Social workers have been involved in public health and health promotion in the United States since the settlement house movement championed by Jane Addams and the inception of social work practice in medical settings guided by Ida Cannon. In those early days, social workers were concerned with individual, community, and environmental public health concerns such as infectious diseases, sanitation, nutrition, and maternal and infant mortality (Caputi, 1978; Moroney, 1995). Throughout the 20th century, social workers increasingly participated as members of multidisciplinary public health teams implementing health promotion and disease prevention programs for contemporary health-related social conditions such as teenage pregnancy, HIV/AIDS, and chronic diseases such as Alzheimer's disease and cancer (Moroney).
The rapid growth of the aging population and demographic changes in the 21st century demand that social workers become proactive in aging and health issues. In 2000, 35 million (13 percent) adults in the United States were age 65 or older, and 58,000 were centenarians. By 2030, 70 million Americans, or one of every five people, will be age 65, and there may be as many as 381,000 centenarians. By 2050, with the aging of the baby boomers, the number of older adults ages 65 and older will triple, and the proportion of the 85-plus age group will increase to about 5 percent of the total population (Administration on Aging, 2001).
Although the majority of older Americans experience good health, national statistics on the prevalence of chronic illness, disabilities, and injury are of concern. Of adults 65 years and older, 88 percent reported having at least one chronic condition, and 21 percent reported having multiple chronic disabilities (Robert Wood Johnson [RWJ] Foundation, 2001). One-third to one-half of women ages 70 to 80 reported difficulty with general mobility (for example, walking a few blocks, climbing stairs, doing housework). More alarming, nearly one-quarter of individuals age 50 and older died within a year of having a hip fracture (RWJ Foundation).
The rapid growth in the proportion of older adults in the population and their concomitant physical status and health needs have captured the attention of leaders in the fields of aging and health care. The Centers for Disease Control and Prevention (CDC), the National Institute on Aging, the RWJ Foundation, the American College of Sports Medicine, the American Geriatrics Society, the National Council on Aging, and the American Association of Retired Persons have formed coalitions to promote healthy aging research and interventions. Where is the social work leadership in addressing these issues? Little is found in the gerontological social work literature on the role of social work in health promotion and aging.
The lack of social work leadership and scholarship in aging and public health reflects the more critical issue of the national shortage of gerontological social workers and the educational and attitudinal problems that exist in the profession. Workforce research conducted in the mid-1990s revealed that a scant 4 percent of master's-level social work graduates and 16 percent of bachelor-level graduates worked in the aging field (Gibelman & Schervish, 1997; Teare & Sheafor, 1995). Even though 62 percent of surveyed members of the National Association of Social Workers (NASW) indicated that geriatric knowledge was relevant for their practice (Gibelman & Schervish), only about 2 percent of social work students reported taking any courses in aging (Damron-Rodriguez, Villa, Tseng, & Lubben, 1997). The Strengthening Aging and Gerontological Education for Social Work project (SAGE-SW) of the Council on Social Work Education (CSWE) (funded by the John A. Hartford Foundation) found in its data gathering that: most social work students and faculty are unaware of the practice opportunities available in aging; unless social work students are experienced in aging or motivated to pursue an interest in aging before beginning their programs, they have few opportunities to obtain gerontological training; there are few resources to fund students interested in pursuing gerontological training; and there are few social work-sponsored continuing education opportunities for practitioners who wish to enter the aging field (CSWE, 2001). …