Development of the brain in the first 3 years of life is genetically programmed but occurs in response to environmental stimuli. The brain is organized “from the bottom up,” that is, from simpler to more complex structures and functions, so the experiences and environment that shape early development have consequences that reach far into the future. This entry describes the ontogeny and processes of fetal and infant brain development, as well as major risks to early brain development (during pregnancy and after birth), with emphasis on the factors seen in social-work practice. Neuroscience research is changing social work practice, and understanding early brain development and the contributors to poor development is critical for social workers in medical, mental health, child welfare, and other practice settings.
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.
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.
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.
Primary prevention involves coordinated efforts to prevent predictable problems, to protect existing states of health and healthy functioning, and to promote desired goals for individuals and groups, while taking into consideration the physical and sociocultural environments that may encourage or discourage these efforts. This entry discusses the history of this basic approach to professional helping from medical, public-health, and social-science perspectives. It also reviews major theories that guide preventive thinking and action. One section sketches the substantial empirical base for evidence-based practice and how such information can be retrieved. This entry concludes with a review of practice methods for increasing individual strengths and social supports while decreasing individual limitations and social stresses, which together characterize most contemporary preventive services.
Jessica M. Black
Sleep is required for healthy and adaptive neurobehavioral and psychosocial functioning throughout the life course. Sleep is restorative, facilitates memory consolidation, improves immune function, and regulates emotional responses. Sleep deprivation, whether due to sleep disorders or other life conditions and transitions, is a significant risk factor for negative developmental outcomes at all stages in the life course. This article adheres to the biopsychosocial model to review current research describing the benefits of adequate sleep and ways in which insufficient sleep, as determined by developmental needs throughout the life course, can undercut healthy development. Particular attention is paid to social issues of relevance to social workers, with a closing discussion of policy and implications for future work within the field.
Paula S. Nurius and Charles P. Hoy-Ellis
Evolving understandings of stress have literally transformed how we think about health as contextualized within complex and multilevel transactions between individuals and their environment. We present core concepts of stress through the lens of life-course and life-span perspectives, emphasizing appraisal-based and biobehavioral models of stress response systems. We describe theories of allostatic load, embodiment, epigenetics, weathering processes, and accelerated aging that operationalize mechanisms through which stress affects health and contributes to health disparities. In addition to social determinant and life-span developmental perspectives on stress and health, we emphasize the value of health-promotive factors that can serve to buffer stress effects. Social work has important roles in targeting health-erosive stress from “neurons to neighborhoods”.