Child health and parental paid work

We ask how the paid work of Canadian married mothers and fathers is affected when a child has a physical/mental condition or health problem that leads to restrictions in daily activities. Using the Statistics Canada National Longitudinal Survey of Children and Youth, we find that married mothers of children with disabilities are less likely to engage in paid work and/or work fewer paid hours per week. No statistically significant changes in paid work participation or hours are apparent for fathers of the same children. We find, moreover, evidence that the degree of specialization within families increases when there is a child with a disability. These responses are consistent with traditional gender roles within families, and may make sense as a ‘household’ coping strategy. However, such a division of labor may generate economic vulnerability for mothers compared to fathers.     

How local health departments work towards health equity

BackgroundHealth inequities are exacerbated when health promotion programs and resources do not reach selected populations. Local health departments (LHDs)¹ have the potential to address health equity via engaging priority populations in their work. However, we do not have an understanding of what local agencies are doing on this front.MethodsIn the summer of 2016, we collaborated with informants from thirteen LHDs across North Carolina. Via semi-structured interviews, the research team asked informants about their LHD’s understanding of health equity and engaging priority populations in program planning, implementation, and evaluation.FindingsAll informants discussed that a key function of their LHD was to improve the health of all residents. LHDs with a more comprehensive understanding of health equity engaged members of priority populations in their organizations’ efforts to a greater extent than LHDs with a more limited understanding. Additionally, while all LHDs identified similar barriers to engaging priority populations, LHDs that identified facilitators more comprehensively engaged members of the priority population in program planning, implementation, and evaluation.ConclusionsLHDs are ideally situated between the research and practice worlds to address health equity locally. To promote this work, we should ensure LHDs hold an understanding of health equity, have the means to realize facilitators of health equity work, and recognize the complex context in which health equity work exists.     

The work–family challenge and mental health

The work–family literature is dominated by studies of white middle-class workers. In this study, we sought to expand this focus by examining work–family issues from the perspective of Mexicans who have immigrated to the USA within the past five years. Using data from qualitative in-depth interviews (N?=?22) and quantitative structured interviews (N?=?150), we documented the work–family experiences associated with immigration, and we examined the extent to which these experiences differed by gender as well as their mental health effects. The in-depth interviews clearly indicated that separation from family and community was a common and poignant strain experienced by Mexican immigrants who came to the USA to find work, and that these experiences did not differ between women and men. Quantitative analyses corroborated the qualitative findings by indicating women and men had similar levels of work–family strain. Analyses also indicated that higher levels of work–family strain were associated with more perceived stress, anxiety and depression, and that these associations did not differ between women and men. Finally, modest evidence suggested that the effects of work–family strain on mental health may be lower when the realities experienced by immigrants in finding employment and sending money home matched their expectations. This study adds a new voice to the work–family literature and the context and results make clear the tension between work and family: families frequently benefit from adults’ paid work, but this paid work is not without costs.     

Women's work, cohort change, and health

Rapid changes in women's labor force participation, access to good jobs, and changing work-family pressures have altered the landscape of work and family life. We use logit negative binomial hurdle models to examine whether these countervailing trends have affected the physical health of women across four birth cohorts. Longitudinal data are used to compare successive cohorts of U.S. women when they are between the ages 44 and 50. While the health of women overall did not change across cohorts, we find an increase in health problems among employed women, explained by increases in the ability of women with physical limitations to become and remain employed. Health problems among housewives decline across cohorts, resulting in better health among housewives than among employed women in the most recent cohort. These findings provide further evidence of the importance of selection processes in understanding health effects of roles, and they highlight the need for greater attention to the health effects of unpaid work.     

Applying health determinants and dimensions in social work practice

Dimensions and determinants related to physical health, mental health and well-being can be used as tools in social work practice. These frameworks are useful for assessment, planning and intervention activities in complex client situations, alerting social workers to consider diverse features and processes that influence well-being in people's lives. They can be applied in social work with individuals, families, groups, and communities. In our view health and well-being need to be viewed holistically, broadly and in each unique situation, changing over time over the life course. Literature based on key word searches of concepts we use in our teaching and research and that has informed our conceptualisation of dimensions and determinants in physical health, mental health and well-being, is reviewed. A case illustration is presented to illustrate how the dimensions and determinants are used to inform practice and compare and apply alternative frameworks. Finally, the implications of these and other frameworks for social work, not only in health care settings, but also in other fields of social work practice, are discussed.     

A model of social work classification in health care

Abstract

The introduction of casemix funding for Australian acute health care services has challenged Social Work to demonstrate clear reporting mechanisms, demonstrate effective practice and to justify interventions provided. The term ‘casemix’ is used to describe the mix and type of patients treated by a hospital or other health care services. There is wide acknowledgement that the procedure-based system of Diagnosis Related Groupings (DRGs) is grounded in a medical/illness perspective and is unsatisfactory in describing and predicting the activity of Social Work and other allied health professions in health care service delivery. The National Allied Health Casemix Committee was established in 1991 as the peak body to represent allied health professions in matters related to casemix classification. This Committee has pioneered a nationally consistent, patient-centred information system for allied health. This paper describes the classification systems and codes developed for Social Work, which includes a minimum data set, a classification hierarchy, the set of activity (input) codes and ‘indicator for intervention’ codes. The advantages and limitations of the system are also discussed.     

Creative solutions: Innovative use of the arts in mental health settings

A recent study of occupational stress on the unit (Clare, 2004) highlighted that staff valued the importance of the socialization process in reducing their stress levels. This process incorporates the need for peer support and acceptance, and an understanding of what is expected of them (e.g., roles and responsibilities), supported by a culture of learning, problem solving, and working together. This process is similar to the approach taken by the arts project in nurturing ideas and initiatives in a safe, respectful way. It is apparent that the arts project has been more than just a creative activity; it has had wider implications for both staff and service users in reducing stress. It has: * Enabled staff retention. In fact, there is a waiting list of nurses wishing to work on the unit. * Reduced incidents of damage to property. * Reduced use of p.r.n. medication. * Enhanced the good reputation of the service, which is often commented on by visitors to the unit. The arts project promotes well-being and lifelong learning for the ward community through meaningful engagement in creative activity.     

Payment mechanisms for social work in health care: Today and tomorrow

Accepting the establishment of a national health policy as iminent, this paper surveys the way social work services are organized and financed within the health care system. It also outlines what measures can be taken to ensure the inclusion and importance of the profession within this system, and what developments can be expected in the next ten years.     

Group work in the mental health field: researching outcome

This paper reviews outcome studies from groups facilitated for persons living with serious mental illness. Although the research base is limited (groups posing considerable methodological challenges), available studies show that, in general, group work is as effective as individual work, if not more so. This paper describes findings from studies of short-term, long-term and self-help groups dealing with mood disorders, schizophrenia, eating disorders and borderline personality disorders over the last 10 years. The concept of ‘time-effective’ group work is discussed as are the potentially harmful effects of group participation. The paper concludes by arguing that group work is an effective and less expensive treatment option that would benefit from further research to establish an evidence base, both for current practice and for the expansion of group work practice in the future.     

National registry of health care providers in clinical social work

News of the societies

National registry of health care providers in clinical social work     

Part-time work and hurried adolescence: the links among work intensity, social activities, health behaviors, and substance use

The present study examines adolescents' part-time work intensity and its relation to participation in various activities as well as substance use. We consider mechanisms articulated in two theoretical perspectives on how high work intensity is associated with substance use: (1) the "time trade-off perspective," and (2) "the precocious development perspective." Nationally representative data were drawn from the "Monitoring the Future" project from 8th, 10th and 12th grade students (overall N approximately 380,000) to address our research questions. Work intensity was found to be linked to more time spent on unstructured social activities, but to less time spent engaged in sports, health behaviors, and school-related activities. Social time use and health behaviors were found to partially mediate the relationship between work hours and substance use. Overall, results provide evidence for a combination of both perspectives.     

Responding to student mental health concerns in social work education: reflective questions for social work educators

In this paper, we explore ways in which social work educators might respond to students who report that mental health issues underlie their difficulty in meeting core competencies, or otherwise use the language of mental health to describe their struggles to succeed in social work programs. We discuss various trends in policy responses in Canada, the US, the UK, and Ireland. While there are general policy trends, it is clear that responding to these kinds of issues requires the development of highly flexible and situated policy processes that can respond to student realities, concern for students’ rights and privacy, and an awareness of potential discrimination against students. These processes also need to meet the specificities of practicums, particular institutional policies, the mandates of relevant professional bodies, and the precise local legislative framework that shapes these situations. Given these varying contexts, in this conceptual paper, we used a framework on disability that is informed by critical theory to engage existing school policies and propose a set of reflective questions that can guide schools of social work to create an overall responsive environment. These reflective questions are designed to help social work educators balance the rights and needs of students with the professional and institutional demands that students meet core competencies in their education.     

Navigating stormy waters: Challenges and opportunities for social work in mental health

The reforms driven by the National Mental Health Strategy have created both opportunities and challenges for social work as a profession. This paper examines the rapidly changing context for practice in mental health, including policy change, and developments in the education and training of the mental health workforce. Key practice issues identified for social work include: (i) the need to establish a viable paradigm for practice; (ii) a more positive response to the challenge of evidence-based practice models; (iii) a national agenda for education and training; and (iv) the importance of working collaboratively with consumers and families in a way that values their human rights and the lived experience of mental illness.     

Individual consequences of volunteer and paid work in old age: health and mortality

The impacts of the productive social activities of volunteer and paid work on health have rarely been investigated among the oldest Americans despite a recent claim for their beneficial effect (Rowe and Kahn 1998). This paper used data from Waves 3 and 4 of the Asset and Health Dynamics among the Oldest Old (AHEAD) Study to (1) investigate the impact of these activities on health measured as self-reported health and activities of daily living (ADL) functioning limitations and to (2) explore possible causal mechanisms. Using multinomial logistic regression analysis, amounts of volunteer and paid work over a minimum of 100 annual hours self-reported at Wave 3 were related to poor health and death as competing risks measured at Wave 4, controlling for health measured at Wave 2 and for other predictors of poor health and death. Findings suggest that performing more than 100 annual hours of volunteer work and of paid work have independent and significant protective effects against subsequent poor health and death. Additional analyses suggest that the quantity of volunteer and paid work beyond 100 annual hours is not related to health outcomes and that physical exercise and mental health measured as cognitive functioning and depressive symptoms explain not entirely overlapping parts of the relationship between productive activities and health.     

Associations of eldercare and competing demands with health and work outcomes among manufacturing workers

Employees juggling eldercare and work report work–family conflicts and poor health-related outcomes, but little is known about eldercare demands (ECDs) in the context of competing demands in the manufacturing workforce. This study determines how ECDs vary by age, gender, income, and job category, and how ECDs and competing demands are associated with health-related and work-related outcomes, among manufacturing workers. Employees from six manufacturing companies completed questionnaires. ECDs were defined as providing assistance to an adult aged 65 and older due to disability or chronic illness; those with ECDs were asked how many care-hours per week and whether assistance included personal care. Workers over age 45 were more likely than younger workers to report ECDs. After adjusting for competing demands and socio-demographic characteristics, ECDs were associated with greater depressive symptoms and family-to-work conflict (FWC), providing 5 or more hours of eldercare weekly was associated with greater depressive symptoms, and providing personal care was associated with greater FWC.