Health Inequalities at the Heart of the Social Work Curriculum

Efforts to reduce the widening gap between the health and social well-being of people within and between countries have become an urgent priority for politicians and policymakers. The Rio Declaration called on governments worldwide to promote and strengthen universal access to social services and to work in partnership to promote health equity and foster more inclusive societies. This paper contributes to international debates about the role of social work in promoting social justice by reducing social and health inequalities. Despite clear commitments to promote good health, there is a notable absence of a social determinants of health perspective in international social work curricula standards. The current review of social work education in England presents a timely opportunity to integrate such a perspective in teaching and learning and to disseminate this more widely. Employing the concepts of downstream and upstream interventions, the first part of the paper examines the distinctiveness of the social work contribution to this global agenda. In the second part of the paper, we consider how the content of learning activities about health inequalities can be incorporated in international social work curricula, namely, human rights, using Gypsy and Traveller families as an exemplar, inter-professional education and international perspectives.     

Relationship Education for Stepcouples Reporting Relationship Instability—Evaluation of the Smart Steps: Embrace the Journey Curriculum

Smart Steps: Embrace the Journey is a research‐based educational curriculum for stepfamily couples (“stepcouples”). The curriculum is designed to build couple strengths while addressing the unique challenges of repartnering with a child or children from a previous relationship. This study evaluated the effectiveness of this curriculum with 151 individuals in relationally less stable stepcouple relationships who either engaged in the Smart Steps curriculum (n = 97) or were part of the comparison group (n = 54). This study represents methodological and conceptual advances in the study of stepfamily programs with the use of a comparison group, a racially and economically diverse sample, and a relationally at‐risk population. Results indicated that those who participated in Smart Steps reported significant increases in individual empowerment, couple quality, family harmony, and parenting efficacy while these measures were unchanged for those who did not receive the program. Implications for future research and for practitioners are provided.     

Changing structures: Necessary but not sufficient

Moves are afoot across the UK to change the mechanisms for managing local inter‐agency child protection policy and practice. This is being achieved through the development of Safeguarding Boards in England and Wales and guidance on Child Protection Committees that took effect from August 2005 in Scotland. Following our review of one Scottish Child Protection Committee (the SCPC), we are concerned that these changes focus almost exclusively on structure and pay scant attention to process and relationships. The study we undertook was an in‐depth evaluation of the functioning of the SCPC and used a range of qualitative methods. The main findings were that the size of the committee, its coverage of three local authority areas, and its patterns of working meant that some aspects of its work were highly developed and effective, such as the guidelines and multi‐agency training, while others, such as links with practice and the management of information systems, were poor. Considering these findings in the light of systems theory suggests that improving the effectiveness of child protection committees, and similar bodies, may need to be based on greater attention being paid to issues of authority, trust and negotiation among their members. Copyright © 2007 John Wiley & Sons, Ltd.     

Integrating Health and Social Care at the Micro Level: Health Care Professionals as Care Managers for Older People

A common problem in the provision of coordinated long‐term care is the separation of health and social care. The present government has been increasingly concerned with promoting convenient, user‐centred services and improving integration of health and social care. One arrangement that could contribute to this for some older service users is for health care staff to act as care managers, coordinating the provision of both health and social care. This paper presents the findings of a survey of arrangements in place in local authorities for health staff to work as care managers for older people. This was designed to provide details about the range and scope of care management activities undertaken by health care professionals. Key areas of enquiry included: which kinds of health care staff undertook care management and in what settings; how long the arrangements had been in place and how widely available they were; whether there was a distinction between the types of cases and care management processes undertaken by health care staff compared with their social service department counterparts; and what management and training arrangements were in place for the health care staff.     

Adoption by foster carers: a profile of interest and outcomes

This paper looks at the issue of adoption by foster carers and in particular its financial aspects. The findings stem from a wider study of remuneration and performance in foster care. Drawing on a survey of 1181 foster carers, this paper examines the characteristics of those who have considered adoption. The outcomes of such consideration, including the part played by financial concerns and anticipated loss of support in decisions to proceed with adoption or not, are also examined. The findings reveal a significant level of interest in adoption on the part of foster carers, to which three particular sets of characteristics are found to be associated. First, interest is greater among those more extensively involved in foster care in terms of experience, specialisms and range of placements offered. Second, it is associated with relatively less concern with payment and less ‘professional’ views of foster care. Third, there is evidence that adoption is more commonly pursued by those who feel less valued by social workers. Fears of losing financial help and support were cited as reasons by more than half of all foster carers who had considered but not pursued adoption.     

Sexual Orientation Moderates the Effect of Gender on Body Satisfaction: Results From a National Probability Sample

Body image concerns typically affect women more so than men, but there is reason to believe that this pattern may depend on sexual orientation. The present study examined differences in levels of body satisfaction among men and women who identified as heterosexual, plurisexual (bisexual and pansexual), gay, and lesbian, using data from a large-scale national probability sample from New Zealand (N = 17,005). As expected, heterosexual men reported higher body satisfaction than heterosexual women. Gay and plurisexual men reported lower body satisfaction than heterosexual men. Gay men also reported lower body satisfaction than lesbian women, and did not differ significantly from heterosexual and plurisexual women. Ratings of heterosexual, plurisexual, and lesbian women’s body satisfaction did not differ significantly. Results held when adjusting for a range of demographic covariates (including age and BMI), and highlight the importance of examining the psychological and health outcomes associated with poor body image among gay men. These findings emphasize the relevance of sexual orientation in understanding men’s body image-related issues.     

Social Exclusion and Social Work: Questions for the Future

This paper describes the experiences of students and service users and carers participating in the Staffordshire University Skills Lab Programme. Two focus groups were held: one with first year social work students and one with service users and carers to explore their views. Qualitative analysis identified key themes that were part of the students' and the service users and carers' experience of the skills lab. The skills lab was very positively rated overall. Several recommendations for improvement will be addressed for future years.