Policy and Advocacy

Adult Protective Services (APS) are empowered by states and local communities to respond to reports and cases of vulnerable adult abuse, neglect, and self-neglect. While incorporating legal, medical, and mental health services, APS programs are part of the social services delivery system and incorporate principles and practices of the social work profession.

Advance care planning (ACP) is the process of determining and documenting desired wishes for the end of one’s life. Referred to by such terms as end-of-life planning, advance (health) directives, and living wills, ACP is a relatively new concept within our society, having emerged as a social, political, and ethical issue in the United States only since the 1960s. Researchers and legislators have been challenged in their efforts to examine healthcare decision-making and design appropriate policy to guide practice. This article will define ACP, provide an overview of the history and evolution of the process and the associated legal and ethical issues, and describe the process with three specific populations. In addition, it examines the role of the social work profession in working with individuals and families on planning for the end of one’s life.

Social work advocacy is “the exclusive and mutual representation of a client(s) or a cause in a forum, attempting to systematically influence decision-making in an unjust or unresponsive system(s).” Advocacy was identified as a professional role as far back as 1887, and social workers consider client advocacy an ethical responsibility. Social workers are increasing the use of electronic advocacy to influence client issues and policy development. As client and societal needs evolve, universities should emphasize advocacy in their curricula, and the National Association of Social Workers should promote electoral and legislative initiatives that reflect an emphasis on social and economic injustices.

African Americans have been a part of the nation's history for nearly four hundred years. Although their history includes the forced imposition of chattel slavery, the strict enforcement of legal segregation, and a tenuous acceptance as equal citizens, African Americans have been, and continue to be, major contributors, creators, investors, and builders of America. In this article we summarize briefly the history of African Americans, we examine racial disparities in key indicators of social, mental, and physical well-being, and we highlight persistent strengths that can be built upon and areas that provide hope for the future. The challenge for social work is to simultaneously celebrate the historical successes and ongoing contributions of African Americans to this country while also recognizing the vestiges of structural racism and fighting for greater civil rights and social and economic justice.

This article discusses the African American social welfare system that began to develop during the early 20th century. This social welfare system, designed by African Americans to serve African Americans, addressed needs that were not being met by any other formal social services while the nascent social work profession was emerging. The myriad programs included settlement houses, boys and girls programs, training schools, and day nurseries. The women’s club movement played a critical role in the development of this social welfare system and provided much of the impetus for change and inclusion. Through formal organizations, including the National Urban League (NUL) and the Universal Negro Improvement Association (UNIA), and an array of clubs and social groups, social services were extended to urban and rural communities throughout the United States.

The rapidly growing older population is more heterogeneous by health and economic status, gender, race, sexual orientation, and family and living arrangements than any other age group. Although many adults face vulnerabilities and inequities as they age, most elders are resilient. This entry reviews this diversity, discusses concepts of productive, successful, and active aging, and suggests leadership roles for social workers in enhancing the well-being of elders and their families.

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.

Alaska Natives represent less than 1% of the U.S. population but reside in more than 229 Native villages and account for 40% of federally recognized tribes. Most Alaska Native communities shared common Euro-American contact experiences: exposure to western religions, education, and disease. Historical trauma contributes to many of the social welfare problems Natives experience today: low educational attainment, unemployment, inadequate health care, substance abuse, and violence. Service delivery mechanisms, lack of cultural appropriateness, and isolation compound these pressing issues. Locally delivered social welfare services that take into account traditional Native worldviews, values, languages, and intergenerational relationships are effective in addressing many of these issues.