The Value-Added of a Social Work Policy Perspective for Population Health

Cross-national comparisons with other OECD countries indicate that the U.S. fares far worse on multiple indicators of health. In fact, the U.S. ranks 27^thout of 34 OECD countries in overall life expectancy and has less years without disability than our peer countries. Coupled with substantial health disparities within the U.S., the “U.S. disadvantage” has become one of the most perplexing issues in population health. These important and substantial disparities cannot be explained away by differences in health spending; per capita, the U.S. spends nearly 50% again as much on health as its closest comparable peer country. Nor can they be explained by differences in lifestyle, as research suggests that many disparities persist even after controlling for differences in smoking, physical activity, and other health behaviors.

Policies, because of their wide-reach and potential to affect population health, can be viewed as fundamental causes of disparities in population health or as possible solutions to these problems (Link & Phelan 1995). Though social workers receive training in social welfare policy, are sometimes involved in the framing, drafting, and implementation of policy, and are frequently on hand to witness the health effects of ill-considered or inadequate policies, they are typically not considered in many of the large-scale policymaking decisions related to healthcare and health. Accordingly, growing out of the work of the newly founded Center for Innovation in Social Work and Health (CISWH) at Boston University, this roundtable will articulate a social work policy perspective for population health and describe its value-added to ongoing and future policy discussions among public health and medical professionals.

The roundtable will involve multiple presenters who will participate throughout the session. The session will begin with an overview of differences between the U.S. and other comparable countries to motivate a focus on policies as relevant to population health. Next, using the person-in-environment perspective as an overarching framework and with reference to key social work values (focus on social justice and equity, attention to strengths, etc.), the roundtable will detail a number of themes that distinguish a social work approach to a more holistic view of health policy. These themes will include: 1. Attention to health and equity in all policies and not exclusively those focused on health care and health service delivery; 2. The importance of relationships to health and health care delivery, which is different than the emphasis on individualized medicine and treatment that has predominated in health policy and health care; and, 3. The presence of social workers across multiple levels of practice and policy, and thus their potential as agents of change to improve population health.

In addition, the final goal of the roundtable will be to identify potential barriers to implementing a social work policy perspective on population health and offer concrete recommendations to overcoming these obstacles. The session will conclude with a moderated discussion between the panel and members of the audience.