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.
Drug Policy Reform
Sheila P. Vakharia
Medicaid and Medicare
Victoria M. Rizzo, Sojeong Lee, and Rebekah Kukowski
In 1965, Titles XVIII and XIX of the Social Security Act were passed, creating Medicare and Medicaid and laying the foundation for U.S. healthcare policy. Originally, Medicare was created to meet the specific medical needs of adults aged 65 and older. In 2022, individuals with end-stage renal disease, amyotrophic lateral sclerosis (ALS), and other disabilities may also receive Medicare, regardless of age. Medicaid was established to provide a basic level of medical care to specific categories of people who are poor, including pregnant women, children, and the aged. As of 2010 as part of the Affordable Care Act (ACA), states are provided with the opportunity to expand Medicaid to close the coverage gap for public health insurance. This entry provides explanations of Medicaid and Medicare and associated social healthcare programs in the United States. An overview of significant programming developments and trends, future directions, challenges, and controversies as of 2021 are also provided.
Military Social Work
Kelli Godfrey and David Albright
Although there are many definitions of military social work, this article primarily focuses on social work by uniformed personnel within the United States military. Social work with military and veteran-connected populations is also done by civilian professionals. The history of military social work in the United States is rooted in the civilian professional social work community and is a microcosm of that sector. Military social work has a rich history of providing services to military men and women and their families during periods of peace, conflict, and national crises. Military social workers have been involved in humanitarian operations and have participated in multinational peace-keeping operations. Social work in the Army, Navy, and Air Force is tailored to the mission of their particular service. However, joint operations between the services are becoming more frequent. Military social workers adhere to the National Association of Social Workers (NASW) code of ethics while providing service to an institution with its own unique culture, standards, and values. The role of military social workers has expanded since the Global War on Terrorism began, in 2001. Military social work encompasses a wide variety of skills, performed by social workers who are both civilian and military, ranging from crisis to working with families. Military social work is unique and often faces ethical dilemmas even though military social workers still follow the National Association of Social Workers’ Code of Ethics. The history of military social work dates back to the early 1940s, but has evolved with the needs of military members and their families. The Army, Air Force, and Navy all have social workers, both civilian and those who wear the uniform. Due to the number of veterans and military families living throughout the United States, and seeking care in community settings, recommendations to establish competencies for social workers working with military and veteran-connected populations is underway.
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.