105 YEARS AGO
The Trend of Medico-Social Effort in Child Welfare Work
A very real need exists in our health departments today for social organizers and directors—men and women of special vision, training and experience in social work—who will do for whole communities work of social organization which is already being done by philanthropic leaders in single and smaller fields. All over the world students, scientists and thinkers are discovering for humankind the immediate medical, sanitary and hygienic causes of suffering and ill-health. The problem now is to discover the social causes of these other causes and to formulate and direct against them a social program, in which all forces shall take part.
From AJPH, November 1912, p. 880
50 YEARS AGO
Health-Welfare Partnership in Programs for Low Income Groups
In the poverty culture, health has a low priority. Poor people have a tendency to accept ailments as they do other misery—fatalism is a strong element of their outlook on life. And they are often both fearful and distrustful of the resources open to them. Many of them are more likely to buy a painkiller from the corner drugstore than to consult a doctor. . . . We must reach out to them, overcome their fears, help them deal with such practical obstacles as carfare and babysitting problems, use all the talents which our best public health nurses and public welfare caseworkers possess.
From AJPH, July 1967, p. 1105
Social work and public health share historical links, with the common goals of addressing social determinants of health, promoting population health, and advancing social justice. In this special issue of the AJPH, a transdisciplinary group of experts explores the potential role of social work in the new health landscape, particularly as it relates to the goals the profession shares with public health. With more than half of the estimated 650 000 US social workers employed in health settings, they have the training and experience to take action that will improve the social conditions that negatively affect the public’s health. In these settings, social workers assess, engage, intervene on behalf of, coordinate, and advocate for the nation’s most vulnerable populations, thus directly confronting existing health inequities. As the articles show, public health social workers can put these skills and knowledge to work, drawing on their deep understanding of the social determinants of health and the populations most affected, to advance the health and well-being of the communities they serve.
Although social work’s unique skill set and social justice mission position the profession for leadership in the current health landscape, the articles also show that social work has struggled to find its identity and define its role. Social work leadership has been stymied by the pressures of sustained and rapidly increasing health care costs and associated efforts to control this trend. These pressures have been exacerbated by a lack of novel sources to finance social work services, as well as task shifting to other health and social needs providers. Although social workers are an integral part of the US health care system, there is a paucity of information about their specific contribution to health outcomes and costs.
More research is needed to clearly document the benefits of using social work methods to address health problems. Research must also aggressively take on the issue of producing evidence of social work’s impact, specifically addressing the efficacy of social work involvement. This critical analysis will help social workers develop measures of health and social needs outcomes as well as social work impact on the social determinants of health. For example, information about how social work involvement improves quality and reduces cost can be evaluated through the rapidly growing data available in electronic health records. Social work must also develop a greater capacity to translate this evidence into policy innovation. More intention is needed to create stronger links among social work education, policy, research, and practice.
Recent health policy and practice advancements, focusing on enhanced linkages between health and social needs care and community-based services, have created opportunities for social work to step into these imperatives. Social work, building on its public health perspective and community-oriented roots, has greater potential to substantially contribute to the goals it shares with public health. The articles in this special issue offer specific ideas for how social work public health can promote new transdisciplinary initiatives at every level, including those that will advance education, health policy innovation, community health, and measurable outcomes of authentic progress in improving population health and mitigating inequities. Most importantly, social workers have the requisite training and skills to work with vulnerable populations that are most at risk for experiencing health inequities. The time has come to integrate these skills, knowledge, and strategies into new health and social needs care models to improve population health, promote efficiency, and advance social justice.
Biography
