Abigail M. Ross is with the Fordham University Graduate School of Social Service, New York, NY. Lisa de Saxe Zerden is with the School of Social Work, University of North Carolina, Chapel Hill.
Am J Public Health. 2020 Jul;110(S2):S186-S190. doi: 10.2105/AJPH.2020.305690.
The seminal Consensus Study by the National Academies of Science, Engineering, and Medicine released in September 2019 describes the benefits of integrating health and social care service delivery, underscoring the central role of social determinants of health (SDOH) in health outcomes. Although the report's focus on the integration of health and social care contributes a much needed perspective to the national discourse on SDOH and offers a useful framework for organizing service delivery activities, the omission of prevention and health promotion throughout the report is a substantial limitation.We call for increased attention to and investment in prevention and health promotion in the proposed 5As framework. We contend that effectively addressing SDOH and improving alignment between health and social systems require reconceptualization of the traditional health care workforce and renewed state and national advocacy efforts.A paradigm shift encompassing a broader "workforce for health" that is well trained in prevention, health promotion, and advocacy is critical to addressing SDOH, improving population health outcomes, and achieving health equity. Given their professional mission, training, expertise, and scope of practice, social workers are well positioned to lead this effort.
2019 年 9 月,美国国家科学院、工程院和医学院发布的开创性共识研究报告描述了整合卫生和社会保健服务提供的好处,强调了健康的社会决定因素(SDOH)在健康结果中的核心作用。尽管该报告侧重于卫生和社会保健的整合,为关于 SDOH 的国家讨论提供了急需的视角,并为组织服务提供活动提供了有用的框架,但报告通篇对预防和健康促进的忽视是一个重大的局限性。我们呼吁在拟议的 5A 框架中增加对预防和健康促进的关注和投资。我们认为,要有效解决 SDOH 问题并改善卫生和社会系统之间的一致性,需要重新构思传统的卫生保健劳动力,并重新开展州和国家的宣传工作。包括在预防、健康促进和宣传方面受过良好培训的更广泛的“卫生人力”的范式转变,对于解决 SDOH、改善人口健康结果和实现健康公平至关重要。鉴于社会工作者的专业使命、培训、专业知识和实践范围,他们非常适合领导这一努力。