Tapping into the Potential of Public Health and Social Services Partnerships

By Kneipp, Shawn; Desjardins, Kerry | Policy & Practice, August 2017 | Go to article overview

Tapping into the Potential of Public Health and Social Services Partnerships


Kneipp, Shawn, Desjardins, Kerry, Policy & Practice


Millions of Americans suffer from one or more chronic diseases. Individuals with lower income, lower levels of education, or who are racial or ethnic minorities bear the brunt of chronic disease, posing a great challenge to their workforce engagement and economic well-being. Despite being a very common and difficult barrier to sustainable employment and self-sufficiency, the human services system generally does not sufficiently address clients' chronic health conditions. But evidence shows that partnerships between public health programs and human services programs can lead to better health and employment outcomes.

Chronic Disease in the United States

Annually, $1.3 trillion is spent on chronic disease treatment in the United States.1 Much of this cost relates to insufficient management of chronic disease conditions and the onset or exacerbation of symptoms that inevitably follow.2,3,4 Over time, poor disease management and symptom control impairs functioning in key life domains-such as employment.5 These health-related limitations manifest as employee presenteeism (the practice of coming to work despite illness or injury, often resulting in reduced productivity) and absenteeism-where reduced productivity in the workplace costs U.S. employers $1,685 per employee per year, or $225.8 billion annually.6 Nearly 48 million Americans report some degree of chronic disease-related functional limitation or disability.7-8 However, socioeconomically disadvantaged populations account for the greatest productivity and health care system costs, given they have a higher disease prevalence, worse symptom control, and more significant health-related work limitations.9-10-11-12

There is a tendency to think of a select few conditions when we hear the term chronic disease. Most often, these are the conditions that are the major causes of U.S. deaths (e.g., heart disease and diabetes), and thus are widely believed to account for most of the individual and societal burdens outlined here. In reality, however, a wide range of health problems meets the criteria of being "chronic health conditions," which are defined as "conditions that are generally not cured, once acquired."13

These statistics, and the ways in which chronic health conditions impede securing or maintaining employment, are familiar to this audience and others working in the social services sector. For example, in the Temporary Assistance for Needy Families (TANF) program, health problems have long been recognized as significant barriers to employment. Incentives for screening for mental health, substance abuse, and domestic violence as health-related barriers to employment, for example, were written into the legislation that established TANF in 1996.14 However, this set of health problems is narrowly defined relative to the wide array of chronic health conditions that can act as barriers to employment.

Health and Employment Outcomes for TANF Clients

A focus on screening for mental health and substance abuse among TANF clients may have encouraged some degree of coordination or integration across the social and health services sectors. What we have learned since 1996 from one of our studies, however, and what is being echoed in the broader health literature, is that a 20-year, policy-driven history of focusing on these chronic health conditions in isolation has blunted the progress that could be made in achieving better outcomes for TANF clients. In a randomized controlled trial sponsored by the National Institute of Nursing Research· that used a community-based approach,15 the first author (Kneipp) tested the efficacy of a public health nursing screening, referral, and case-management program on improving health and employment outcomes with 432 women receiving TANF. (See details of the intervention at https://innovations. ahrq.gov/profi les/public-health-nursesprovide-case-management-low-incomewomen-chronic-conditions-leading.) In that study, chronic health conditions were defined broadly (as described above). …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Tapping into the Potential of Public Health and Social Services Partnerships
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.