Social Work in Canada An Introduction Third Edition

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SOCIAL WORK IN CANADA

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An Introduction
Third Edition
Chapter 9: Social Work and the Health of Canadians
Chapter 9: Social Work In Canada

Social Work and the Health of Canadians Copyright © 2010 Thompson Educational Publishing, Inc.
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Social Work & the Health of Canadians
 Health and Inequality

 History of Health Policy
 Medicare Under the Microscope
 Canada’s Health Care Spending
 Universal Public or Privatized Health Care?
 Community Health Centres
 Medical Social Work Practice
 Mental Health and Social Work
 Social Work and HIV/AIDS
 Addictions and Social Work
 Aboriginal Health

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Health and Inequality
 Health Gap – Growing divide between rich and

poor in terms of health and well-being, despite
universal public health care
 Only 47% of low-income Canadians rate their
health as excellent
 73% of high-income Canadians rate their health
as excellent

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History of Health Policy
 Universal public health care in Canada took time

to evolve
 First Canadian medical school founded in 1824
 First health directive dealt with the quarantine of
immigrants infected with cholera
 British North America Act, 1867, established
jurisdiction of federal and provincial governments
in delivering health services

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 From 1880 to the 1950s there were a variety of

pre-payment health plans
 By 1934, there were 27 hospital-sponsored pre-
payment plans in 6 provinces

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Federal Involvement
 1942: Heagerty Report proposed federally funded,
two-stage health insurance scheme
 1945: Royal Commission on Dominion Provincial
Relations produced series of proposals, which included
health care
 1957: Hospital Insurance and Diagnostic Services Act
passed
 Under the Act, the federal government agreed to
finance 50% of the cost of provincial hospital care

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Medical Care Act, 1968

 1964: Hall Report disclosed that 7.5 million Canadians did
not have medical coverage
 Recommended that a publicly administered universal
health service plan be implemented
 Report received massive grassroots support
 Medical Care Act was passed in 1968
 Provided for equal federal-provincial cost sharing

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Medicare Under the Microscope
From Hall to Romanow

 2002: Final Report of the Romanow Commission released
 Romanow guided by two things: Canadian values of
fairness, equity, and solidarity, and the evidence
 Report has been the backdrop for major debates between
the federal and provincial governments

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Medicare Under the Microscope
Recommendations of Romanow Commission

 47 detailed recommendations
 Premised on three main themes:
 Strong leadership needed
 More responsive and efficient
 Both short-term and long-term strategies

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Canada’s Health Care Spending
Medicare:
Publicly funded and universal health insurance
in Canada delivered through hospitals, private
physicians, and other health care providers

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Five Principles of Medicare:

 Public administration
 Comprehensiveness
 Universality
 Portability
 Accessibility

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Universal Public or Privatized Health Care?
Threats to the public system:

 Privatization
 Comprehensiveness
 Contracting out

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Universal Public or Privatized Health Care?
Advantages of public system:

 Spreads costs of health care
 Financing through taxation is efficient
 Encourages Canadians to seek preventative care
services
 Government can cut costs as single buyer of
supplies/services

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Community Health Centres
Community health centres (CHCs) provide

primary care, health promotion, and prevention
services using salaried primary health care
professionals.

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Medical Social Work Practice
 Setting is the hospital

 Almost every hospital in Canada has social
workers
 Most medical social workers have a graduate
degree in the field
 Primary role is discharge planning

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Interdisciplinary teams
 Teams of health care professionals, including
social workers, doctors, psychologists, etc.
 Address patient’s physical, psychological, social,
and cultural needs

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Hospice (or Palliative) Care

 Hospice social work involves one or more of the
following services:
 Pain management
 Symptom management
 Social, psychological, emotional, and spiritual
support
 Caregiver support

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Mental Health and Social Work
“Mental health is the capacity of each and all of us to feel,

think and act in ways that enhance our ability to enjoy life
and deal with the challenges we face.
It is a positive sense of emotional and spiritual well-being

that respects the importance of culture, equity, social
justice, interconnections, and personal dignity.”
The Public Health Agency of Canada

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Mental Health and Social Work
Social workers in the mental health field deliver

the following services:
 Direct services  Program management

 Case management  Teaching and research
 Community development  Policy analysis
 Administration  Social action

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Social Work and HIV/AIDS
Services that social workers deliver for people

with HIV/AIDS include:
 public education and  hospice care

prevention initiatives  support groups
 primary care  family support
 hospital care  advocacy
 home care

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Addictions and Social Work
 Treatment of addictions is a growing concern

 Social workers and social service workers
increasingly called upon to address problems
 Social workers at forefront in developing
innovative ways to help
 Many use a harm-reduction approach

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Addictions and Social Work
 Insite – first legal supervised injection site in

North America
 Example of a harm-reduction approach
 Facility is accessible to injection drug users
 Since opening in 2003, Insite has been a safe
place where people can go to inject drugs and
connect to health care services

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Aboriginal Health
 Federal government is obligated through treaties

to fund 100% of the cost of First Nations health
care
 In general, the health status of Aboriginal people
is much worse than that of the average Canadian

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Aboriginal Health
 First Nations leaders wish to see an integrated,

holistic, inter-departmental & inter-organizational
strategy to address inequities

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Websites
 Health Canada Online

www.hc-sc.gc.ca
 Canadian Health Coalition
www.healthcoalition.ca
 World Health Organization
www.who.int
 Public Health Agency of Canada
www.publichealth.gc.ca

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Questions for Discussion
In what ways has federalism shaped Canada’s

health care system?

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What are some ways social workers can be

involved in addressing the rising rates of obesity
in the Canadian population?
Why is obesity an important issue for social

work?

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The federal government funds 100% of First

Nations health care.
What are some of the reasons for the

increasing health gap between First Nations
people and the non-Native Canadian
population?

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What are some of the benefits of the community

health centre model in the delivery of health
care services?
What are some of the challenges?

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What are some of the ways that socio-economic

status/ethnic background/migration
status/Aboriginal status shape health status?
Pick one of these factors to discuss with your

neighbour.


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SOCIAL WORK IN CANADA

Chapter 9: Social Work and the Health of Canadians

Chapter 9: Social Work In Canada

 Health and Inequality

Chapter 9: Social Work In Canada

 Health Gap – Growing divide between rich and

Chapter 9: Social Work In Canada

 Universal public health care in Canada took time

Chapter 9: Social Work In Canada

 From 1880 to the 1950s there were a variety of

Chapter 9: Social Work In Canada

Chapter 9: Social Work In Canada

Chapter 9: Social Work In Canada

Medical Care Act, 1968

Chapter 9: Social Work In Canada

From Hall to Romanow

Chapter 9: Social Work In Canada

Recommendations of Romanow Commission

Chapter 9: Social Work In Canada

Chapter 9: Social Work In Canada

Five Principles of Medicare:

Chapter 9: Social Work In Canada

Chapter 9: Social Work In Canada

Threats to the public system:

Chapter 9: Social Work In Canada

Advantages of public system:

Chapter 9: Social Work In Canada

Community health centres (CHCs) provide

Chapter 9: Social Work In Canada

 Setting is the hospital

Chapter 9: Social Work In Canada

Chapter 9: Social Work In Canada

Hospice (or Palliative) Care

Chapter 9: Social Work In Canada

“Mental health is the capacity of each and all of us to feel,

It is a positive sense of emotional and spiritual well-being

Chapter 9: Social Work In Canada

Social workers in the mental health field deliver

 Direct services  Program management

Chapter 9: Social Work In Canada

Services that social workers deliver for people

 public education and  hospice care

Chapter 9: Social Work In Canada

 Treatment of addictions is a growing concern

Chapter 9: Social Work In Canada

 Insite – first legal supervised injection site in

Chapter 9: Social Work In Canada

 Federal government is obligated through treaties

Chapter 9: Social Work In Canada

 First Nations leaders wish to see an integrated,

Chapter 9: Social Work In Canada

 Health Canada Online

Chapter 9: Social Work In Canada

In what ways has federalism shaped Canada’s

Chapter 9: Social Work In Canada

What are some ways social workers can be

Why is obesity an important issue for social

Chapter 9: Social Work In Canada

The federal government funds 100% of First

What are some of the reasons for the

Chapter 9: Social Work In Canada

What are some of the benefits of the community