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Article

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.

Article

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.

Article

Hospice  

Mary Raymer and Dona J. Reese

Hospice social workers are essential members of the interdisciplinary team that provide biopsychosocial and spiritual care to terminally ill patients and their significant others during the last 6 months of life. Hospice philosophy emphasizes symptom control, quality of life, patient self-determination, and death with dignity. Hospice social workers must be skilled in providing evidence-based interventions including direct client services; collaboration with the interdisciplinary team; community outreach; developing culturally competent services; and advocating for policy change on the organizational, local, and national levels.

Article

Colleen Galambos

This entry provides an overview of the state of health care in the United States. Service delivery problems such as access and affordability issues are examined, and health care disparities and the populations affected are identified. A discussion of two primary government-sponsored health care programs—Title XVIII (Medicare) and Title XIX (Medicaid), and the Patient Protection and Affordable Health Care Act—are reviewed along with various health care programs and major existing service delivery systems. Ethical conflicts in providing health care, and new directions and challenges are discussed, along with future roles for social workers.

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

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.

Article

Grace Christ

The ability of medical technology to prolong life over the past century has forced an examination of the experience and care of the dying. Many diseases that once were expected to follow a sloping illness trajectory with predictable deterioration and ultimately death are now more commonly experienced as chronic illnesses. They require more medical and other resources and challenge the family's ability to cope for much longer periods. The knowledge, value, and skill base of social work, and its broad range of practice sites make it uniquely suited to contribute to the movement to improve the care of the dying. The Social Work Hospice and Palliative Care Network were formed in 2007 to advance and give voice to social work's expertise in this area and to promote its development in practice, education, research, and policy.

Article

Marie M. Lauria

Oncology social work is a specialization of social work in health care. Its practitioners provide supportive services and programs, patient navigation, education, research, administration, policy development, and advocacy to address the social, psychological, practical, and spiritual concerns of cancer patients, their families, and caregivers from pre-diagnosis through treatment, survivorship, and end of life care or bereavement. The coming decades will present many challenges and opportunities for oncology social workers in helping patients, families, and caregivers overcome barriers to quality of life and care.

Article

Ellen Fink-Samnick

The past two decades have witnessed a surge in the growth of initiatives and funding to weave physical and behavioral health care, particularly with identification of the high costs incurred by their comorbidity. In response, a robust body of evidence now demonstrates the effectiveness of what is referred to as collaborative care. A wide range of models transverse the developmental lifespan, diagnostic categories, plus practice settings (e.g., primary care, specialty medical care, community-based health centers, clinics, and schools). This article will discuss the foundational elements of collaborative care, including the broad sweep of associated definitions and related concepts. Contemporary models will be reviewed along with identified contextual topics for practice. Special focus will be placed on the diverse implications collaborative care poses for the health and behavioral health workforce, especially social workers.

Article

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.

Article

Stephen H. Gorin, Julie S. Darnell, and Heidi L. Allen

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.

Article

Karen M. Sowers, Catherine N. Dulmus, and Braden K. Linn

In the 2010s, mental health and related issues such as suicide have become major global issues of public health concern. The indirect costs to the global economy of mental illness—encompassing such factors as loss of productivity and the spending on mental health services and other direct costs—amount to approximately $2.5 trillion a year. Global health experts and economists project this amount will increase to approximately $6 trillion by 2030. When gone untreated, mental illnesses account for 13% of the total global burden of disease. By the year 2030 it is expected that depression alone will be the leading cause of the global disease burden. Unfortunately, many persons suffering with mental illnesses do go untreated or receive marginally effective treatments. However, recent advances in technology, evidence-based treatments, and delivery systems of care provide hope for the world’s mentally ill population.

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

Michael A. Patchner and Lisa S. Patchner

The complicated nature of illness and health care delivery along with the complexity of insurance and health policy demand team-based health care. As a consequence, social workers have become engaged in team-based health care with numerous other professionals within multiple settings. Through the engagement of client-centered practice social workers experience systems that weigh the provision of direct services against macro quantitative accountability. This has resulted in newly defined roles and expectations for social workers who are well trained for both micro and macro practice. In multiple health care settings, social workers are partners in team-based models of care where patient-centered practice is a component within larger public and private delivery systems.

Article

Vikki L. Vandiver

Since the mid-1980s, managed care has been one approach used to address the economic crisis in the American health-care system. This entry overviews managed care from the perspective of policy, procedure, practice, and system. Specifically, emphasis is given to understanding the emergence and history of managed care, multiple definitions, how it works, and examples of managed care plans, key legislation, existing research, its future, and implications for social-work practitioners.

Article

Jared Sparks

Personalized health care (PHC) is a broad term that describes how we leverage our growing understanding of the human body and developing technology to provide more effective health care. PHC requires that health care providers consider prevention and treatment in the context of available advanced technologies, best practices, and known variables that define us as individuals. These variables or characteristics may run the gamut from genetic, to biologic, to environmental, to even personality, personal values, and choice. By considering how these characteristics interact with specific illnesses and available interventions, outcomes can be improved. The purpose of this article is to: describe PHC’s current conceptualization including relationship with personalized medicine and patient-centered models of care, discuss its development and application by specific stakeholders, and review pertinent economic, legislative, and ethical issues.

Article

Goldie Kadushin

Home health care is professional medical and non-medical care delivered in the home (home refers to a private residence, an assisted living facility, or a group home) to assist ill, injured, or disabled seniors or adults remain safely at home for as long as possible. As the population ages, and the numbers of Baby Boomers age 85 and older increases, it is likely that there will be a growing need for long-term care, including home health care. In this article, the role of social work in home health care is reviewed as it is impacted by sources of payment and demographic characteristics of home care users. Social work assessment and intervention in home health care is also discussed with a focus on effective referral practices.

Article

Edward Pecukonis

The concept of health profession centrism and its effects on interprofessional education is important to Social Work practice. Profession centrism is concerned with a student’s professional socialization and their ability to work effectively with other health professionals and clients. This cultural frame determines the salience of curriculum content, core values, practice rituals and customs. It determines the meaning and etiology of symptoms and what constitutes health and treatment success. The interprofessional education (IPE) agenda is often seen as “soft curriculum” content and put to the side for the rigors of health sciences. Paradoxically, it is these issues of communication, ethics, role definition, and working as a team that creates problems among health professionals which compromise safety and efficiency in patient/client care. Learning to minimize profession centrism is a critical education and training objective for health social workers.

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

James K. Whittaker

This entry addresses the current state of therapeutic group care services for children and youth. Demographic programmatic trends and research findings are reviewed as are emergent issues and critical questions for further research and practice innovation. Suggestions for improvement of therapeutic group care services are offered in the context of an overall spectrum of services for children and families.