This entry describes the development and key provisions of the Patient Protection and Affordable Care Act (ACA), which instituted a major overhaul of the U.S. health system, much of which took effect in 2014. The key provisions of the ACA included an individual mandate to purchase insurance, an employer mandate to offer coverage to most workers, an expansion of Medicaid to all persons below 138 percent of the federal poverty level (FPL), minimum benefit standards, elimination of preexisting condition exclusions, and reforms to improve health-care quality and lower costs. This historic legislation has deep roots in U.S. history and represents the culmination of a century-long effort to expand health care and mental health coverage to all citizens.
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Affordable Care Act
Stephen H. Gorin, Julie S. Darnell, and Heidi L. Allen
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Age Justice
Steve Burghardt, Joseph Dibenedetto, and Bobbie Sackman
As baby boomers enter their later years, it has become apparent that ageism is a primary cause of much of the social marginalization and economic inequity experienced by older people. It is thus important to understand that ageism has both structural as well as cultural causes that require collective mobilization to correct. As such, anti-ageism and the fight for age justice fit within the intersectional movements of the 21st century seeking systemic change. This attention to systemic issues of ageism and the call for collective forms of action and organizing have become the foundation for an age justice movement. Therefore, an age justice organizing approach to the problems of older Americans is necessary and its solutions to aging-related problems are similar to solutions in other social justice movements. The historical context of aging and ageism informs present models of age justice organizing and issues addressed in age activism. For example, older workers have experienced workplace discrimination, and in the early COVID-19 pandemic, older people were marginalized. Looking to the future, an age justice framework that consistently addresses ageism as the systemic issue it is can be developed in micro, mezzo, and macro settings for all social workers and the older people with whom they work.
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Agencies and Organizations in Nonprofit Settings
Jennifer E. Mosley, Jade Wong, and Jan Ivery
Nonprofit organizations play a dominant role in providing social services in the United States. This entry begins by exploring the roles and origins of the nonprofit sector, reporting on its current scope and scale, and reviewing federal regulations governing nonprofit organizations. Special attention is then given to understanding human service organizations and their financing, including the implications of changing government–nonprofit relationships. Also discussed are four additional issues facing the sector—accountability, marketization, political participation, and nonprofit growth around the world—as well as recommendations for meeting future challenges.
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Reducing "Extreme Economic Inequality": A Social Work Grand Challenge
Laura Lein, Jennifer Romich, Trina R. Williams Shanks, and Dominique Crump
The Social Work Grand Challenge to reduce economic inequality is one of 13 Grand Challenges guiding future practice, research, and education. This article on the Grand Challenge to reduce extreme economic inequality documents the problem, probes the mechanisms by which inequality continues and deepens, and proposes approaches for addressing this problem so interwoven into our economy and society. This article describes economic inequality in the U.S. context as well as social work–oriented responses. It briefly compares the inequality level of the U.S. with that of other countries. It explores the distinctions between poverty and economic inequality and the particular ways in which economic inequality is maintained and grows in the U.S. It also explores the kinds of policy and program initiatives addressing this grand challenge, the barriers to and potential benefits of such ideas, and the roles for social workers and the social work profession in reducing extreme economic inequality in our society.
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Asset Building: Toward Inclusive Policy
Michael Sherraden, Lissa Johnson, Margaret M. Clancy, Sondra G. Beverly, Margaret Sherrard Sherraden, Mark Schreiner, William Elliott, Trina R. Williams Shanks, Deborah Adams, Jami Curley, Jin Huang, Michal Grinstein-Weiss, Yunju Nam, Min Zhan, and Chang-Keun Han
Since 1991, a new policy discussion has arisen in the United States and other countries, focusing on building assets as a complement to traditional social policy based on income. In fact, asset-based policy with large public subsidies already existed (and still exists) in the United States. But the policy is regressive, benefiting the rich far more than the poor. The goal should be a universal, progressive, and lifelong asset-based policy. One promising pathway may be child development accounts (CDAs) beginning at birth, with greater public deposits for the poorest children. If all children had an account, then eventually this could grow into a universal public policy across the life course.
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Asylum Seekers, Refugees, and Immigrants in the United States
Miriam Potocky and Mitra Naseh
This article presents introductory information on asylum seekers, refugees, and immigrants in the United States, including distinctions among them, major regions of origin, demographic, and socioeconomic characteristics, challenges in social, economic, and cultural adaptation, and best practices for social work with these populations.
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Black Lives Matter
Mildred Delozia and Charles M. S. Birore
Black Lives Matter (BLM), which led to the Black Lives Matter movement (BLMM), has been described as a movement with a global following. The movement is aligned with the social work profession’s purpose and values. The social work profession is a human rights profession and has a history of involvement with movements, beginning with the settlement house movement in the late 19th century. The BLMM frames its narrative based on human rights and espouses an agenda that calls out injustice in all facets of social justice. Therefore, a central aim is to understand the BLMM from multiple perspectives. Definitions, theoretical perspectives, and types of social movements are presented, and then the framework of social movements is used to understand the BLMM. Finally, the BLMM is examined in relation to historical social movements, advocacy organizations, and criminal justice reform.
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Child Labor
Usha Nayar, Priya Nayar, and Nidhi Mishra
The paper presents a global scenario of child labor by placing the issue in a historical context as well as comparing current work in the field. It specifically explains the psychosocial, political, and economic determinants of child labor and the prevalence of different forms as well as its magnitude in the different regions of the world. It features innovative programs and actions taken against child labor by local governments, civil societies, and United Nations bodies—mainly the International Labor Organization and the United Nations Children’s Fund. The paper also highlights multilateral collaborations among the UN and other international agencies that stand against child labor in general and the employment of children in hazardous conditions. It illustrates the cooperation among local governments, civic organizations, and child-rights movements that have brought gradual changes over the decades toward ending child labor. Further, it suggests that social work, relevant professional schools, and associations working in various disciplines should be engaged in research-based advocacy and find innovative solutions to control child labor.
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Child Protection
Brett Drake and Melissa Jonson-Reid
All children require a safe and nurturing environment for optimal development. Child maltreatment is among the most serious societal problems, with severe behavioral, health, and economic costs. Preventing and responding to child maltreatment is therefore among the most critical services a society can provide. Child protection in the United States is handled by many agencies in a general sense, including law enforcement and health departments. The main agency tasked with protecting children is the Child Protective Services (CPS) system, which is charged with supporting the safety and well-being of children who may be at risk of child maltreatment. Child maltreatment is a common societal problem, with various national studies suggesting that up to a third of children may experience maltreatment before turning 18. CPS contacts about 4% of all children in the United States each year. Among children contacted, about one fifth are substantiated and a very small proportion of all children reported are placed in foster care. CPS serves poor persons at higher rates than wealthier persons, consistent with the higher need for protection faced by those under economic stress. Similarly, Black children are contacted by CPS at a rate almost twice that of White children, consistent with increased risks and stressors faced by that population, largely associated with historical and current racism, particularly as manifested in economic racial stratification. Child welfare practice innovations include, among other things, the increased use of “differential response” programs, in which situations presenting fewer safety risks are handled with less emphasis on investigation, and an increased awareness of the need for preventative services, including services aimed at supporting those under severe economic stress.
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Child Welfare: History and Policy
Christina Paddock, Debra Waters-Roman, and Jessica Borja
Child welfare services in the United States evolved from voluntary “child saving” efforts in the 19th century into a system of largely government-funded interventions aimed at identifying and protecting children from maltreatment, preserving the integrity of families that come to the attention of child welfare authorities, and finding permanent homes for children who cannot safely remain with their families. Since the 1970s, the federal government has played an increasing role in funding and creating the policy framework for child welfare practice. Today, communities of color receive a disproportionate amount of attention from child welfare services, yet often have access to fewer resources.
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Civic Engagement
Jennifer C. Greenfield, Heather Arnold-Renicker, and Amanda Moore McBride
Civic engagement is the backbone of the social work profession. Through our civic mission, we have long organized and empowered citizens in common pursuits to address social, economic, and political conditions, although this mission may conflict with social workers’ roles in maintaining and implementing systems of oppression and social control. In the United States, social and political engagement are receiving increased attention, particularly as emerging research demonstrates a range of effects for participants, their communities, and the broader society. The challenge for social work is to increase the capacity of communities and the nonprofit sector to promote and maximize engagement, especially among historically oppressed and disenfranchised individuals, through theory-driven, evidence-based interventions, while also ensuring that these efforts center the goals, expertise, and voices of those who are marginalized and minoritized.
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Civil Rights
Tanya Smith Brice, Denise McLane-Davison, and Tyler A. Brice
Civil rights is the protection of citizens from infringement by governmental entities and the extension of basic rights. Civil rights are based on citizenship status. The 14th Amendment establishes U.S. citizenship that has been extended throughout history to different groups. Civil rights legislation is grounded in this question of citizenship. As social workers, it is important that we understand this relationship and advocate to continue broadening the constitutional promise of “equal protection under the laws” to all who reside within the United States.
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Climate Change and Macro Social Work
Kelly Smith
The compounding and escalating effects of environmental degradation, which include climate change, threaten the human-earth system with severe implications for the future of macro social work. Systems of power and oppression, including racial, economic, and gendered inequities, are exacerbated by environmental changes with significant impacts on human rights, public health, and various measures of well-being. While climate change is often not the root cause of inequality, it compounds existing inequities, making it substantially more difficult for marginalized populations to rebound from escalations of the myriad acute and chronic consequences due to climate change and environmental collapse. Experiences of environmental change consistently highlight the expanding resource and resiliency gaps among vulnerable populations, leading to disproportionate repercussions felt initially and, to an arduous degree, by marginalized groups. Simultaneously, these circumstances create opportunities for social workers to intervene and advance the causes of social justice. Macro-level interventions and climate solutions can emerge from social work development and support of policies and interventions that overcome short-term thinking to produce beneficial outcomes for populations and the environment by building capacity in the human-earth system and economic policy systems. Social work is ideally situated to confront climate change by balancing immediate needs with long-term ecological sustainability and relying on its historical understanding of systems to improve policy development and practical climate change mitigation approaches.
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Community Building
Umeka E’Lan Franklin
The history, theory, and empirical and practical knowledge of community building social networks and social ties contribute to informal social control, while neighborhood behavior is key to the development and maintenance of social cohesion. Diversity, equity, and inclusion is considered when examining the relationships among the elements of community resources, civic engagement, and civic participation. Empirical work provides evidence of effective ways to produce and promote community building in poor neighborhoods, as well as the practical knowledge that suggests its importance for the role of social work.
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Community Economic Development
Steven D. Soifer and Joseph B. McNeely
The basic concepts and history of community economic development (CED) span from the 1960s to the present, during which there have been four different waves of CED. During this time period, practitioners in the field have worked with limited resources to help rebuild low-to-moderate-income communities in the United States. There are particular values, theories, strategies, tactics, and programs used to bring about change at the community level. The accomplishments in the CED field are many, and social workers have played a role in helping with community building at the neighborhood, city, county, state and federal levels.
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Community Organizing
Geoffrey W. Wilkinson, Lee Staples, Ashley Slay, and Iliana Panameño
Community organizing centers the leadership of community members in developing and controlling organizations created to express, sustain, and build community power through action for social justice. It is distinguished from other forms of community practice by the ethos, “nothing about us without us,” and may combine elements of community development, direct action, popular education, and community action research. Community organizing promotes individual and collective empowerment. It is practiced in communities of geography, identity, shared experience, and other arenas. In the United States, organizing takes three major approaches to building sustainable bases of community power—organizations formed through individual membership, institutional networks, and coalitions. Innovations in community organizing arising particularly from the leadership of women and people of color—known as transformational organizing—take an intersectional approach to addressing racism, sexism, homophobia, and other forms of systemic oppression while also addressing the personal and social needs of community members. Organizing increasingly takes advantage of internet technology and is effective for influencing legislation and electoral politics, as well as a wide range of community-based issues.
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Community: Practice Interventions
Anne Williford and Marie Villescas Zamzow
This article offers an introduction to macro social work practice interventions. Specifically, it seeks to: (a) identify the difference between direct service (micro) and macro practice; (b) describe historical and contemporary foundations for macro practice; (c) establish a connection between macro practice and core social work values; (d) describe specific examples of macro social work practice using 21st-century social justice issues as exemplars; and (e) identify roles needed for macro social work practice. This article emphasizes the need for macro social work practice to create much needed change in the areas of social, environmental, and economic justice. It will examine the trend in social work that has increasingly placed emphasis and value on micro practice, which has marginalized macro-level social work as a result.
Society continues to confront seemingly intractable social justice issues and is, in the early 21st century, experiencing a critical reckoning of how systems of oppression continue to exact violence against vulnerable populations. This article uses examples of social, environmental, and economic justice issues with specific recommendations on how to adopt an anti-oppressive macro practice framework.
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Complex Systems Science and Social Work
John Halloran and Fred Wulczyn
Extending social work’s familiarity with the metaphorical use of systems concepts, formal systems science enables macro social workers pathways of understanding and description of system-level behavior. Systems, in a formal sense, are coherently organized and interconnected sets of parts that, when operating together, perform a function. The behaviors of complex systems are not reducible to the behavior of individual components, and behaviors of systems are unique to the system as a whole. We introduce a formal approach to systems thinking, provide an overview of central concepts in complex systems analysis, and conclude with an in-depth example of an agent-based simulation model, which puts complex systems thinking into action in a research and practice context.
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Conflict Theory for Macro Practice
Susan P. Robbins and George S. Leibowitz
Conflict theory encompasses several theories that share underlying assumptions about interlocking systems of oppression and how they are maintained. The relevance of Marx’s theory of class conflict, C. Wright Mills’s power elite, and pluralist interest group theory are all important to understand and address social and economic gaps and informing policy for macro practice.
Conflict theory can provide an understanding of health disparities, racial differences in mortality rates, class relationships associated with negative outcomes, poverty, discrimination in criminal justice, as well as numerous factors that are broadly associated with inequality embedded in social structures. Social workers play a significant role in addressing disparities in research, curricula, primary and secondary intervention, and public policy, and conflict theory can provide the framework necessary to enrich this understanding.
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Congressional Social Work Caucus
Charles E. Lewis Jr.
The Congressional Social Work Caucus is a bicameral authorized Congressional Member Organization (CMO) founded by former Congressman Edolphus “Ed” Towns in November 2010 during the 110th Congress. The mission of the caucus is to provide a platform in Congress that will allow social workers and allies to engage the federal government. The Social Work Caucus consists of members of the House of Representatives and the U.S. Senate who are professional social workers or who generally support the ideals, principles, and policies germane to the social work profession. Because of House Ethics rules, CMOs are prohibited from possessing resources of their own and must depend on the office budgets of their members. Consequently, the Social Work Caucus has participated in a number of congressional briefings and seminars in conjunction with other social work organizations such as the National Association of Social Workers, the Council on Social Work Education, and the Society for Social Work and Research. These public events covered a wide range of topics such as social workers’ roles in the Affordable Care Act, military social work, funding for mental health research, and trauma-based practice in child welfare.
