Amy Colver, LCSW
Melody Griffith, MSW, LMSW, OSW-C
AOSW Communications Director
Jeanice Hansen, LCSW, OSW-C
To submit a story or information for inclusion in a future issue of AOSW Newsletter, contact Amy Colver or Melody Griffith on the list above.
Oncology Social Work and Public Health Research: Reuniting Long-Lost Cousins
At first glance, it may appear that oncology social work and public health research are not at all related. To greatly simplify, the former is primarily concerned with the psychosocial and health concerns of individuals and small groups, while the latter’s primary focus is the health and well-being of populations of people. Of course, social workers are trained to start where the client is, but how broadly do we interpret that imperative? How many of us were educated well on the psychological aspects of mental health, but not as well on the sociological aspects of health, illness and wellness? It’s true that over the decades, the education and practice of social work clinicians and the public health practitioners have grown apart, but if we trace the origins of both medical social work and public health, we will find that we share grandparents.
Medical social work was born in the United States 111 years ago, in an era when the social factors of disease were just beginning to be discovered. Tuberculosis (TB or “consumption,” as it was then called) was ravishing communities, especially in cities where living quarters were overcrowded breeding grounds of contagious diseases. John Snow was a pioneer in this era in England in the 1850s. Snow gave birth to public health epidemiology by questioning the prevailing wisdom about cholera transmission. His investigation led him to believe a single water pump was responsible for the deaths of hundreds of people infected by cholera.
On our side of the Atlantic (and a few decades later), Ida Cannon, who began her career as a nurse in 1898, enrolled in sociology courses and heard Jane Addams lecture about the living conditions of the poor. As Cannon’s eyes became increasingly open to the intersection of poverty, work conditions and disease—i.e., the social determinants of health—she enrolled in social work school. Massachusetts General Hospital (MGH) hired its first social worker in 1905, and Ms. Cannon was hired in 1906. She subsequently become the first Chief of the MGH Social Service Department in 1914. Early social workers were also public health practitioners, investigating the incidence, severity and social conditions surrounding TB. These early medical social workers were the first to complete a comprehensive TB investigation in the U.S. and made recommendations to medical staff on how help patients, including means of TB prevention, which became part of the medical treatment plan.
Social workers also worked to ameliorate lead poisoning, sexually transmitted diseases, alcohol and narcotic abuse, and other medical and social issues of the day. In sociological terms, these social workers used their sociological imaginations, making connections between “personal troubles” and social issues (Mills, 1959). Rather than label the individual as the source of problems, these social workers looked to the societal structures that created conditions ripe for disease and ill health. Medical social workers were early advocates for social equality and social justice.
An offspring of medical social work, oncology social work clinicians and researchers share goals with public health practitioners and researchers in promoting the best quality of life for those diagnosed with cancer and their families and caregivers. The relationship between oncology social work and public health is underscored in that “most care for chronic illness occurs in health care settings. Because most of life happens outside of this realm, there is great potential [for public health] to leverage the infrastructure of community-based settings for both lifestyle interventions and community-based care” (Harris, 2012, para. 9). An example of how oncology social work research skills can benefit public health research and practice is that the oncology social worker can bring her/his knowledge of evidence-based practices for ameliorating distress for cancer patients and families and help develop and evaluate a community-based program. Further evidence of this relationship would be this oncology social work researcher’s interest in studying the roles and functions of patient navigators, to promote that navigation should supplement, not supplant, oncology social work services in clinical settings.
Coming full circle to reclaim our place in the family tree, oncology social work clinicians and researchers might advance our concern for those whose zip code or race/ethnicity increases their likelihood for cancer incidence and mortality. One of the objectives of AOSW’s 2017 Annual Conference relates to underserved populations. Specifically, the objective calls us to “identify disparities in the delivery of cancer care and evidence-based strategies for improving psychosocial care for underserved and medically vulnerable oncology patients and survivors, their families and caregivers." In a way, we can think of this year’s conference as a family reunion, where the cousins will realize how close they really are.