Social Care, Social Needs, and Social Work: Opportunities and Challenges for Social Work Science and Practice in Medical Settings

In 2019, the National Academies of Science Engineering and Medicine (NASEM) released a consensus study titled "Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health." This report called for addressing patients' social needs (e.g., food, housing) in order to improve health outcomes. Such activities are well-aligned with the Social Work Grand Challenge of closing the health gap by developing a "socially-oriented model of healthcare that breaks down and removes the root causes of health inequity."

Because social work has a long history of developing and implementing programs to address health-related social care needs, social workers would seem well-positioned to lead these efforts. Often, however, social workers are not fully recognized as the primary workforce addressing social needs in health and community sectors. In this roundtable, we will discuss opportunities and challenges for advancing social workers in research and practice related to social care across various health settings. These challenges include community capacity to meet patients' needs, workforce development, technology infrastructure, regulatory issues, and research considerations. We will also examine the downsides to addressing social needs in clinical settings, which--if not grappled with--have the potential to make health disparities worse instead of better.

Our roundtable will include an engaging discussion between panelists with a range of research and practice backgrounds, with each panelist posing questions to invite audience participation. The first speaker will discuss serving as one of the few social work members of the NASEM social care panel. She will highlight the need to provide evidence to advance social work practice and research and discuss how the social work field can capitalize on its role in communities to demonstrate positive outcomes and elevate the value of social work. The second speaker will discuss how different kinds of social needs may change over time. She will describe the current state of the science to assess and address unmet social needs in cancer patients and survivors, as well as the implications of involving caregivers in social care screening and referral. The third speaker will articulate how current data sources to enumerate the social work workforce are limited, making it difficult to assess adequacy and availability of social workers addressing social care needs across health settings. The fourth speaker will discuss how we can use principles from implementation science to improve access to effective hospital- and community-based social needs interventions to advance health equity. The fifth speaker will focus on the benefits and challenges of using electronic health records to document social care, as well as the importance of both screening for social care needs and ensuring there are appropriate referral/service supports to follow-up on identified needs. She will address potential regulatory changes that could improve social care, including those that impact payment (i.e., what services are billable in which settings), licensure, and scope of practice regulation. The overarching goal of this roundtable is to recenter social work science and practice in health care settings in order to improve outcomes for patients and families.