International social work research and health inequalities -
1
I
NTERNATIONAL
S
OCIAL
W
ORK
R
ESEARCH AND
H
EALTH
I
NEQUALITIES
Malcolm Payne
Director, Psycho-social and Spiritual Care, St Christopher’s Hospice51-59 Lawrie Park Road, Sydenham, London SE26 6DZ.Telephone: 020 8768 4500; Email: m.payne@stchristophers.org.uk The international definition of social work (IFSW, 2000) claims that social justice isfundamental to it. Therefore, we might assume that health inequalities, which arewidely recognised internationally, would also be a focus of social work and also of social work research. That this is not so arises from:
the varying role of social work and therefore its research in nationalwelfare regimes, and the consequences for international research;
the complex relationship between social work and healthcare;
weaknesses in social work research.I argue that for social work research to tackle health inequalities requires a newagenda in social work research and a structure and policy for initiating and developingresearch.
National and international social work
National welfare regimes and international scholarship on social work
Social work is not the same activity and profession everywhere. In any country, it isstructured as part of that country’s ‘welfare regime’, a term that I have adapted fromthe work of Esping-Andersen (1990). He analyses how different countries providewelfare according to the way in which roles of the state and the market connect tocreate a particular pattern of provision. This provides a set of social assumptions thatform how the welfare services are organised. Social work, as part of those services, isdivided differently in every country, to fit that country’s social assumptions andwelfare regime. It originated in Western welfare regimes and is primarily Western.However, it has a worldwide influence and is present in many, if not all, societies, butin different forms. There is a range of ‘social professions’, occupational groups thatoperate in the territory of responses to identified social issues. The welfare regimeresponds to administrative, government and political structures, legal constraints andcultural and social expectations.To understand social work in any country, it is necessary to have an understanding of its position, structurally, ideologically and politically, in the welfare regime of thatcountry. This is a legitimate part of social work research, but the main focus of thispaper in on research that examines social work practice rather than the organisation,provisions and people served of social services.Social work is connected to or plays a part in different aspects of welfare provision indifferent regimes. Where social work plays a significant role and where it is excludedfrom major involvement affects what social work is in that welfare regime. In somecountries, for example Denmark, it is part of or responsible for social securityprovision. In the UK, significant aspects of social work are incorporated into
International social work research and health inequalities -
2
healthcare, child and family social work is part of local government educationprovision and social workers may be found in many other aspects of social welfareprovision and in agencies where social work is a dominant professional group.The limitations of an international perspective in social work may be seen in itsliterature. The (British) Blackwell Encyclopaedia of Social Work (Davies, 2000) doesnot mention international social work, but lists five articles on ‘transnational issues’:European perspectives on social work, globalisation and social work, intercountryadoption, race and racism in social work and social work with refugees. The(American) Encyclopedia of Social Work (Edwards, 1995) is a much biggerproduction and contains three articles with ‘international’ in the title. Midgley (1995)writes about comparative research on social welfare services and social policyresearch, Healy (1995) on organisations in international work, focusing successivelyon United Nations organisations, American government agencies and internationalsocial welfare organisations and Hokenstad and Kendall (1995) write aboutinternational social work education activities.A number of publishing activities indicate the presence of international connections insocial work. Individual texts, for example Midgley (1997), and several seriescomparing social welfare systems have been published. Examples are series publishedby Greenwood Press, edited by Elliott, Mayadas and Watts (Watts et al, 1995;Mayadas et al, 1997), IFSW by Tan and colleagues (Tan and Envall, nd; Tan andDodds, 2002), and various British texts edited by Shardlow and associates (Adams etal, 2000, Adams et al, 2001; Shardlow and Payne, 1998), focusing on Europe.Journals called
International Social Work
,
Community Development Journal
,
Social Development Issues
and
Global Social Development
publish a great deal of materialabout transnational projects and activities in social work, and descriptions of activitiesin single countries with commentary on their relevance and interest for internationalaudiences. Regional journals are well-established, such as the
Asia-Pacific Journal of Social Work
,
the
European Journal of Social Work
, the
Journal of Social Development in Africa
and
Nordisk Social Arbied
(Nordic Social Work). Many other journals occasionally publish comparative article, material based in countries otherthan that of the country of publication and the journal
Social Work Abstracts
recognises a number of core international journals, mostly published in the USA, butincluding the
British
and
Indian
journals of social work.Examining the literature discloses a number of points about social work knowledgeproduction:
it is often regional in character, for example associated with Africa, American,Asian, European and Nordic regions;
it is comparative, being mainly concerned with comparisons at a fairly highlevel of generality between welfare regimes within which social work ispractised in different countries;
it often relies on contacts between editors and writers through internationalorganisations or projects.
The development of international knowledge in social work
There is, however, a significant history of international work and knowledgedevelopment in social work, although this might not be termed ‘research’ in thecurrent social science meaning of the term. This history originated at the time of the
International social work research and health inequalities -
3
foundation of social work in the late 19
th
century. It emerged from experiments indifferent countries responding to urbanisation; some of these, primarily thesettlements, the charity organisation (COS) movement and the Elberfeld system of community visiting were internationally influential (Payne, 2005). There was also aninternational municipalisation movement (Hietala, 1987), which meant that as socialwork developments began to be incorporated into local government, there wereinternational visits, conferences and circulation of ideas. For example, when Japaneseservices began to develop in the early 20
th
century, they were explicitly based on theCOS and Elberfeld models, although they also incorporated indigenous ideas(Takahashi, 1997). Other primarily national developments such as the 19
th
centuryFrench development of services to respond to
abandon moral
(moral danger) of children had some international involvements (Schafer, 1997), and the work of andElizabeth Fry on prisons and Josephine Butler on women (van Drenth and de Haan,1999; Jordan, 2001).This international exchange of ideas was reflected in the influence of psychodynamicideas on social work from the 1920s onwards, the impact of the mental hygiene andeugenics movements of the 1920s and ‘30s and the emergence of the child guidancemovement and psychiatric social work in the 1930s. It was cemented by theinternational conferences on social work starting in 1929, and by Alice Salomon’s(1937) international research on provision of social work education, which wasprobably the first major international comparative survey relevant to social work.These developments were interrupted by the second world war, and the internationalorganisations restarted their activities. This accounts of them derives form Payne(2006) There are three main ones, which continue in existence today:
International Association of Schools of Social Work (on social work education);
the International Council on Social Welfare (representing agencies andprimarily voluntary or non-governmental agencies); and
the International Federation of Social Workers (a grouping of nationalprofessional associations of social workers).Although of varying strength and size, and having different purposes, these provide ameans of communication through publications, conferences and joint projects of various kinds. More recently, specialised bodies have developed, for example theInter-University Consortium on International Social Development.There are three other forms of international activity relevant to social work:
International non-governmental organisations (INGOs). Examples areinternational charities and welfare groups like the International Red Cross orCrescent, Save the Children, Caritas, and Médicin Sans Frontiéres. Theseprovide welfare services for people who are crossing borders, such as refugees,and development activities or welfare services in emergencies. Although theseare not conventional ‘social work’ as it is known in Western countries, theseorganisations represent international commitments to welfare in various ways.
Governmental and intergovernmental activities. Examples are the provision of aid and joint projects such as the many European programmes which encourageshared training, research and other transfer of expertise across the EuropeanUnion and, more widely, with the eastern European countries and the states of the former USSR. Similar schemes exist more widely, for example between the
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International social work research and health inequalities
A paper given by Malcolm Payne at an ESRC seminar in 2006 on health ineqaulities, discussing ways in which research in international social work has potential but has so far failed to focus adequately on health ineqaulities.
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