Community violence is a widespread concern that is receiving increasing attention by social workers. We consider here the problem of community violence and the present understanding of its rates, risk factors, protective factors, consequences, and some orientations for prevention and intervention. Growing evidence identifies a multifaceted and multisystemic ecological perspective of risk and protective factors linked with community violence exposure and its effects. Current research points to potentially helpful ameliorative and preventive strategies for social workers to consider at the micro and macro levels; however, the main focus of this article is on the macro-level factors and processes.
Muhammad M. Haj-Yahia, Neil B. Guterman, and Maria João Lobo Antunes
Deinstitutionalization in Macro Practice
Steven P. Segal
The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.
As technological advances continue to develop, delivering macro human service through social work innovations becomes a new priority for the discipline. Digital technologies offer potential applications using tablets, smartphones, cloud computing, artificial intelligence, and wearable technology to enable whole new possibilities for human services. As a result, policymakers and community organizers alike can access the existing information much faster, and potentially connect with hard-to-reach communities to make meaningful decisions. Incorporating the latest digital trends from business and industry settings to macro social work practice are highlighted. By utilizing digital technology, human service organizations can become more proactive and citizen-centered, potentially transforming personal and economic capacity.
Drug Policy Reform
Sheila P. Vakharia
Social workers are uniquely qualified to be effective drug policy advocates for effective and equitable policies through their commitment to advancing social welfare and promoting social justice. The prohibitionist antidrug policies that began at the turn of the 20th century have been a key driver for the criminalization of millions of Americans over time, a disproportionate number of whom have been people of color. The period beginning with President Richard Nixon’s “War on Drugs,” in addition to contributing to inequality and marginalization, has exacerbated a number of public health and safety harms, suggesting that past policy approaches have not met their intended aims. The North American opioid overdose crisis in the early 21st century is presented as an illustrative case study because its persistence and mounting death toll exemplify the challenges with the current model of drug prohibition. Areas for macro social work interventions include legislative advocacy through lobbying, provision of expert testimony in legislative hearings, engagement in reform through litigation, involvement in social action, and performing policy analysis and research.
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.
Life Span: Older Adulthood/Seniors (From Ages 60 to 75)
Nancy P. Kropf
Although the terms older adult and senior citizen are commonly defined as individuals 60 years and above, later adulthood contains various life-course phases and developmental periods. The young-old, defined as individuals in the age range of 60–75 years, often experience various health, social, and economic transitions. Both the individual and family systems must negotiate some of the changes that accompany the journey into later life. Therefore, this first decade of older adulthood is one that can simultaneously be enjoyable, exciting, demanding, and stressful for aging persons and their families.
Public Health Social Work
Sarah Gehlert, Julie A. Cederbaum, and Betty J. Ruth
Public health social work is a substantive area within the discipline of social work that applies social work and public health theories, frameworks, research, and collaborative practices to address contemporary health issues through a transdisciplinary lens. It is epidemiologically informed and characterized by prevention, health promotion, and other integrative practices. With its strong focus on health impact and population health, public health social work is central to the profession’s viability and success for tackling pervasive 21st-century challenges, such as health inequity, behavioral health integration, chronic disease, health reform implementation, and global health.
After a period of mass incarceration that spanned the 1970s through the 2010s, the United States remains the leading incarcerator in the world. Incarceration rates in the United States outpace those of other countries by several hundred per 100,000. Incarceration rates began to decline slightly in 2009, when there was a loss of fiscal, political, and moral will for mass incarceration policy and practices. First, the onset of smart decarceration approaches, the historical context from which smart decarceration stems, and the societal momentum that led to the conceptualization of smart decarceration are described. Smart decarceration is a lead strategy in social work that has been adopted by the American Academy of Social Work and Social Welfare as one of the 12 Grand Challenges for Social Work for the decade 2015–2025. Finally, an overview of the current status of smart decarceration and details shifts and initiatives to pursue at the intersection of social work and smart decarceration is provided.
Suicide and Public Policy
Janelle Stanley and Sarah Strole
The historical context of suicidal behavior and public policies addressing suicide arose simultaneously within the United States, and both reflect a culture of discrimination and economic disenfranchisement. Systems of oppression including anti-Black racism, restrictive immigration policy, displacement of American Indigenous communities, religious moralism, and the capitalist economic structure perpetuate high-risk categories of suicidality. Suicidal behavior, protective factors, and risk factors, including firearms, are examined in the context of twentieth and early twenty first century public policy. Recommendations for public policy will be discussed with consideration for policies that impact communities disproportionately and social work ethics, such as right to die laws and inconsistent standards of care.
Ruth A. Brandwein
This overview article introduces the topic of women, beginning with general demographic information. The section on poverty and inequality, which follows, describes the gender differences and delineates some reasons why women are poor and unequal. Issues of child care, welfare, and education are explored. Interpersonal violence and sexual trafficking are discussed, followed by a discussion of health and mental health issues affecting women, including access to health care. The role of women as well as women social workers in politics is briefly explored. Throughout, attention is paid to intersectionality. The article concludes with a discussion of current trends and challenges, with a brief examination of changes in policies affecting women from the Obama presidency to the end of the Trump administration in 2020, including implications for social justice, as well as implications for social work.