Public Health and Community-Based Health Care Social Work

2019 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Work ◽  
Community Based

The application of the complexity theory to public health interventions: a review of the literature

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Contu ◽  
E Breton
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Complexity Theory ◽  
Health Care Services ◽  
Health Interventions ◽  
Review Of The Literature ◽  
Community Based Interventions ◽  
Community Based ◽  
Care Services

Abstract Background There is a growing recognition of the limitations of a linear cause-and-effect rationality in planning and evaluating public health interventions. Although this perspective is amenable to programme planning and evaluation, it leaves aside a whole array of mechanisms of change triggered by interactions taking place in complex social systems. Generative causality is one and recognized under a number of works referring to the complexity paradigm. Here we review the state of knowledge on what is often referred to as the complexity theory (CT), and present the results of a review of the literature on its application in public health. Methods We searched PubMed for articles, commentaries, editorials published in English, French and Italian, using the keywords 'Complexity Theory' (also plural). We categorized the fields of application of the CT according to the three core WHO's Essential Public Health Operations, i.e., Health Promotion, Prevention and Protection. All papers addressing issues related to health care services (but not prevention) were included in the category “health care services” while others were tagged as “others”. Results We found 203 papers meeting our inclusion criteria. The largest share of the research output applying the CT was in health care services (n = 167), followed by Health Promotion (5), Prevention (3) and Protection (2). 26 papers were labelled others. In health promotion/ prevention, applications of the CT have yet to integrate most of its concepts. Most authors tap into both the linear and generative rationality perspectives. Conclusions Although regularly deemed as promising in uncovering mechanisms for change triggered by public health intervention, applications of the complexity theory remain uncommon and has made little inroads in the public health domain. This is particularly the case for health promotion where one would assume that participatory community-based interventions would be an incentive to integrate this perspective. Key messages Although deemed promising the complexity theory has made little inroads in public health. Health promotion with its participatory community-based interventions can benefit from its application.

Rapid Creation of a Multiagency Alternate Care Site for COVID-19– Positive Individuals Experiencing Homelessness

2021 ◽  
Vol 111 (7) ◽  
pp. 1227-1230
Author(s):  
Chen Y. Wang ◽  
Melissa L. Palma ◽  
Christine Haley ◽  
Jeff Watts ◽  
Keiki Hinami
Keyword(s):  
Public Health ◽  
Health Care ◽  
Care Coordination ◽  
Support Services ◽  
Cook County ◽  
Medical Services ◽  
Health Resource ◽  
Community Based ◽  
Community Based Organizations ◽  
Care Agency

Cook County Health partnered with the Chicago Departments of Public Health and Family & Support Services and several dozen community-based organizations to rapidly establish a temporary medical respite shelter during the spring 2020 COVID-19 peak for individuals experiencing homelessness in Chicago and Cook County, Illinois. This program provided low-barrier isolation housing to medically complex adults until their safe return to congregate settings. We describe strategies used by the health care agency, which is not a Health Resource and Services Administration Health Care for the Homeless grantee, to provide medical services and care coordination.

scholarly journals Only Half the Problem is Being Addressed: Underinsurance is as Big a Problem as Uninsurance

2010 ◽  
Vol 40 (3) ◽  
pp. 507-523 ◽  
Author(s):  
Carol L. Link ◽  
John B. McKinlay
Keyword(s):  
Public Health ◽  
Health Care ◽  
Socioeconomic Status ◽  
Health Policy ◽  
Health Insurance ◽  
Community Based ◽  
Men And Women ◽  
Large N ◽  
Policy Challenge ◽  
Middle Socioeconomic Status

This article examines the sociodemographic and health characteristics of the underinsured—people who have some health insurance but are having trouble paying for health care or medications. It uses data from the Boston Area Community Health (BACH) Survey, a large (N = 5,503) community-based random sample of Boston residents aged 30 to 79 years (1,767 black, 1,877 Hispanic, and 1,859 white; 2,301 men and 3,202 women). The authors found that minorities were less likely than whites to have health insurance (for men and women, respectively, 30% and 19% of Hispanics, 16% and 9% of blacks, and 9% and 7% of whites lacked health insurance). Blacks were the most likely to be underinsured (for men and women, respectively, 18% and 20% of blacks vs. 9% and 14% of Hispanics and 8% and 12% of whites were underinsured). Those of lower and middle socioeconomic status were also more likely to be uninsured or underinsured. The health status of the uninsured was similar to that of the adequately insured, whereas those who were underinsured reported more co-morbidities and depression. The underinsured are generally older and sicker, and make greater use of the health care system, and may present a larger public health and health policy challenge than the uninsured.

scholarly journals Protecting our health care workers while protecting our communities during the COVID-19 pandemic: a comparison of approaches and early outcomes in two Italian regions, 2020

2020 ◽  
Author(s):  
Nancy Binkin ◽  
Federica Michieletto ◽  
Stefania Salmaso ◽  
Francesca Russo
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Workers ◽  
Primary Care Physicians ◽  
Public Health Services ◽  
Patient Centered ◽  
Community Based ◽  
Care Workers ◽  
Italian Regions ◽  
The Impact

AbstractIntroductionItaly, which has been hard-hit by the COVID-19 pandemic, has an overriding national strategy, but its 21 regions have adapted their response based on the organization of their curative and public health services. In this paper, we compare short-term outcomes for two northern Italian regions which had almost simultaneous initial outbreaks: Lombardy, which had a patient-centered approach that relied on primary care physicians and hospital care, and Veneto, which focused on community-based diagnosis and care.MethodsWe used numerator and denominator data from public Italian government sources to calculate reported rates of COVID-19 testing/1000, COVID-19 cases/100,000 overall and for health care workers (HCWs) and non-HCWs, deaths per 100,000, and the percent of cases admitted to hospitals and ICUs for February 24-April 1, 2020.ResultsAs of April 1, 2020, Lombardy experienced 44,733 cases and 7,539 deaths; for Veneto, the corresponding values were 9,625 and 499. The cumulative case rate was 445/100,000 for Lombardy and 196/100,000 for Veneto, a 2.3-fold difference. Mortality rates were 7.5 times higher in Lombardy than in Veneto (75/100,000 and 10/100,000, respectively). Cumulative rates of testing were nearly twice as high in Veneto and were 2.7 times higher in the first week of the epidemic. In Lombardy, 51.5% of patients were admitted, including, 5.2% to intensive care units; for Veneto, the corresponding figures were 25.1% and 4.3%, respectively. HCWs account for 14.3% of all cases in Lombardy compared with 4.4% in Veneto. In Lombardy, the rate among HCWs was 19.1 times higher than in the general population (6,924/100,000 versus 362/100,000), while in Veneto it was 3.9 times higher (676/100,000 versus 172/100,000).DiscussionThe community-based approach in Veneto appears to be associated with substantially reduced rates of cases, hospitalizations, deaths, and infection in HCWs compared with the patient-centered approach in Lombardy. Our findings suggest that the impact of COVID-19 can be reduced through strong and aggressive public health efforts to confirm and isolate initial cases and contacts in a timely way and to minimize unnecessary contact between HCWs and cases through home-based testing and pro-active home follow-up.

scholarly journals ‘Jack of All Trades and Master of None’? Exploring Social Work’s Epistemic Contribution to Team-Based Health Care

2021 ◽  
Author(s):  
Hannah Cootes ◽  
Milena Heinsch ◽  
Caragh Brosnan
Keyword(s):  
Public Health ◽  
Health Care ◽  
Social Work ◽  
Multidisciplinary Teams ◽  
The Social ◽  
Scant Attention ◽  
Health Related ◽  
And Function ◽  
Role And Function ◽  
Work Knowledge

Abstract From its inception, the social work profession evolved in tandem with public health, and has historically contributed to public health efforts to restore, protect and promote public health principles. In recent times, however, the most prominent role for health-related social work is in hospital-based, multidisciplinary teams. Curiously, scant attention has been paid to the place of social workers’ knowledge—their ‘epistemic contribution’—within this medical context. This article reports the findings of a scoping review that examined the role and function of social work knowledge in healthcare teams. Thematic analysis of the literature revealed four key themes: (i) a lack of clarity and visibility—‘Ok, what is my role?’; (ii) knowledge Hierarchies—‘Jack of all trades and master of none’?; (iii) mediator and educator—‘Social work is the glue’ and (iv) public health principles—‘We think big’. Findings show that despite social work’s epistemic confidence, and alliance with broader public health principles and aims, its knowledge can be marginalised and excluded within the multidisciplinary team context. The article introduces Fricker’s theory of ‘Epistemic Injustice’ as a novel framework for inquiry into health care teams, and the mobilisation of social work knowledge within them.

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