Strategies to Close the Health Gap

Strategy 1: Focus on Settings-Based Research and Interventions to Improve the Conditions of Daily Life 

The social determinants of health inequities are found in the “places” and “social contexts where people engage in daily activities, in which environmental, organizational and personal factors interact to affect health and well-being, and where people actively use and shape the environment, thus creating or solving health problems.” The presence of social work in these settings is critical.  

An accessible starting place to start solving the healthcare crisis is from the bottom-up, facilitating settings-based health policy initiatives to address these social determinants of health inequities.

Strategy 2: Advance Community Empowerment and Advocacy for Sustainable Health Solutions and Prevention 

By focusing on the community as the center of efforts to advance health—efforts that will complement those of the health-service sector—activists build community-based interventions that are not only culturally grounded but sustainable.  

A community organized for health improvement may work on either or both of two goals: representation in governance of the health-care delivery system and interventions that create sustainable community changes. Community health coalitions and local learning communities can also play critical roles in developing local capacity for representation, monitoring progress, training volunteers, and demonstrating local options if reform implementations break down.

Strategy 3: Cultivate Innovation in Primary Care 

Improving the health of those suffering lifelong and even intergenerational disadvantage, especially those previously without regular primary health care, will require innovation in primary and other care. There are a number of promising steps that can be taken to develop a comprehensive continuum and to construct social interventions that facilitate positive outcomes whereby social work is poised to make a significant contribution.   

Strategy 4: Promote Full Access to Healthcare 

To achieve health equity, social work must embrace and advance community-based, culturally grounded interventions to facilitate health care access. Such interventions must focus on financial and bureaucratic barriers that have plagued access to the health care system for decades. In pursuing universal access to health care, social work should promote maximum enrollment in health insurance, particularly among disadvantaged populations and advocate on behalf of vulnerable populations.    

Strategy 5: Generate research on social determinants of health inequities. 

Research on social determinants of health is essential for analyzing how environmental and traumatic stressors, racism (and other isms) harm health and how these determinants become embodied over time, generations, and political-historical contexts. Many emerging models of social determinants of health equity need testing. Moreover, there is quite often a gap between what is known through health equity research and what is actually taken up within communities.   

Strategy 6: Foster Development of an Interprofessional Health Workforce 

Social work can lead integrated initiatives for evidence-based workforce development by reviewing practitioner preparation for transdisciplinary social interventions, defining a core curriculum for the initiatives, establishing training standards for advanced practice in specialized areas, and identifying new competence areas for the emerging health system.

Strategy 7: Use Multi-Sectoral Advocacy to Promote Health Equity 

Social work’s disciplinary competencies offer unique opportunities to forge broad alliances capable of advocating for a more comprehensive, multi-sectorial view of health determinants as well as for healthcare policies that address the racial and economic injustices that cause health inequities.