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Article

Stephen H. Gorin and Terry Mizrahi

This entry presents an overview of 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. Specifically, it concentrates on the programs and strategies to obtain universal coverage for health and mental-health services for all Americans at the national level, with limited success. It ends with a discussion of the Affordable Care Act (ACA). Special emphasis is laid on the roles of social workers and their professional organizations during this period.

Article

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.

Article

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.

Article

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.

Article

Lori Messinger and Jennifer Wheeler Brooks

This entry provides an overview of research on lesbians in the United States using an overarching framework of oppression and empowerment. Historical and current demographic and cultural information about lesbians will be reported, along with an analysis of personal and environmental factors critical to social work practitioners' ability to enhance the well-being of lesbian individuals, couples, and families.

Article

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.

Article

Tanya Smith Brice

Jay Carrington Chunn, II, (1938–2013), was a leader in social work education, a professor, and an author who focused on public health and policy within urban populations.

Article

Hans S. Falck

Thomas Owen Carlton (1937–1992) was an expert in curriculum development in social work education as well as an author, an editor, and a scholar in health social work and social policy. He believed history influences social welfare planning.

Article

James Midgley

Lord William Beveridge (1879–1963) was one of the founders of the British welfare state. His report of 1942 formed the basis for the Labour Government's social policies between 1945 and 1950 and fostered the creation of Britain's national health services.

Article

Victoria M. Rizzo 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 US healthcare policy. Medicare was originally created to meet the specific medical needs of adults age 65 and older. Currently, 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 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 current issues of legislative consideration are also provided.

Article

Maryann Syers

Richard Morris Titmuss (1907–1973) was a scholar, administrator, and educator who developed the subject area of social policy and administration as an intellectually respectable field of inquiry. He was chair of Social Administration at the London School of Economics.

Article

Shrivridhi Shukla and Arpita Gupta

India’s rapid economic growth is accompanied by economic inequality, poverty, and a range of social issues, thus, raising important questions concerning the breadth and depth of social protection and promotion policies prevalent in the country. The social welfare system in India is different for the formal and informal sectors of the economy. It consists of two largely parallel systems. With respect to the formal economy or the organized sector, it operates directly through the government, state-owned enterprises, and/ or private corporations that provide reasonably strong social protection to their employees through mandatory legislations spanning aspects such as payment of gratuity, employees’ provident fund, and the employees’ state insurance fund. In contrast, the informal or the unorganized sector is covered through a fragmented system of welfare schemes and benefits provided by the central government and the respective state governments. Along with tracing the historical evolution of India’s welfare system, this article outlines the constitutional place of welfare in the country. With respect to the informal sector of the economy, it provides an overview of some of the key promotion and protection-orientated welfare policies and schemes, including those that address poverty, unemployment, education, health and food insecurity. Further, it discusses the barriers experienced by people in accessing welfare benefits, such as corruption and bureaucratic hurdles, and challenges faced by the government in welfare provision, such as scale of operation and identification of the target population groups. Finally, it assesses the country’s welfare system in light of the Global Social Protection Floor Initiative of the ILO-UN.

Article

Sleep  

Jessica M. Black

Sleep is required for healthy and adaptive neurobehavioral and psychosocial functioning throughout the life course. Sleep is restorative, facilitates memory consolidation, improves immune function, and regulates emotional responses. Sleep deprivation, whether due to sleep disorders or other life conditions and transitions, is a significant risk factor for negative developmental outcomes at all stages in the life course. This article adheres to the biopsychosocial model to review current research describing the benefits of adequate sleep and ways in which insufficient sleep, as determined by developmental needs throughout the life course, can undercut healthy development. Particular attention is paid to social issues of relevance to social workers, with a closing discussion of policy and implications for future work within the field.

Article

King Davis and Hyejin Jung

This entry defines the term disparity as measurable differences between groups on a number of indices. The term disparity originated in France in the 16th century and has been used as a barometer of progress in social justice and equality in the United States. When disparity is examined across the U.S. population over a longitudinal period, it is clear that disparities continue to exist and that they distinguish groups by race, income, class, and gender. African American and Native American populations have historically ranked higher in prevalence and incidence than other populations on most indices of disparity. However, the level of adverse health and social conditions has declined for all population groups in the United States. The disparity indices include mortality rates, poor health, disease, absence of health insurance, accidents, and poverty. Max Weber’s theory of community formation is used in this entry to explain the continued presence and distribution of disparities. Other theoretical frameworks are utilized to buttress the major hypothesis by Weber that social ills tend to result from structural faults rather than individual choice. Social workers are seen as being in a position to challenge the structural origins of disparities as part of their professional commitment to social justice.

Article

Yin-Ling Irene Wong and Claudia J. Vogelsang

Homelessness is a major social problem in the United States. The article starts with an overview of homelessness in American history, followed by the definition of contemporary homelessness, its prevalence, and the composition and diverse characteristics of the homeless population. Contrasting perspectives on what causes homelessness are discussed, while the multidimensionality of the homeless experience is explored. The unique experiences of three subpopulations, including homeless persons who are involved in criminal justice, emerging youth leaving foster care, and older homeless persons are further featured. Public and community responses to homelessness are examined, highlighting evidence-based and emerging practices that aim at reducing and preventing homelessness. A discussion of international homelessness follows, as homelessness is recognized as a global issue affecting people living in poverty in both the developed and developing world. The article concludes with discussion of the implications for social work.