Jeanette C. Takamura
Public policy advances in the field of aging in the United States have lagged compared to the growth of the older adult population. Policy adjustments have been driven by ideological perspectives and have been largely incremental. In recent years, conservative policy makers have sought through various legislative vehicles to eliminate or curb entitlement programs, proposing private sector solutions and touting the importance of an “ownership society” in which individual citizens assume personal responsibility for their economic and health security. The election of a Democratic majority in the U.S. House and the slim margin of votes held by Democrats in the U.S. Senate may mean a shift in aging policy directions that strengthens Social Security, Medicare, and Medicaid, if the newly elected members are able to maintain their seats over time. The results of the 2008 presidential election will also determine how the social, economic, and other policy concerns will be addressed as the baby boomers join the ranks of older Americans.
Carole B. Cox
Dementia is not a disease, but a group of symptoms so severe that they inhibit normal functioning. Alzheimer's disease is the most common type of dementia in older persons impacting not only the person with the illness but the entire family. Obtaining an accurate diagnosis is essential in order to assure appropriate and timely care and to exclude reversible causes of dementia. Social workers can play key roles throughout the course of the illness as educators, therapists, supporter and advocates for improved policies and services.
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.
Romel W. Mackelprang
Characteristics that we contemporarily define as disabilities have existed in the human population from earliest recorded history. Societal explanations for disability have varied greatly by time and populations in which disabilities have occurred. At various times in history, disability has been viewed as a blessing from deity or the deities, a punishment for sin, or a medical problem. Social workers have worked with persons with disabilities from the inception of the profession, and in recent years, social work has begun to embrace the concept of disability as diversity and to treat disability as diversity and welcome disabled persons as fully participating members of society. Social work has begun welcoming persons with disabilities as fully participating members of society, including valuable members of the profession.
Maryah Stella Fram
This entry provides an overview of current knowledge and thinking about the nature, causes, and consequences of food insecurity as well as information about the major policies and programs aimed at alleviating food insecurity in the United States. Food insecurity is considered at the nexus of person and environment, with discussion focusing on the biological, psychological, social, and economic factors that are interwoven with people’s access to and utilization of food. The diversity of experiences of food insecurity is addressed, with attention to issues of age, gender, culture, and community context. Finally, implications for social work professionals are suggested.
Valire Carr Copeland and Sandra Wexler
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—differences in health status and healthcare utilization that are influenced by complex social structural, economic, and cultural factors. Illustrations are offered of health disparities found among diverse populations in this country. The “problem” with health disparities is then explored. From an ethical standpoint, health disparities can be seen as unjust. From a cost perspective, health disparities exact not just a financial toll that is borne by society, but individual, group, and community consequences, as well. From a human rights vantage, health disparities can further disadvantage people who are already vulnerable and marginalized—health disparities can cost people their lives. Factors contributing to health disparities, commonly referred to as social determinants, are reviewed. Finally, future directions, including social workers’ role as advocates, are considered.
Larry D. Icard, Jacqueline J. Lloyd, and Gisoo Barnes
HIV/AIDS has introduced an array of issues and needs for children, youth, and their families. Family-focused interventions have emerged as a viable strategy for researchers and practitioners seeking effective and appropriate responses for the prevention, treatment, and care of children, youth, and families affected by HIV/AIDS. This discussion provides an overview of the epidemiology of HIV infection among children and youth, and highlights common elements and trends in the development, implementation, and testing of family-focused interventions. The discussion concludes with a commentary on areas for future attention.
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.
Judith G. Gonyea
As a result of rising life expectancies, America’s older population is itself aging. The U.S. Census Bureau projections suggest that by the middle of the 21st century, more than 40% of Americans aged 65 and older can expect to live to at least the age of 90. Although the oldest-old is a diverse population, advanced old age is associated with a greater risk of experiencing economic hardship, disabling illnesses or health conditions, and social isolation. A growing public policy challenge will be ensuring the economic well-being, the health, and the dignity of society’s very oldest citizens.
Valire Carr Copeland and Daniel Hyung Jik Lee
Social reform efforts of the settlement-house movement have provided, in part, the foundation for today’s Maternal and Child Health Bureau’s policies, programs, and services. Planning, implementing, and evaluating policies and programs that affect the health and well-being of mothers and children require a multidisciplinary approach. Social workers, whose skills encompass direct services, advocacy, planning and research, community development, and administration, have a critical role to play in improving the health outcomes of maternal and child populations.