PUBLIC HEALTH & SOCIAL WORK

Chapter 4Handbook of Health Social Work, 2nd Edition

Created by Teri Browne

Aims to ensure a standard of living adequate for the maintenance of health.

The science and art of… Preventing Disease Prolonging Life Promoting Physical Health

PUBLIC HEALTH

Focus on eliminating disparities between and among various populations.

A commitment to enhance … Social Justice Economic Justice Environmental Justice

SOCIAL WORK

Beginning Roots Immunization campaign to prevent smallpox. Active social reformers changed legislation. Programs impacted quality of life among populations.

Building Programs—Children’s Bureau U.S. DHHS Goal—investigate & reduce infant mortality Legislative Reforms—aim to provide & regulate maternal &

child health services, crippled children’s services, & child welfare services. Maternity & Infancy Protection Act … AKA (Sheppard Towner Act of 1921)

HISTORY…

Settlement Houses & Social Reform Late 1980’s residents of settlement houses worked to improve the

communities in which they lived.

Famous Faces Jane Addams Lillian Wald Alice Hamilton

Initiatives Hygiene & Sanitation Health Promoting Behaviors Working Conditions Occupational Exposures

HISTORY…

Healthy People 2020… Sets of National Health Promotion & Disease Prevention Goals &

Objectives. Developed by DHHS beginning in 1980 & continuing each decade.

Goals Healthy People 2020…a)Eliminate preventable disease, disability, injury, & premature

death. b)Achieve health equity, eliminate disparities, and improve the

health of all groups. c)Create social & physical environments that promote good health

for all d)Promote healthy development and healthy behaviors across

every stage of the life cycle.

HISTORY…

Healthy People 2020: Objectives –Social Determinants of Health

Access to Health Services

Adolescent Health

Early & Middle Childhood

Educational & Community- Based Programs

Environmental Health

Family Planning www.healthypeople.gov/hp2020

Social Work Practice in Public Health 1) Emphasizes health promotion, protection from environmental

harms, and disease prevention. 2) Targets populations rather than individuals & groups.

1996—a group of public health social workers convened to develop a definition of public health social work. Examined common attributes of the person & the job.

INTERSECTION OF FIELDS…

http://oce.sph.unc.edu/cetac/phswcompetencies_may05.pdf

Determinants of Health “The range of personal, social, economic, & environmental factors

that determine the health status of individuals or populations.” (p. 69)

Foundation of public health research is based on… Epidemiology

the study of the distribution and determinants of disease in populations. Evidence-based interventions

developed & verified through research to control & prevent epidemics.

EPIDEMIOLOGY & THE DETERMINANTS OF HEALTH…

Overarching Determinants of Health1) Macro-level Issues of Policies & Interventions2) Access to Quality Healthcare

Patient Protection & Affordable Care Act (PPACA) Passed in March 2010 Requirement—Everybody has insurance by 2014

System Barriers Limited # of healthcare providers (inner cities & rural) Limited safety-net clinics for the under/uninsured

EPIDEMIOLOGY & THE DETERMINANTS OF HEALTH…

Elimination of Health Disparities Unequal Treatment –a film development at the request of

Congress in 1999 to examine the extent to which racial & ethnic minority health disparities are attributable to disparities in health-care services.

Promotion of Justice Social Economic Environmental

COMMON VALUES…

Socioeconomic Status is a primary Determinant of Health Income-associated health inequalities Infant Mortality (IM) Low birth weight (LBW) & maternal mortality Place-based health disparities

Food Deserts—neighborhoods with limited access to healthy foods.

HEALTH DISPARITIES…

Nancy Krieger identifies 5 pathways through which racism can harm health (2003, 2005). 1) Economic & social deprivation2) Exposure to toxins3) Socially inflicted trauma4) Targeted marketing of products harmful to health (drugs,

alcohol, tobacco)5) Inadequate or degrading medical care

PROMOTING JUSTICE…

Sound Social Work & Public Health Interventions & policy are… Evidence-based Possess strong evaluation

Aim to improve quality of life outcomes among individuals & populations.

COMMON METHODOLOGIES…

Community Assessment Method of identifying the strengths & weaknesses in a defined

community. Social Epidemiology

Study of the impact of social factors on the distribution of health & illness in a population.

Geographic Information Systems Allow for the spatial analysis of distributions, trends, services,

clusters, etc.

COMMON METHODOLOGIES…

Micro (Direct Practice Level) Interventions are implemented using clinical social work skills or

provide social work services as a part of a larger public health program.

Macro Contribute knowledge of psychosocial & cultural issues to the

development of public health interventions. Mezzo (Indirect Practice Level)

Develop, implement, & administer public health programs.

LEVELS OF PRACTICE…

Disease prevention is divided into 3 levels:1) Primary

Intended to protect from injury/disease. Ex: Immunizations & Tobacco Taxes

2) Secondary Early diagnosis & treatment of disease. Ex: Pap smears & prostate exams

3) Tertiary Minimize the effects of disease. Ex: Eye exams to treat diabetic retinopathy

COMPONENTS OF PREVENTION…

Want to input diagram from book here Figure 4.5

TYPES OF INTERVENTION…

Public Health Social Workers do NOT practice in isolation.

Federal Public Health Agencies State & Local Health Departments National & Regional Offices

Create & administer regulations for policy implementation & manage & provide oversight for grants.

Conduct & use research to inform evidence-based interventions.

Act as liaisons to state programs funded by block grants

TODAY’S ERA…

Enroll in an MSW/MPH Graduate Program.

Participate in regional & national meetings of health social workers.

(APHA) (ASTPHSW)Gather experience in interdisciplinary

or transdisciplinary work. Keep current with changes in the

field.

PROFESSIONAL PREPARATION…

The following issues will shape the focus of much public health social work practice in the future… Disaster Preparedness—emergencies of a severity and magnitude

resulting in deaths, injuries, illness, and/or property damage that cannot be effectively managed by the application of routine procedures or resources.

Terrorism & Climate Change—threats to personal & societal well being.

Oppression & Social Justice—equality regardless of age, sex, gender, race, religious affiliation, etc.

EMERGING GLOBAL ISSUES…

A myriad of issues exist within the public health social work field, including…

Services for immigrants & refugees Health care for men and women not related to reproduction. Inner-city & rural concerns (safety, crowding, social & physical isolation)

…all of which impact the ability of these populations to achieve the maximum potential health status.

IMPACT OF THE PROFESSION…