Social Work in the COVID Era
If the COVID-19 pandemic has made one thing clear, it’s the reality that social workers are on the frontlines of healthcare—no less than doctors and nurses.
Rather than treating medical symptoms, however, social workers are mitigating barriers to health, from housing to poverty to access to testing.
As colleagues at the Rush University Medical Center in Chicago explained recently in an op-ed in The Hill, “Social workers care for and support the most marginalized and vulnerable among us, and work in many settings to develop, implement, and advocate for programs and policies to address health inequities. In health and social care settings, we evaluate and address barriers to health and wellbeing, like food insecurity, social isolation, unemployment, or mental health concerns. We build on the unique needs, strengths, and preferences of those we serve, making care responsive to what they want and not what we assume they need.”
Professor Tom Byrne and colleagues, for example, examined the issue of homelessness during the pandemic. In April, they reported an immediate need for 400,000 additional emergency beds nationwide to manage the impact of the coronavirus on the homeless population. Cities around the country sought out his team’s guidance, prompting them to create a web application that allows local communities to estimate the needs of their homeless residents based on their particular circumstances.
In addition to meeting emergent needs, BUSSW faculty advocate for using COVID-19 as an opportunity to take a systems-wide approach to address social ills. While pandemic eviction moratoriums across the country have proven to be popular measures to keep people housed, Professors Dawn Belkin Martinez, Linda Sprague Martinez and Judith Scott note the potential for these policies to push problems down the road. “While widespread evictions in the present moment will be prevented, the inability of renters to pay the significant rent debt they’ve accumulated in the meantime could well result in a tremendous surge in evictions once the economy begins to reopen and these policies are lifted,” they write. “Clearly, the magnitude of the current housing crisis calls for much bolder, more visionary solutions that begin to address not just the immediate threats at hand, but also the long-term problems of ensuring adequate, affordable housing for every American.”
In childhood poverty, we see the ongoing issues intensified by the pandemic. “Well before COVID-19, poverty was causing hunger, homelessness and housing instability for millions of our nation’s children,” notes Professor Lenette Azzi-Lessing. “Children growing up in poverty are at high risk to do poorly in school and experience serious mental and physical health problems throughout their lives. As with so many facets of disadvantage, racism plays a role here too, with poverty and its grim, lasting outcomes more prevalent among children of color.”
This includes the disproportionate percentage of black and brown children in foster care—another system ripe for reform. When it comes to child welfare, Professor Mary E. Collins calls for post-pandemic planning for both the mid- and long-term. While the stress of economic insecurity and enforced isolation may contribute to more child abuse now and in the future, Collins argues for balancing child protection with promoting well-being. “This requires a laser focus on normalcy for kids in foster care,” she asserts. “A commitment to normalcy may lead to new ideas for reforming the entire child welfare system.”
As the country looks ahead to a new normal, Professor Linda Sprague Martinez sees a watershed moment. In 2009 the American Journal of Public Health (AJPH) published Protection of Racial/Ethnic Minority Populations During an Influenza Pandemic. The authors foreshadowed the threat of influenza pandemic and detail the ways in which communities of color would be left vulnerable. Chilling, given today’s headlines: “It’s a racial justice issue: Black Americans are dying in greater numbers from Covid-19.”
Moreover, the AJPH article highlighted a number of relevant strategies discussed in a 2008 CDC convening to evade racial inequities during a pandemic including a focus on “…ways to strengthen public health and community health systems for ensuring provision of safety net services, minimizing economic burdens through social policies that address income and job loss, and maximizing access to food, water, and shelter.”
“Flash forward a decade, we find ourselves, again, witnessing a disproportionate burden of death, illness and economic devastation in our communities. Perhaps, more disturbing is the lack of available racial and ethnic data and the failure to effectively monitor and test in communities identified more than a decade ago as vulnerable,” says Sprague Martinez.
As she describes it, “Social workers are needed downstream to deal with the fallout of COVID-19, as well as upstream—crafting programs to redress the effects of racialized policies that created deep social inequities in the first place. That will require collecting and analyzing data. Without racial and ethnic data, cities are unable to direct resources to communities that need them most — before, during and after a public health crisis. Data on COVID-19 testing is also necessary because testing mostly white or affluent communities skews results. During the crisis such data could be used to help communities stay safe — by providing food or eviction moratoriums, for example. Once the pandemic is behind them, leaders should work directly with the community to assess their needs for the future.”
The National Association of Social Workers Code of Ethics makes it very clear, “social workers should provide appropriate professional services in public emergencies to the greatest extent possible.” As the executive director of the National Association of Social Workers – Massachusetts Chapter summed it up in a recent opinion piece, “That is exactly what social workers are doing. Social workers always have been, and always will be, on the front lines.”