From ‘public health’ to ‘safeguarding children’: British health visiting in policy,practice and research

This study examines the location of British health visiting in contemporary policy discourses concerned with public health and safeguarding children. It argues that professional identity and orientation can be understood through health visiting’s long history of public health work with children and families, which has included an engagement with protecting children. The expansive safeguarding children agenda, which includes the requirement to undertake a progressive universal approach to service provision and which incorporates a broad concept of risk and requires early intervention, has created tensions, particularly given current workforce constraints. The location and visibility of British health visiting in the academic and practice worlds also shape how the profession is understood.     

Vision and state health department public relations practitioners: Prepared to lead?

Visions are important to organizational effectiveness. Although providing vision has been identified as one of the behaviors that best captures organization-wide public relations leadership, little public relations research has focused on vision. Similarly, state health departments have drawn little interest among public relations scholars even though states are a central part of the nation's public health system. This study addressed the perceptions of the top public relations professionals at state health departments concerning vision and their involvement in the visioning process. The practitioners were nearly unanimous in their belief that organizational visions are important. However, results indicate that some top public relations practitioners at state health departments are not prepared to make optimal contributions to the visioning process. In order to take full advantage of opportunities to serve as organization-wide leaders, public relations practitioners should seek out information about visioning in order help chart their organization's future and enhance their careers.     

Inoculation theory and public relations

Inoculation theory explains how an existing state (an attitude, a belief, a position) can be made more resistant to future influence, in much the same way a medical inoculation can make an existing state (a healthy body) more resistant to future viral influence: through pre-exposure to weakened forms of challenges. The theory has established efficacy as an effective messaging strategy in a number of contexts, including politics and health. Another area that has received attention in inoculation theory scholarship is public relations. A comprehensive review of this work, however, is long overdue. We outline existing work in inoculation theory and public relations, and then show how inoculation theory and public relations research can bring new applications and theoretical development to the public relations areas of (1) issues management; (2) crisis and risk communication; and (3) character assassination.     

Cultural Citizenship

This paper seeks to give a sense of the diversity of work that falls within the boundaries of 'cultural citizenship'– a term it locates as emerging from the problematisation of traditional citizenship models by issues of identity and mediation. This paper outlines three distinct strands of cultural citizenship theory, which respectively emphasise multiculturalism, the politics of cultural texts, and dialogical communication. Subsequently, this paper conducts a brief analysis and critique of these strands, enabled by an interrogation of the ways in which they each define and deploy the term 'culture'. It is argued that for cultural citizenship to develop a more coherent terminological 'face', a balance must be struck between a commitment to specificity, and the appeal of abstracted re-imaginings of civil society.     

A paradigm shift: from disease to health orientation

The history of science has been described as ‘paradigm shifts’ of sequential overthrow, each new paradigm replacing the previous one. A paradigm is an overarching view-point which guides the articulation of theories and other activities in a particular field. In the exploration of health, two different types of approach can be identified. The pathogenic view, which has dominated the orientation of medicine over the last hundred years, focuses on disease states and underlying factors that modify the chances of entering into one of those states. The competing salutogenic view appears to be undergoing a renaissance in the new strategies of public health and health promotion, and producing theories of health based on more holistic approaches and diverse methods. The two paradigms exist side by side, and both are in a constant state of flux. The advocates of the health-oriented paradigm say it is difficult to reach a true, in-depth understanding of human health on the basis of a disease-oriented approach or from the traditional vantage-point of risk-factor epidemiology, whereas opponents point out that health does not lend itself to exact measurements or experimentation in keeping with the Galilean natural science ideal. The importance and utility of health orientation need to be explored and ascertained in further research. The approach seems, however, to have a number of crucial assets that might help avoid the limitations of the established disease and risk-factor epidemiology approaches and promote new directions of pursuit, including a better understanding of the complex relationships between aging and health, and other current challenges in creating healthy public policy.

This paper was presented at the Second International Workshop on the Aging Male, Weimar, Germany, November 1999     

Adding value to organizations: An examination of the role of senior public relations practitioners in Singapore

A key characteristic of public relations excellence in organizations is ensuring that the senior public relations practitioner – the head of the communication function – has the competencies to enact the strategic role of a manager. It is only when the top communicator possesses strategic management knowledge and engages in managerial work with support from colleagues who are technically skilled in traditional craft work can public relations work be considered to be value-generating.This paper presents the findings of the examination of the role of senior public relations practitioners in organizations in Singapore. It also explores the importance of core communication activities to the role of top in-house communicators, examines the time they allocate to managerial and technical work, and assesses if the managerial role which the practitioners play adds value to organizations. Data collected from both in-depth interviews and self-reported log of daily activities showed that although top communicators in Singapore enjoy strategic reporting and unhindered access to senior management, it also revealed, paradoxically, senior management's mixed worldviews of public relations; and that Singapore's top in-house practitioners lack the strategic knowledge to enact the managerial role as they are too focused on technical work.The paper concludes with recommendations on how the level of public relations professionalism can be raised in Singapore, starting with the practitioners themselves having to be fully equipped with the relevant academic knowledge of what makes communication excellent.     

Teaching Note—Educating Public Health Social Work Professionals: Results From an MSW/MPH Program Outcomes Study

Dual-degree programs in public health and social work continue to proliferate, yet there has been little research on master’s of social work (MSW)/master’s of public health (MPH) graduates. The purpose of this study was to describe and better understand the self-reported professional experiences, identities, roles, and outcomes associated with 1 group of graduates from an established MSW/MPH program. A 57-question electronic survey was administered to 214 alumni in 2010; the response rate was 71.4% (n = 153). Findings provide a snapshot of public health social work alumni experiences, including diverse employment opportunities, high career satisfaction, and a strong sense of reported public health and social work integration in the workplace.     

The challenge of interdisciplinary collaboration in addressing the social determinants

The importance of professional disciplines working together to address the critical social and health issues facing society today cannot be overstated. Policy makers, service providers and researchers have long been calling for greater interdisciplinary collaboration. Despite this there has been little systemic analysis of the constraints involved in such collaboration. Far too often disciplines continue to work in silos. This paper aims to analyse the barriers to interdisciplinary collaboration through a case study of the relationship between social work and public health. These two disciplines have a lot more in common than might first appear. There is real potential for social work and public health to work together and enhance each other's efforts to address their common goal of greater social equality. However, this will require a genuine commitment from both disciplines to develop a shared political analysis, common language and a framework for action, which utilises their respective strengths.     

Infant Mortality and Racially and Culturally Sensitive Care:

This paper addresses a public health issue-infant mortality-of which society has been aware since at least 1900. However, this issue does not receive the public and professional attention given to many other public health issues. The aim of this paper is to review the problem and present a synopsis of initiatives that have been taken to reconsider and revive, from a social work perspective, the person-environment concern, focus, and commitment to reduce infant mortality, especially among Blacks and other racial-ethnic minorities. The proposal calls for the help of inter-related and reinvigorated micro, mezzo, and macro levels of social work intervention in conjunction with the intervention of other professions, government officials, community leaders, and consumers of services.     

Uncounted care

Family care (care for dependent persons at home by family members and friends) is widely endorsed, politically and personally, as the chronic care option that is superior to institutionally-based, formal care services. Politicians, health planners, and analysts may be especially supportive of a preferred form of care which is also believed to be economical. But the full costs of family care, including the value of the unpaid work of caregivers, are rarely acknowledged. This article reviews studies of caregiving and its costs and acknowledges the gender bias inherent in caregiving which has been regarded as free before its costs were calculated. Policy and health care practice will benefit from examination of both the costs and benefits of family care.Debbie Ward is Assistant Professor in the Community Health Care Systems Department of the School of Nursing (mail stop SM-24) at the University of Washington, Seattle, WA 98195. She trained as a family nurse practitioner at Yale University in New Haven, Connecticut, and earned her Ph.D. in health policy from Boston University. Her research interests include women's paid and unpaid labor, and public health policy.     

Mental Health Workforce Change Through Social Work Education: A California Case Study

The 2004 CaliforniaMental Health Services Act requires large-scale system change in the public mental health system through a shift to recovery-oriented services for diverse populations. This article describes an innovative strategy for workforce recruitment and retention to create and sustain these systemic changes. The California Social Work Education Center Mental Health Program provides stipends to master's of social work students at 17 California universities. In return, students must work for 1 year postgraduation in community mental health practice. Results of a 5-year study show that stipend recipients closely mirror the diverse demographics of the state, and 94% have remained in community mental health practice. The article also discusses lessons learned and implications for social work education in California and other states.     

Passing a Mental Health Levy

ABSTRACT

The “devolution revolution” has decreased federal and state roles in the funding of social services and increased the burden on local sources, both public and private. This article describes how a community passed an initially unpopular property tax levy earmarked to support local drug, alcohol and mental health services. The article illustrates how social workers employing specific community practice knowledge provided leadership to the successful campaign. This example of community practice leadership includes building and maintaining coalitions, managing group tension and conflict and demonstrating fundamental social work values.     

A Leadership Role for Social Work in the Mental Health Transition to Local Care

Current philosophy, policy, and practice involving care of persons with serious mental illnesses are reviewed, with a focus on the movement that is usually called deinstitutionalization. Past efforts and future trends are discussed within the context of public mental health systems at the state level. The paper argues for a greater leadership role for social work in providing mental health care in local communities because of the social work tradition of client empowerment, family involvement, and systems intervention.     

A Case Study Using Photovoice to Explore Racial and Social Identity Among Young Black Men: Implications for Social Work Research and Practice

This article describes an exploratory qualitative case study using a research method novel to social work known as Photovoice. This case study of the Photovoice process assesses its value as a community-based participatory research (CBPR) method with marginalized communities within social work research. Photovoice was used to engage young Black men as researchers into their own lived experience. Through a photographic and group participatory project, participants discussed how intersections of race, gender, and sexuality affect their lives and health. While this methodology has proliferated within public health literature, little research exists within social work. Photovoice represents a research well-aligned with core social work values of empowerment and social justice. This method offers our profession a participatory, action-oriented tool to inform practice and policy and does so in the voices of communities who often go unheard.     

Contributions of ergonomics to the construction of bus drivers health and excellence in public transport and at work

This article is the product of research that analyzed the work of bus drivers of a public transportation company that is considered a benchmark reference in its field of operations, in which it strives to achieve operating excellence. Within this context, the authors sought to understand how such a company has managed to maintain a policy that is capable of reconciling quality public transport while also providing working conditions compatible with the professional development, comfort and health of its workers. Ergonomic work analysis and activity analysis were the guiding elements used in this study. Initial analyses indicate that the activity of drivers includes serving a population and providing mobility for it, which depends on driving the vehicle itself and on relationships with colleagues, users, pedestrians, drivers and others.     

Sources of health insurance and characteristics of the uninsured: analysis of the March 1997 Current Population Survey

This Issue Brief provides summary data on the insured and uninsured populations in the nation and in each state. It discusses the characteristics most closely related to individuals' health insurance status. Based on EBRI analysis of the March 1997 Current Population Survey, it represents 1996 data--the most recent data available. In 1996, 82.3 percent of nonelderly (under age 65) Americans had private or public health insurance. Seventy-one percent had private insurance, 64 percent through an employment-based plan. Sixteen percent had public health insurance. The percentage of uninsured Americans has been increasing since at least 1987. In 1987, 14.8 percent of the nonelderly population was uninsured, compared with 17.7 percent in 1996. However, the erosion of employment-based health benefits cannot fully explain this increase since 1993. Instead, the decline in public sources of health insurance would partly explain it. It may be that, while the percentage of individuals with employment-based coverage is rising, individuals previously covered by Medicaid and CHAMPUS/CHAMPVA are not being fully absorbed into the employment-based health insurance market. Between 1995 and 1996, the percentage of nonelderly Americans without health insurance coverage increased from 17.4 percent to 17.7 percent. Further examination indicates that children completely accounted for this increase. In 1995, 13.8 percent of children and 19 percent of persons ages 18-64 were uninsured, compared with 14.8 percent of children and 18.9 percent of persons ages 18-64 in 1996. With the recent passage of legislation designed to reduce the number of uninsured children, the next focal point for health care reform could be early retirees and unemployed persons. President Clinton and some members of Congress have expressed an interest in improving access to and affordability of coverage for these groups. Currently, health care cost inflation is at its lowest point in years, but there are signals indicating that it is about to rise above current levels. The federal government's recent announcement that health insurance premiums will rise for federal employees an average of 8.5 percent in 1998 may portend higher future health care costs. Similarly, disappointing earnings announcements from several large insurers because of higher medical costs and lower-than-expected revenues may indicate that health insurance plans will increase premiums. Employment and income play a dominant role in determining an individual's likelihood of having health insurance. Age, gender, firm size, work hours, and industry are also important determinants; however, these variables are also closely linked to employment status and income. Some of the widest variations involve factors that are not always looked at in traditional demographic assessments, such as citizenship. However, variations by race, ethnicity, and citizenship are also closely linked to employment status and income.     

Understanding men's health and illness: a gender-relations approach to policy, research, and practice

Men's health has emerged as an important public concern that may require new kinds of healthcare interventions and increased resources. Considerable uncertainty and confusion surround prevailing understandings of men's health, particularly those generated by media debate and public policy, and health research has often operated on oversimplified assumptions about men and masculinity. A more useful way of understanding men's health is to adopt a gender-relations approach. This means examining health concerns in the context of men's and women's interactions with each other, and their positions in the larger, multidimensional structure of gender relations. Such an approach raises the issue of differences among men, which is a key issue in recent research on masculinity and an important health issue. The gender-relations approach offers new ways of addressing practical issues of healthcare for men in college environments.     

LCSW Examination Pass Rates: Implications for Social Work Education

State licensure pass rates are a commonly used indicator of professional academic program quality. To date, social work education has largely ignored the existence of the crucial LCSW examination and of its importance to MSW graduates seeking careers in clinical practice. This information should become more transparent and carefully considered by MSW faculty and administrators when evaluating the effectiveness of one’s program in preparing its graduates for careers in clinical practice. Three years worth of LCSW examination pass rate data are provided for MSW programs within the state of Florida, illustrating the value of this heretofore hidden information. The implications of providing this data to the public are discussed.