Promoting Health Social Work Education In the Era of Federal Health Care Reform

Background: The 2010 Patient Protection and Affordable Care Act (P.L. 111-148) brings a growing demand for social workers trained in health. This landmark legislation will require a cadre of workers able to navigate an increasingly complex insurance marketplace and an on-going shift toward ambulatory/community-based delivery models. Despite this clear call to arms, the education of social workers equipped to practice in the health continues to lag behind. While great strides have been made in bringing geriatric social work to the forefront, the promotion of training of clinicians in non-aging health care tracks remains stagnant.

Methods: A systematic review of all accredited MSW programs was undertaken to understand concentration year curriculum and course offerings. Accredited MSW programs (n=200) were identified using the CSWE Directory of Accredited Programs. Data was extracted from school websites on: health concentration/ specialization options, health-related course offerings, and the presence of a joint Public Health (MPH) option. Concentration information was found on School's MSW specific sites; a course-listing search via the University's registrar was completed (AY 2009 & 2010). Search terms for courses relevant to health included: (1) health, (2) hospital, (3) human sexuality, (4) HIV, (5) medical, and (6) disability, (7) aging. Accredited programs were linked to the 2010 Carnegie Classifications Data File for university-level characteristics. Bivariate statistics and logistic regression models were used for analysis.

Results: Forty-nine (49) programs (24.5%) listed health as a concentration or specialization (HCS). Of these, 34 had a dedicated health concentration (HC; 17%). Of the 34 programs with a HC, 13 (38.2%) specifically focused on health; the remainder combined health with another area. Therefore, of the 200 accredited programs, only 13 (6.5%) offer an undiluted HC. Of the 49 programs with a HC, 29 (59%) were housed on a campus with an academic medical center (AMC). There is a large relationship, r= .85, (p<0.01) between schools with a HCS and presence of an AMC. Forty-one MSW HCS programs were housed on a campus with an MPH program (83%); 19 (39%) offered a joint MPH. There is a moderate relationship, r= .48, (p<0.01) between schools with a HCS and an MPH. Finally, there is a moderate relationship r=.41 (p<0.01) between schools with a HCS and university size. Controlling for university-level characteristics, university size (β=1.69, p < .001) and presence of an MPH program (β=2.0, p<.0001) were associated with having a MSW HCS.

Conclusion: This review of social work education revealed a substantial gap between the demand for health care social workers and specific programs of study in health in accredited MSW programs. Less than 10% of programs offer a health specific concentration not blurred by a dual focus. Schools of Social Work at a university with an MPH are twice as likely to offer a HCS; yet, only slightly more than 1/3 of HCS MSW programs take advantage of this critical workforce development opportunity. It is imperative that social work education works to develop health specific educational tracks to meet the insurance and ambulatory care provision challenges of our nation's health.