Health Social Programs Research Articles

World Mental Health Casebook: Social and Mental Health Programs in Low-Income Countries

World Mental Health Casebook: Social and Mental Health Programs in Low-Income Countries

It's time we became more political as a profession

or elimination of the welfare state. 2,3 The decreased funding for public health in the United States is mainly a result of these neoliberal policies, rather than a result of “the absence of discernible, visible, organized professionalism” in public health. Thus, professionalization in public health is unlikely to improve the situation significantly. Resisting the global decline of social and public health programs is an enormous challenge not only for the public health profession but also for other professions being adversely influenced by the decline. Resistance entails a concerted effort involving transnational collaboration between different professions, social movements, and political organizations. Workers in public health have a potentially key role to play in organizing such an effort. Rather than take a parochial approach and appeal only to the public health profession in the United States, we must attempt to organize as a truly international profession to engage politically with public health issues that increasingly are posed on a global scale.

Fully integrated care for frail elderly: two American models

Integrated care for the frail elderly and other populations with complex, chronic, disabling conditions has taken centre stage among policymakers, planners and providers in the United States and other countries. There is a growing belief that integrated care strategies offer the potential to improve service co-ordination, quality outcomes, and efficiency. Therefore, it is critical to have a conceptual understanding of the meaning of integrated care and its various organisational models, as well as practical examples of how such models work. This article examines so-called "fully integrated" models of care in detail, concentrating on two major, well-established American programs, the social health maintenance organisation and the program of all-inclusive care for the elderly. A major challenge to understanding the performance and outcomes of fully integrated care and other organisational models is the lack of a meaningful, analytical paradigm. This article builds upon the work of Walter Leutz, to develop a framework by which new and existing programs can be analysed. This framework is then applied to the two American models that are the focus of this article. Existing data about integrated care in general, and the two model programs in particular, were collected and analysed from reports published by governmental and non-governmental organisations, and journal articles retrieved from Medline, HealthStar and other sources. This analysis strongly suggests that fully integrated models of care, such as the social health maintenance organisation and program of all-inclusive care for the elderly, are not only feasible, but offer significant potential to improve the delivery of health and social care for frail elderly patients. In addition, the authors identify the factors that are the most critical to the success of fully integrated care, and offer lessons for their development and implementation. Finally, issues are raised concerning the transferability of this complex model to other countries, as well as the vital importance of evidence-based evaluation research in furthering the evolution of integrated care.

The changing elderly population and future health care needs.

The impending growth of the elderly population requires both fiscal and substantive changes in Medicare and Medicaid that are responsive to cost issues and to changing patterns of need. More emphasis is required on chronic disease management, on meaningful integration between acute and long-term care services, and on improved coordination between Medicare and Medicaid initiatives. This paper reviews various trends, including the growth in managed-care approaches, experience with social health maintenance organizations and Program of All-Inclusive Care for the Elderly demonstrations, and the need for a coherent long-term care policy. Such policies, however, transcend health care and require a broad range of community initiatives.

The development of the Hill-Burton legislation: interests, issues and compromises.

The Hill-Burton Hospital Survey and Construction Act has its roots in the social health and welfare programs of the New Deal. This paper traces its development and the positions of three groups-the hospital industry, the U.S. Public Health Service, and the Senate Subcommittee on Wartime Health and Education-on four issues: the nature of federal funding to states, the use of public funds by private hospitals, the oversight powers of a Federal Hospital Council, and health services for the poor. The analysis involves two lines of thought: the political strategy of incrementalism and the roles of the three interest groups in reaching compromises to quickly pass an "unsponsored" bill. Relevance to the current effort to pass a single payer national health insurance is explored.

Asian Villages: Downtown Sanctuaries, Immigrant Asian Reception Areas, and Festival Marketplaces

Field research in fifteen cities in the United States and Canada reveals that planning departments working with nonprofit local development corporations (LDCs) and for-profit developers are rejuvenating central city East Asian villages. LDCs are instrumental in formulating strategic plans and negotiating community benefits. Implementation includes special district designation, revising land use and zoning codes to permit low-density mixed residential-commercial development, developing design and streetscape standards, and increasing community access, capacity, and resources. Where villages serve as immigrant reception areas or sanctuaries for elderly non-English-speaking Asians, providing community social services and health programs, preserving and expanding low-and moderate-income affordable housing, creating jobs, and encouraging business diversification are important priorities.

Integrating social work and public health education: a clinical model.

In Florida, the need for clinically oriented social workers with expertise in planning and evaluating maternal and child health programs has led to the establishment of a joint master of social work and master of public health degree program. This program has a clinical social work concentration combined with a public health concentration in maternal and child health content, administration, and research design. The philosophy and development of the program, the course content and degree requirements, the field placement content, issues regarding student acceptance and advisement, faculty appointments, and program directions and goals are discussed. Descriptions of both the social work and public health programs that operate the joint-degree curriculum and the differing perspectives are outlined as well as skills that students obtained through their participation in the program.

The problem of replicability in program evaluation: The component solution using the example of case management

Specificity and replicability of a program are crucial in order to rigorously evaluate the program's effectiveness. However, the traditional approaches to evaluation have ignored the problem that most social and mental health programs consist of vaguely specified interventions and cannot meet minimal standards of replicability. Consequently, the results of effectiveness evaluations of poorly defined programs have little generalizability. Nevertheless, effectiveness information concerning such programs is much needed. One solution to this problem is to focus on program components, examining interventions at a level where operational definitions can be employed and replicability is possible. In this paper, this approach is expanded using the example of case management programs. A component-oriented approach ensures a systematic evaluation of “program” effectiveness for which the first question for evaluators is whether a program consists of interventions that reliably produce specific immediate outcomes. Then, and only then, is it possible to address questions concerning whether a program will reliably produce those outcomes that are the overall objectives of the program.

The Challenge of Privately-Financed Community Health Programs in an Era of Cost Containment: A Case Study of Poison Control Centers

Many prevention-oriented community health services have relied on support from private sector organizations, particularly hospitals. As cost containment pressures and price competition increasingly push hospitals into the economic mainstream, the viability of hospital support of non-revenue-producing community health services is called into question. Poison control centers (PCCs) constitute an example of one such service that appears to produce social benefits well in excess of its social costs. Ignoring important indirect social benefits, and measuring only savings from avoided emergency room visits and hospitalizations, we estimate an annual net savings per center of $ 121,000, or a net benefit nationwide of $14.5 million through a system of regionalized PCCs. As the costs of the PCCs are borne predominantly by hospitals, however, without receipt of commensurate financial benefits, the private support base of PCCs is jeopardized. Using PCCs as an example of hospital-funded community health services, we examine the implications of the divergence between social and private net benefit for the future of these valued social health programs.

Health Maintenance Organizations as Medicaid Providers

Evolution of a one-door, one-class system of medicine for all Americans was the professed goal of the social legislation of the 1960s. The development of health maintenance organizations (HMOs) was seen to be a major mechanism for assuring access to care and at the same time reducing the costs of social health programs. This has currently been reinforced by procompetitive proposals, which predict great efficiency resulting from the envisaged competition among organized systems of care. This article argues that established HMOs have no incentives to enroll Medicaid beneficiaries and that under current arrangements. Medicaid beneficiaries have no incentives to enroll in HMOs. As Medicaid programs across the states are cut, resulting in fewer benefits and more restricted physician payments, beneficiaries may have greater incentives to enroll in organized systems. Private physicians may also face greater incentives to develop HMOs to serve Medicaid beneficiaries. If that happens, however, a two-class system--one for the poor and one for others--will be institutionalized; and to assure minimum standards of care for the poor, more, not less, regulation will be required.

The Challenge of Child Abuse and Neglect

The Challenge of Child Abuse and Neglect Get access Traumatic Abuse and Neglect of Children at Home Edited by Williams Gertrude J. and Money John. Baltimore, Md.: Johns Hopkins University Press, 1980. 616 pp. $30.00. Child Abuse: Prevention and Treatment Through Social Group Work By Wayne Julianne L. and Avery Nancy C.. Boston: Charles River Books, 1980. 90 pp. $12.50 cloth, $5.75 paper. Barry Pomerantz, MSW Barry Pomerantz, MSW Head Social Worker Comprehensive Child Health Program, Children's Hospital Medical Center, Boston, Massachusetts Search for other works by this author on: Oxford Academic PubMed Google Scholar Health & Social Work, Volume 6, Issue 1, February 1981, Pages 87–91, https://doi.org/10.1093/hsw/6.1.87 Published: 01 February 1981

India: Report of United Nations Advisory Mission

Five experts in the field of family plnaning were appointed by the United Nations Secretary General to visit India as an Advisory Mission. They were requested to consider 1) the needs for action in family planning and coordination of the activities of governmental agencies and 2) the problems of coordinating family planning with other related social activities such maternal and child health programs community development and the status of women. This article summarizes the major recommendations of the team of experts in the area of 1) family planning methods 2) services and personnel 3) family planning personnel 4) education of the public 5) research and 6) evaluation. It would be possible to reduce the birth rate in India by about 1/3 in a decade if there were concerted efforts in raising the age at marriage promoting other necessary social changes to reduce fertility and intensifying the sterilization program. The people would have to be convinced of the necessity of practicing family planning as a patriotic act and national duty.