victims of HT are exploited for their labor or services and are typically forced to work in inhumane conditions. The majority of these victims are from marginalized populations throughout the world. Although both men and women are victims of HT, women and children are heavily targeted. Interdisciplinary and multi-level approaches are necessary to effectively combat HT. Combating HT is particularly relevant to the profession of social work with its mission of social justice. To address the needs of the most vulnerable of society, prevention, intervention and advocacy strategies are presented. Roles and implications for social workers in education and practice and for the profession are presented at the micro level.

Article

Immigrant Communities in the United States and Macro Practice  

Laura Folkwein

Macro social work practice with immigrant organizations and communities in the United States requires a basic understanding of the underlying values and history of U.S. immigration laws and policy. U.S. immigration policy frequently reflects multiple and conflicting interests and values in labor needs, global politics, family unification, and national security, and policies often shift in response to political leadership, ideology, and public opinion. Some areas of the history of U.S. immigration laws and various macro social work approaches to U.S. immigration policy include (a) advocacy at local, state, and federal levels; (b) anti-immigrant legislation proposed at the state level; and (c) collaboration between grassroots organizations and local leaders to build policies and practices that support immigrants.

Article

Immigration Policies in the United States  

Uma A. Segal

Immigrants from around the globe form a continuous stream to the United States, with waiting lists for entry stretching to several years. Reasons for ongoing arrivals are readily apparent; the United States continues to be one of the most attractive nations in the world, regardless of old and new problems. There is much in the United States that native-born Americans take for granted and that is not available in most other countries, and there are several amenities, opportunities, possibilities, lifestyles, and freedoms in the United States that do not appear to be found together in any other nation. In theory, and often in reality, the United States is a land of freedom, of equality, of opportunity, of a superior quality of life, of easy access to education, and of relatively few human rights violations. This entry will focus on policy most relevant to migrants as is evidenced through legislative history and its impact on demographic trends, the economy, the workforce, educational and social service systems, ethical issues, and roles for social workers. “Immigration policy” should be distinguished from “immigrant policy.” The former is a screening tool determining eligibility entry into a country; the latter, on the other hand, provides insight into national policies specifically designed to enable integration (or segregation) of immigrants once they have entered its borders.

Article

Income and Wealth Inequality  

Laurel Sariscsany

Reversing extreme economic inequality is one of the grand challenges for social work, identified as one of the most critical issues in the field. Two key types of economic inequality, income and wealth inequality are described. Although, wealth and income inequality are often discussed synonymously they have differing levels of inequality and impact clients’ lives differently. Perhaps more importantly, as this article describes, solving income and wealth inequality require differing solutions. The article further explores the specific income and wealth inequality experienced by women and people of color, due in part to discrimination. Lastly, the efforts of social workers to address economic inequality through research, practice, and advocacy are described.

Article

Indigenous and Tribal Communities  

Megan G. Sage

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

Integrating Macro–Micro Practice  

Jason A. Ostrander, Kerry Kelly, and Patricia Carl-Stannard

Social work sets itself apart in the “helping professions” in recognizing the significance of its students and practitioners engaging with the theoretical knowledge and practice experiences sufficient for fluency across macro to micro settings. This practice integration assures comprehensive understanding of person-in-environment, from casework to complex systems work, and is raised to an ethical standard in the National Association of Social Work Code of Ethics and in the International Federation of Social Work Principles. Yet macro-oriented scholars have accused social work educators and professionals of abandoning their obligation to social justice and policy participation and of focusing their energy instead on micro practice. This literature is helpful in addressing how integrated practice can be achieved and informs the development of social workers who solidly embrace a commitment to macro knowledge and participation.

Article

Interdisciplinarity and Social Work  

Terry Mizrahi and Yossi Korazim-Kőrösy

Social workers have had a major role in participating in and promoting work with those in different disciplines and professions. Collaboration between social workers and those in other disciplines is essential given the complexity of sectors and settings in which the profession operates. Various terms have been used that have different meanings: multi-, inter-, and transdisciplinarity. Moreover, social work as well as other professions and applied disciplines also use the term interprofessional for cross-boundary collaborations. In multidisciplinary practice, social workers practice with those in other disciplines and professions but for the most part continue to pursue their own intervention aims. Interdisciplinarity links social work to other disciplines within complex domains of practice. It includes a blending and combining of those practices distinctive within each of the disciplines in pursuit of a common set of outcomes about an agreed upon social problem. It also requires the integration of knowledge and action, and the formation of a common agenda of practice, guided by compatible if not identical goals. Transdisciplinarity is the newest of the three terms. It connotes transformative outcomes that go beyond professional boundaries and include other stakeholders to effect particular change with real-world consequences. The lines among the three are blurred, mutable, and, at times, inconsistent, overlapping, and changing. Challenges and barriers remain, although opportunities have increased to move beyond monodisciplinary practice in all practice domains.

Article

International Aid, Relief, and Humanitarian Assistance  

Carmen Monico, Karen Smith Rotabi, and Taghreed Abu Sarhan

International development, humanitarian aid, and relief are at the heart of international social work practice. They have evolved historically and globally; shaped by world markets, social and environmental forces, including natural disasters. Considering this context, the authors cluster relevant social-work theories and practices as (a) human rights perspectives and (b) ecological, feminist, and cultural theories. They discuss both micro and macro practice, with an emphasis on the latter. Case studies are presented with the overlay of relevant international conventions, guidance, and international private law. A continuum of humanitarian assistance is presented considering different countries. Guatemala is a prominent example in addition to Haiti’s massive earthquake of 2010 with recent revelations of sexual abuse and exploitation by humanitarian aid workers, post-conflict community-based practices in Afghanistan, and the largest cross-border forced migration in modern history of Iraqi, and Syrian refugees with this second group being of particular concern given their mass displacement. Capacity building as related to social work training is emphasized. This entry concludes that much remains to be accomplished with regard to capacity building among humanitarian assistance organizations so that the principles and practice strategies of international social work are institutionalized.

Article

International Child Development Accounts  

Michael Sherraden, Li-Chen Cheng, Fred M. Ssewamala, Youngmi Kim, Vernon Loke, Li Zou, Gina Chowa, David Ansong, Lissa Johnson, YungSoo Lee, Michal Grinstein-Weiss, Margaret M. Clancy, Jin Huang, Sondra G. Beverly, Yunju Nam, and Chang-Keun Han

Child Development Accounts (CDAs) are subsidized savings or investment accounts to help people accumulate assets for developmental purposes and life course needs. They are envisioned as universal (everyone participates), progressive (greater subsidies for the poor), and potentially lifelong national policy. These features distinguish CDAs from most existing asset-building policies and programs around the world, which are typically regressive, giving greater benefits to the well-off. With policy innovation in recent years, several countries now have national CDA policies, and four states in the United States have statewide programs. Some of these are designed to be universal and progressive. Evidence indicates that true universality can be achieved, but only with automatic account opening and automatic deposits. In the absence of automatic features, advantaged families participate and benefit more. Today, momentum for universal and automatic features is gradually gaining traction and accelerating. At this stage in the emergence of inclusive asset-based policy, this is the most important development.

Article

International Community Practice  

Cindy Sousa and Tamarah Moss

As social work continues the ongoing work of developing frameworks for community practice, globalization and the increase in multicultural societies make urgent the need to consult international models. Community practice must center attention on building and sustaining relationships; determining who defines need and who controls the practices within the social work cycle of engagement, assessment, intervention, and evaluation; and maintaining community-centered practices that grapple with power dynamics in terms of status, resources, and culture. A learning approach is needed within international social work collaborations, characterized by an ethics of respect for sovereignty, cultural integrity, and the ways historical, political, cultural, and sociocultural contexts inform practice. Solidarity, authentic collaboration, and a respect for individual and collective autonomy and grassroots power are key features of community practice in international settings. The goal of the comparative perspective is for social workers to be better able to apply an international perspective to the building of theory and practice modalities within community practice.

Article

International Social Welfare: Organizations and Activities  

Doreen Elliott

The major international governmental and nongovernmental organizations and their activities are discussed with reference to their global co-coordinating, advocacy, service, and research functions. Attention is also given to the work of international professional associations.

Article

International Social Work and Social Welfare: Africa (Sub-Sahara)  

Kwaku Osei-Hwedie

Africa is one of the world's poorest regions and it faces numerous and complex challenges as it strives to achieve its development objectives. The main challenges relate to poverty and its alleviation, economic growth, democratization leading to political stability, improving social welfare, and generally creating a just and equitable society. The resolution of these issues is critical to social work if the profession is to make an impact.