NYU Silver School of Social Work Examines the Role of Social Workers in Improving Global Health and Well-Being
Bringing together many experts on issues of pressing global importance, the NYU Silver School of Social Work convened a three-day conference on “Global Health and Well-Being: The Social Work Response,” on June 17-19.
The conference illuminated the social work profession’s contributions to multidisciplinary efforts to improve human well-being around the world. Over 140 speakers and panelists came together to discuss the latest research and trends on issues such as poverty, reproductive health, adolescence, mental health, human rights, evidence-based interventions, and health care access. The conference helped to clarify the directions that the social work profession can embrace in response to these challenges and their impact on education, research, and practice.
Summaries of representative sessions are included below.
“Global Health Status: The Pivotal Role of Social Determinants”
Cheryl Healton, Director Designate, NYU Global Institute of Public Health; Dean, Global Public Health, New York University
The conference opened with a talk by Healton, who discussed the role of social determinants and social justice in shaping global health efforts. She noted, however, that many people still do not believe social conditions predict poor outcomes and instead the blame is placed on the individual. She referenced a recent article in The Economist, which stated that 1.2 billion people live on less than $1.25 a day. She argued that the role of poverty is key in predicting health outcomes.
“Broad based societal interventions need to produce maximum health benefits,” she said. Citing a March 2013 New England Journal of Medicine article, she said any global health systems must have four essential functions: production of global goods, management of externalities (to mitigate the effect one country has on another), mobilization of global solidarity, and stewardship (which provides overall direction to the global health system). She said, “People with clinical training have a role to play in all of this.”
She went through the Millennium Development Goals to show where progress had been made and where goals still have not been met. She noted that there needed to be framework convention for global health, which she hopes will come out of a recent meeting held at NYU. She cited major progress in China and India, but little change in Sub-Saharan Africa. She also noted that a clear balance needed to be made with regards to corporate actions in developing countries—health needs to be put in all policies and above a company’s bottom line.
“Substance Abuse in the American Indian/Alaskan Native Populations: Implementing a Screening and Brief Education Intervention as Standard Care”
David A. Patterson Silver Wolf, Assistant Professor, George Warren Brown School of Social Work, Washington University in St. Louis
Patterson began the session by sharing his research and work on substance abuse in American Indian and Alaskan Native populations. Noting that these groups have among the highest rates of substance abuse in the United States, he suggested that barriers to preventive care implementation greatly contribute to these statistics. He proposed that substance abuse screenings and educational interventions be incorporated into routine medical visits in order to begin work toward a solution.
When asked about the role of culture, Patterson engaged the audience in a discussion about cross-cultural assessment and treatment methods and, given the various social and historical factors that contribute to this population’s high risk for substance abuse, whether this influences his proposed standardized screening method. At times of the highest risk, when individuals are first seeking treatment, it is important to intervene in the most direct way and focus later on the social factors. But at every stage social workers in the substance abuse field have a significant opportunity to utilize the signature value of cultural competency to engage and work effectively with clients.
“Harm Reduction and Other Approaches to Substance Use Problems”
Ethan Nadelmann, Founder and Executive Director, Drug Policy Alliance
Nadelmann discussed the wide range of definitions of harm reduction policies, which he describes as “at the intersection of public health and human rights.” He highlighted the traditional, more widely-known definition as policies which seek to reduce the harms of potentially dangerous behaviors, such as needle exchange programs, to a more expanded definition that includes more general policies that encourage safety, such as motorcycle helmet and seatbelt laws. He encouraged the audience to think more broadly about the definition and goals of harm reduction practices.
He explored the histories of various substance harm reduction policies employed by various countries, assessing their effectiveness in promoting human rights and ethical standards. He discussed recent policy developments, such as readily available overdose reversal drugs, and the more controversial practice of safe injection rooms in some European countries. Significantly, stigma around drug use and abuse negatively affects the creation of harm reduction strategies, potentially making them less effective. Ultimately, he argued, harm reduction strategies should provide education for individuals, but should allow sovereignty over a person’s body. In this way, social workers are equipped to advocate for substance users and the reform of harm reduction policy.
“The Global Network University”
John Sexton, President, New York University
The second day of the conference opened with remarks by Sexton, who discussed progress NYU has made in becoming a global network university. The university now has 16 campuses on six continents. This includes two portal campuses in Abu Dhabi and Shanghai. What was once viewed as a liability—lack of a campus—has become NYU’s greatest strength—being directly in the city of New York, and now, the world. The description of NYU as a global network university “is simply noticing the deep, distinctive DNA of this place.”
By the time the Abu Dhabi and Shanghai campuses are fully operational in 2020, 60 percent of NYU students will be based in New York, 10 percent in Abu Dhabi, 10 percent in Shanghai, and the rest will be in study abroad sites. He said, “It’s given us an extraordinary mission.”
Drawing on philosopher Karl Jaspers, Sexton noted we need to view the world through the “many facets of a diamond,” and not through one window. This is the notion of the second Axial Age and the notion of hope. He said, “We here at NYU have begun to articulate this.”
“Collaboration and Cooperation Between Institutions of Higher Education Across Borders and Its Impact on Global Health and Well-Being”
José Alfredo Miranda, President, Universidad Popular Autónoma del Estado de Puebla (UPAEP)
The Silver School of Social Work, through the Center for Latino Adolescent and Family Health (CLAFH), is forging a bond with UPAEP, in part because of the immigration flow between Puebla and New York. Forty percent of Poblanos in the U.S.—a number equal to 240,000—live in the tri-state area. Said Miranda, “Relations between the U.S. and Mexico are close, and relations between New York City and Puebla are very real.”
The two schools are planning a conference in Puebla for the 2013-14 academic year, a research grant is being developed, and they are working to bring UPAEP students to NYU Silver to study. For many years, Latin American was not considered a hub for higher education due to political and economic instability, but this is changing. Strong trade between Mexico and the U.S. has created a superior education system producing a high quality workforce. With half of Mexico’s population under age 25, the country is now investing in education more than ever. Along with gains in higher education come improvements in overall health outcomes.
“The MicroConsignment Model: From Uncertainty to Risk to Opportunity”
Greg Van Kirk, Ashoka Lemelson Fellow; Co-Founder, The New Development Solutions Group; Adjunct Associate Professor, NYU Wagner School of Public Policy
Van Kirk shared his journey from an investment banker in New York to a Peace Corps volunteer and restaurant entrepreneur in Guatemala to his eventual design of the Micro-Consignment Model, an innovative response to issues related to economic development. The model seeks to empower individuals and promote collaboration among community stakeholders. It involves the delivery of start-up capital to local communities, whose residents sell the commodities to other community members, who, in turn are able to live more sustainably and further stimulate the local economy. Using his first Micro-Consignment initiative as an example, he demonstrated how the local manufacturing and distribution of basic concrete stoves was able to contribute the overall improvement of community health, as the harmful smoke from camp-style cooking could be reduced.
Van Kirk emphasized that poverty is not the problem. It is a symptom of a variety of global forces, and that in looking for solutions to global poverty, it is important to focus on “scalable and sustainable solutions” that promote both economic development and community empowerment.
“Angst Within: Brutal Assassination of Damini and Other Young Girls”
Sreerupa Mitra Chaudhury, Chairperson, Special Task Force on Rape and Violence against Women of Government of India
Chaudhury began with a video presentation providing an overview of recent sexual violence toward young girls in India and the growing social movement to bring awareness to issue of violence and abuse toward women in South Asia. Following the video, she introduced her work as an advocate for highly marginalized women in rural India, who suffer high rates of intimate partner violence, and young girls, often subjected to sexual commodification and trafficking.
She noted the many roadblocks in working towards large-scale gender equality in India. The issue is embedded in economic inequality that might leave families with few economic options; a lack of legislation that empowers women, such as marital rape laws; and vague or biased medical record-keeping that minimizes the occurrences of sexual abuse. Thus, much of Chaudhury’s work focuses on educating men and empowering women on a local level.
PANEL: HEALTH SYSTEMS AND SOCIAL DETERMINANTS OF HEALTH
“Social Determinants of Health: What You Should Know and Why You Should Care”
Joel Finlay, Director, KPMG, Vancouver, Canada
Finlay described social determinants of health as the “causes of the causes of ill health,” and highlighted their often undervalued significance in the global health conversation. According to the CDC, half of U.S. adults have at least one chronic disease. By 2020, chronic diseases, many of which are preventable, will account for 70 percent of premature deaths in the U.S. Moreover, healthcare costs account for a growing percentage of national spending. While solutions often focus on the curative side by improving healthcare, Finlay argued this is not sustainable, and addressing the social causes of ill health are critical to minimizing the occurrence of preventable diseases.
Finlay discussed the population health approach, which presents an opportunity to involve the private sector in the field of public health. Citing examples in the U.K., Australia, and the United States, he demonstrated that while members of the private sector may have different motivations for supporting and financing public health initiatives from those in the social services sector, collaborating and working together toward the same goal is ultimately the most effect approach toward addressing public health issues.
“Health and Human Service’s Global Engagement of the Social Determinants of Health”
Holly Wong, Deputy Director of the Office of Global Affairs, US Department of Health and Human Services
Wong echoed the call for the engagement of a variety of sectors in addressing global public health issues, saying that the social services sector “cannot do this alone, and certainly should not do this alone.” She focused primarily on preventable non-communicable diseases (NCDs), which, according the World Health Organization, result in early death most frequently in resource-poor, low- and middle-income countries.
Wong discussed the recent global progress that has been made in the prevention of NCDs. In 2011, the UN held a high-level meeting on NCDs, the second time that a high-level meeting had focused on a health issue. During this meeting, NCDs were acknowledged as both a health and development issue, and in the same year, the World Conference on Social Determinants of Health developed the Rio Political Declaration and promoted participation in policymaking. Wong praised the United States’ Affordable Care Act on expanding healthcare coverage and increasing the budget for disease prevention initiatives, but noted that there is still a lot of work to do in addressing the social causes of poor health, including engaging the private sector and implementing interventions on a more local level.
“The Social Work Response”
Lynn Videka, Dean and Professor, NYU Silver School of Social Work
Social workers are underrepresented as part of the public health workforce globally. In a brief overview of the conference, Videka explored the ways that the unique skill set of social workers can contribute to the global issues that were presented. Social workers’ knowledge of family dynamics, problem-solving and conflict resolution skills, appreciation for cultural diversity, commitment to social justice, and the ability to view problems from an ecological perspective are all skills and qualities that can be applied to improving global health issues. In thinking about how social workers can improve their position to contribute to this global health challenge, Videka suggested better educating social workers in health knowledge, and better preparing them to work in low-resource environments and to work with peer and indigenous non-professional workforces. She also stressed that social workers need to be ready to compete well in an interdisciplinary job market.
PANEL: SOCIAL WORK EDUCATION ACROSS THE GLOBE
Darla Spence Coffey, President, Council on Social Work Education
Theresa Kaijage, Co-Director, Kaijage Consultants in African Family Health; Founder and Director, Tanzanian NGO Walio Mapambano Na AIDS Tanzania
James Herbert Williams, Dean and Milton Morris Endowed Chair, Graduate School of Social Work, University of Denver
Lynn Videka, Dean and Professor, NYU Silver School of Social Work
In the final session, Coffey, Videka, Kaijage, and Williams reminded all to listen to the many voices that social workers hear in the field, respect each individual for what he/she is saying about the challenges faced, and not to differentiate based on location in the world. Whether social workers are working with immigrants in the United States or Africans a continent away, challenges are challenges and social workers have the skills and tools to engage and help bring about change and opportunity for improved health, education, alternatives to poverty, abuse, and neglect. The mission is to become more informed and an agent of change in this evolving and very complicated world.
Andrea MacFarlane, MSW ’14, contributed to this article.