Vivian Jackson and Wendy Jones
The revised NASW Standards and Indicators for Cultural Competence in Social Work Practice (2015) requires social workers to “provide and advocate for effective communication with clients of all cultural groups, including people of limited English proficiency or low literacy skills, people who are blind or have low vision, people who are deaf or hard of hearing, and people with disabilities” (p. 43). This article focuses on one component of this standard—literacy, specifically health literacy. It presents a summary overview of health literacy and its implications for social work practice. It also presents the history of the concept and provides various definitions and types of health literacy as described in the literature. The authors describe the association between health literacy levels of the population, the intricacies of health systems, and their impact on health outcomes. The negative impact for marginalized populations including persons with limited English proficiency and immigrants and refugees—a major focus of the social work profession—signals the need for action at multiple levels. The authors explore a multifaceted approach to health literacy at the clinical, organizational, and policy levels with reference to the role of the social work profession.
Since the start of the human immunodeficiency virus (HIV) pandemic, numerous biomedical advances have caused the social-work response to shift from management of a crisis to prevention of an incurable, but treatable chronic disease. About 1.3 million people in the United States and more than 33 million people worldwide are estimated to be living with HIV. Rates of incidence in impoverished, marginalized communities are highest, with the rates continuing to increase among young African American gay and bisexual men. Other communities at high risk are people who are incarcerated, engage in sex work or other kinds of exchange sex, and participate in risky injection-drug use. Minority groups are often impacted because of reduced access to quality medical care and HIV testing. Social workers in HIV prevention work are challenged to educate clients and communities on the sexual risk continuum, provide more interventions that are culturally tailored for disadvantaged at-risk groups, and implement evidence-based HIV prevention and testing programs worldwide. The National HIV/AIDS Strategy now provides structure to funding opportunities for HIV prevention programs, and there is disparate access to effective treatments worldwide for those living with HIV.
Michele Rountree and Courtney McElhaney Peebles
Communities of color are disproportionately burdened by the prevalence of HIV/AIDS. Research has shown that race and ethnicity in the United States are population characteristics that correlate with other fundamental determinants of health outcomes. This entry will chronicle the history of the epidemic, report the disparate impact of the disease affecting communities of color, and acknowledge the social determinants of health that contribute to the vulnerability of risk. A call to address the imbalance of health inequities, with a complement of individual-level interventions and new approaches that address the interpersonal, network, community, and societal influences of disease transmission, is discussed.