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Human Needs: Health  

Toba Schwaber Kerson

Health is a need, a basic requirement for life. Needs can become rights when bodies of people, usually governments or organizations such as the World Health Organization sanction them. While many have declared health as a right, the greatest burden of illness continues to be carried by minority and medically underserved populations. Also, industrialization, urbanization, economic development, and food market globalization have brought with them the poor health habits that place people at risk for cardiovascular and other diseases. Improved health habits and universal health care coverage would help to address the health needs of all.


Global Health and Global Health Education  

Michele Eggers-Barison and Lalit Khandare

Global health has been gradually gaining more traction in social work education. Global health addresses prevalent health vulnerabilities and collective responsibilities that transcend national borders. Global health is a multidimensional issue, which elicits an interdisciplinary multidimensional response. Various disciplines are in search of definitions, theoretical frameworks, and practice methodologies, including the development of competencies to meet global health needs. The need for social workers to critically engage in health inequities within social, cultural, economic, and political contexts globally is essential to bring effective change in the lives of those most marginalized and impacted by global health inequities. Social work is well positioned to address these needs through international social work practice and professional global standards to advocate for just policies and practice and to enhance equity and inclusiveness to promote social justice and human rights.


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.


Health Literacy  

Vivian Jackson and Wendy Jones

The revised NASW Standards and Indicators for Cultural Competence in Social Work Practice (2015) requires social workers to “provide and advocate for effective communication with clients of all cultural groups, including people of limited English proficiency or low literacy skills, people who are blind or have low vision, people who are deaf or hard of hearing, and people with disabilities” (p. 43). This article focuses on one component of this standard—literacy, specifically health literacy. It presents a summary overview of health literacy and its implications for social work practice. It also presents the history of the concept and provides various definitions and types of health literacy as described in the literature. The authors describe the association between health literacy levels of the population, the intricacies of health systems, and their impact on health outcomes. The negative impact for marginalized populations including persons with limited English proficiency and immigrants and refugees—a major focus of the social work profession—signals the need for action at multiple levels. The authors explore a multifaceted approach to health literacy at the clinical, organizational, and policy levels with reference to the role of the social work profession.


Mental Health Disparities  

Rhonda Wells-Wilbon, Rhea Porter, Taylor Geyton, and Anthony Estreet

Millions of Americans are affected by a mental illness or disorder each year. Given the prevalence, it is unfortunate that significant disparities exist within mental health care. Some of the most common reasons mental health disparities exist include stigma, previous negative experiences, limited mental health literacy, lack of culturally aware providers and services, language access, and lack of financial resources. Additionally, members of racial and ethnic, gender, and sexual orientation minority groups, who already encounter higher levels of bias, experience poorer mental health outcomes due to disparities than their counterparts. Grounded in the values and ethics of the profession, it is no surprise that social workers play a vital role in reducing mental health disparities.


Primary Health Care  

Rebecca S. Ashery

The passage of the Affordable Care Act (ACA) has injected new life into primary health care by establishing the primary care medical home (PCMH) as a cornerstone of health-care reform legislation. In addition to the PCMH, the ACA has a number of primary-care components that can open opportunities for social workers. Concerns remain for payment reform in the implementation of the PCMH. The implementation of the ACA is still a work in progress, with anticipated modifications and changes as issues arise.


Mental Health Parity  

Wayne Lindstrom

Continuing a history of inequity, private insurers have placed restrictions and limitations on coverage for mental health conditions making access to treatment services increasingly more challenging. A state-by-state advocacy movement has led to the enactment of various state laws to require mental health parity. With the Clinton Administration’s attempt at health care reform, mental health parity became part of the health reform debate and led to the passage of the Mental Health Parity Act of 1996. The inadequacies of this law were partially corrected in the Mental Health Parity and Addiction Equity Act of 2008, which included mandated coverage for substance use conditions. The Obama Administration in 2011 included these provisions in the Patient Protection and Affordable Care Act, which does not require compliance monitoring nor does it provide a definition for “mental health,” which leaves insurers to define it and hence determine what coverage will actually be available.


Mindfulness-Based Therapy  

Edward R. Canda and Sherry Warren

This entry provides an introduction to mindfulness as a therapeutic practice applied within social work, including in mental health and health settings. It describes and critiques mindfulness-based practices regarding definitions, history, current practices, best practices research, and ethical issues related to using evidence-based practices, acquiring competence, addressing social justice, and respecting diversity.


Disaster Mental Health  

Leia Y. Saltzman, Regardt J. Ferreira, and Tonya C. Hansel

Disaster mental health refers to the provision of psychological and substance use services in environments coping with and recovering from disasters. In addition, disaster mental health refers to the study of the psychological and emotional impacts of disasters on individuals, families, and communities. Disasters—including climate-related, human-caused, biological, technological, and infrastructure failure—have documented impacts on the mental health of survivors. Disasters do not equitably impact individuals, families, and communities but rather may exacerbate existing disparities, worsening health and mental health outcomes and limiting access to mental health care. As societal and environmental factors continue to evolve, communities that previously were not impacted by disasters have begun to feel the effects. Simultaneously, communities that have previously been impacted by disasters are now facing recurring or compounding disaster experiences—for example, repeated wildfires, hurricanes, or flooding. The 2020 COVID-19 pandemic has also increased concerns about protracted and lengthy disaster experiences and the impact these events may have on new and/or worsening mental health symptoms. Social workers have a unique perspective that can contribute to the practice of disaster mental health with individuals, families and communities—from the provision of clinical services to policy and preparedness, to research. The system approach coupled with a strengthsbased perspective which is the hallmark of social work is imperative when working with individuals, families, and communities impacted by disasters and those who face mental health challenges in the wake of these experiences.


Eliot, Martha May  

Jean K. Quam

Martha May Eliot (1891–1978) was an educator and public health official. She was the first woman president of the American Public Health Association. She became chief medical consultant for UNICEF in 1947. She was later assistant director general of WHO, and the U.S. representative to the executive board of UNICEF.


Wittman, Milton  

Ruth Irelan Knee

Milton Wittman (1915–1994) was a social worker, writer, and leader in social work, public health, and mental health. He played a key role in the expansion of opportunities for social work education and for the involvement of social workers in the provision of mental health services.


Children: Health Care  

Barbara L. Jones and Casey Walsh

Despite rapid medical advances, children in this country still face significant barriers to adequate health care, including unequal access to insurance and health care. There is great need and opportunity in our nation at this time to advocate for the advancement and prioritization of pediatric health care. Children remain vulnerable to the challenges of poverty, violence, firearms, mental health, and health care access. Social workers play an important role in assisting children and families who face health care crises by providing supportive services, advocacy, culturally grounded assessment, trauma informed care, and evidence-based interventions to improve healthcare outcomes and quality of life. The Patient Protection and Affordable Care Act (ACA), signed into law in 2010, has increased access to pediatric health and behavioral health services. While the future of this law is uncertain at the time of this writing, social work is and will continue to be an important discipline to assist children and families in the areas of health promotion and adaptation to illness and injury.



Larry W. Foster

Bioethics and biomedical ethics are defined. Common bioethical concepts, exemplary moral values, fundamental ethical principles, general ethical theories, and approaches to moral reasoning are reviewed. The scope of topics and issues, the nature of practice situations in bioethics, and social work roles on organizational bodies that monitor and respond to bioethical issues are summarized, as are trends in bioethics. Practice contexts, from beginning to end of life, are highlighted with biopsychosocial facts, ethical questions and issues, and implications for social work—a profession uniquely positioned in giving bioethics a social context.


HIV/AIDS and People of Color  

Michele Rountree and Courtney McElhaney Peebles

Communities of color are disproportionately burdened by the prevalence of HIV/AIDS. Research has shown that race and ethnicity in the United States are population characteristics that correlate with other fundamental determinants of health outcomes. This entry will chronicle the history of the epidemic, report the disparate impact of the disease affecting communities of color, and acknowledge the social determinants of health that contribute to the vulnerability of risk. A call to address the imbalance of health inequities, with a complement of individual-level interventions and new approaches that address the interpersonal, network, community, and societal influences of disease transmission, is discussed.


Health Disparities and Inequities  

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.


Latinx Immigrant Health and Mental Health  

Cecilia Ayón, Tanya Nieri, and Maria Gurrola

Latinx immigrants represent a large segment of the immigrant population in the United States. While immigrants tend to be healthier than native-born people, they experience a number of health disparities. Latinx immigrants experience many barriers to accessing health care, including immigration policy barriers related to undocumented or recent permanent resident status, lack of culturally and linguistically responsive services, challenges during the access verification process, discrimination by providers, and external resource constraints (e.g., cost). Many are uninsured or underinsured and experience limited access to care. Existing models to understand health are examined. A social determinants of health framework is used to understand immigrants’ health outcomes. Within this framework immigration is a social determinant of health. Substantial empirical evidence illustrates how the immigration policy context impacts on immigrants’ health through exposure to enforcement activity, threat of detainment and deportation, and actual deportation. Enforcement activity is racialized to effect all Latinxs regardless of status. Other domains including economic insecurity, education, and community and social support are other sources that may disadvantage immigrants and impact on their health. The search for economic opportunity is a primary motivation for Latinxs to migrate to the United States, yet many face economic challenges and live in poverty. Education has significant impact on immigrants across the development spectrum as they experience disparities in access. Social ties are critical to the wellbeing of Latinx, evidence suggests disparities in access to support by status. Immigrants contend with a number of challenges as they integrate into society. Social determinants of health, through multiple domains, affect immigrants’ health.


Women: Health Care  

Marian A. Aguilar

This entry provides an abbreviated version of the status of women's health in the United States, highlighting health care utilization, health care expenditures, policy issues, barriers to health care, and the impact on populations at risk. The findings accentuate the importance of moving the women's health care agenda forward because of the persistence of health disparities not just among women of color but among women with disabilities, adolescents, women in violent relationships, women with AIDS, women who are incarcerated, women who are homeless, older low-income women, women on welfare, and lesbian women.


Health Care Social Work  

Shirley Otis-Green

Health social work is a subspecialization of social work concerned with a person's adjustment to changes in one's health and the impact this has on that person's social network. Social workers in every setting must be ready to assist individuals and families adjusting to illness and coping with medical crises. This entry provides a brief overview and history of health social work and describes the settings and roles where this work is practiced. Significant challenges and opportunities in clinical care, research, education, and policy are discussed. Standards and guidelines for quality practice are then noted.


Gonzalez Molina de la Caro, Dolores  

John F. Longres

Dolores Gonzalez Molina de la Caro (1910–1979) was a pioneer in mental health training, public welfare, public health, school health, and university counseling in Puerto Rico. She was director of the Bureau of Medical Social Work and Mental Health Program.


Samora, Julian  

Juliette Silva

Julian Samora (1920–1996) was a researcher and scholar in sociology and Mexican American studies and the first Mexican American in the fields of sociology and anthropology. He was professor of sociology at the University of Notre Dame.