Research Digest: Cultivation Social Work Leadership in Heath Promotion and Aging: Strategies for active aging interventions

Marshall, Victor, W., Altpeter, Mary. Health and Social Work May 2005 v30 i2 p135 (10)

The overall goal of this article is to encourage social workers to employ health promotion techniques particularly with the older client. The article also provides clarification of the meaning of health for the aging population and how health can be viewed as a resource for optimal living and not just merely the absence of disease. Various frameworks of health promotions employed by social workers are examined with the ecological approach being suggested as the ideal approach for devising successful strategies for the aging population. The importance of physical activity is used as an example of a strategy social workers can use to promote healthy aging.

The social work profession has evolved over time becoming increasingly part of multidisciplinary public health teams. Now, as the aging sector of the population grows, there is great need for social workers to have expertise in aging and health issues. For example, by 2030, one fifth of the US population will be 65 or older, and by 2050 five percent of the entire population will be 85 years and above. These demographics highlight the need for health promotion and disease prevention programs however; this has not been acknowledged in the gerontological social work literature as little has been written on the role of the social worker in health promotion and aging. The authors point out that there is a marked need for gerontological social workers.

Health promotion techniques the authors consider to be the most successful are those which employ a broad based multilevel ecological approach. These theories focus on how individuals adapt to and cope with their environment. Health promotion techniques employed by social workers should also reflect the changes in how health among older adults has been perceived from Rowe and Kahn's (1998) model of "successful aging" to today's "health aging". In other words, the emphasis should be on injury prevention and health promotion. Overall, the approach taken by the social worker needs to allow for modest changes in health in order for the individual to perceive the goals as attainable.

In 2001 the Robert Wood Foundation stated the importance of delivery channels for implementing better choices for healthy aging and physical activity. Delivery channels are simply places in the community and social situations where people engage in everyday behaviors. Social workers interested in promoting a healthy lifestyle through physical activity should incorporate the eight strategies noted by the authors through these channels. The major strategies social workers should use to promote physical activity in older patients are:

1. Develop and activity-friendly community - activities in place within a community for groups of all ages and fees are not a barrier for participation

2. Advocate for transportation friendly communities-lower speed limits, easy to read maps

3. Develop health work environments- promote and advocate for a healthier lifestyle at work - take the stairs instead of the elevator

4. Foster coordination and collaboration across jurisdictions, government levels, and agencies - help to provide senior housing, parks and recreation and disability agencies

5. Create opportunities to promote healthy aging in clinical services - participate on multidisciplinary teams and begin to assess and counsel older patients about their physical activities

6. Enhance community competence-work with senior groups to help develop programs and strategies to meet their goals

7. Support economic development for health- help to advocate for training programs and placement programs

8. Promote profession-community research partnerships

Social work education needs to provide the training and leadership for individuals
interested in health promotion for older adults. With the right background and skills, social workers can successfully access the needs of older adults and identify areas of concern.

Although the ecological approach has been researched for years, interventions also are strongly individualized. Social workers should assess each client and try strategies at all levels and connect them together. Health promotion should not just be based on an individual but an entire community. Social workers who work to enhance people's health can have an enormous effect on the well being of all older people.

Posted on June 10, 2005