The Dean of the Boston University School of Social Work (BUSSW) and Director of the Center for Innovation in Social Work & Health (CISWH), Dr. Jorge Delva, has named three inaugural core directors to guide the Center’s strategy and expand its impact on research, global health, and social work leadership. The three professors will work with Dr. Delva, researchers, BUSSW faculty, and staff to implementthe Center’s mission to expand the impact of social work in health care and public health—with a goal to improve the health and well-being of vulnerable populations nationally and globally.
Dr. Christina Lee, associate professor, will serve as director of the Research Core. In this role, she will foster the development of research that advances public health social work, social work leadership, practice, and education, that impacts policy, and improves health equity. She will lead the building of the Center’s research priorities, which include social work’s role in advancing health equity, understanding the social determinants of health, and innovative health care models involving social work. She will also help foster and strengthen relationships between multiple stakeholders including community partners, BUSSW and CISWH researchers, practitioners, and policy makers.
Geoffrey W. Wilkinson, clinical associate professor, will serve as director of the Leadership Core. He will focus on advancing social work leadership in health care, public health, behavioral health, and improving social determinants of health for vulnerable populations. He will also develop and implement programs to enhance social workers’ participation in policy and advocacy. His work will include organizing events that address challenges and opportunities in the field of social work, strengthening the framework and approaches of public health social work, developing a leadership incubator for social workers, and fostering professional development and networking opportunities.
Dr.Luz Marilis López, clinical full professor and associate director of BUSSW’s MSW/MPH Program, will serve as director of the Global Health Core. She will develop partnerships with international organizations to advance social work leadership and culturally responsive practices in health globally. She will lead the development of education, training, and research opportunities that advance social work’s role in global health equity. Dr. López will also help foster social workers’ participation in policy, advocacy, and public health, and will lead the implementation of innovative technology and transdisciplinary collaborations to improve health outcomes globally.
“The establishment of these cores represents a significant step forward for the Center in achieving our mission,” saidDr. Delva. “We are committed to making meaningful contributions to social work research and practice in ways that can be seen and measured. Thanks to the vision, experience, and innovative ideas contributed by our core leaders, we are well on our way to meeting that goal.”
Ada Avila (SSW’19) was worried when she saw that after heavy rains, the basement of her childhood home in Chelsea, MA would flood with sewage—a serious threat to health. But when she learned that her family’s neighbors were also experiencing the same sanitation problem, she began to ask questions and advocate for solutions.
The flooding began about two years ago and has affected at least five to seven families, said Avila, who is now working on her MPH in environmental health at BU School of Public Health. Chelsea, which has a population that is 60 percent Hispanic, had previously suffered from a lack of investment, but in recent years, numerous luxury housing developments have been built. “Chelsea is already densely populated, has aging infrastructure, and we’re right near the water, which means we’ll experience climate change effects,” she said. “You can’t keep developing without updating the infrastructure and not see these problems.”
Avila learned that her neighbors had previously tried to get the attention of city government, with little success. “Some went to city hall in person to complain but the message never got through,” she said. She started contacting her city councilor, city manager, and the city engineer via phone, mail, and in-person meetings, and has attended community meetings with her neighbors. She also enlisted the support of the Chelsea Collaborative, a Latino-led community advocacy organization.
“Communities of color will be most impacted by climate change, and I feel that the flooding in Chelsea is a red flag.”
In response, the city provided a reimbursement plan for affected families, allowing them to upgrade pipes in their homes, although it’s a short-term fix. “A lot of neighbors had these new valves installed, and they are still facing flooding,” said Avila. She learned that the root cause of the problem was a lack of separate systems for sewage and storm drainage, and ultimately, these systems must be upgraded. Although Avila considers the city engineer to be a partner, the work will still take three to five years to complete, if approved.
Throughout the process, she has learned that persistence and patience are key. “Change takes time. Pushing has been the most effective thing: asking ‘where are we on this?’ They realize, oh, you’re not going away.”
Avila credits her social work education with giving her the skills to navigate advocacy work. “Macro social work provides tools to understand community members’ motivations for development—how people can benefit, their strengths, their weaknesses, their conflicts of interest. You have to use a certain type of communication if you want change,” she said. “Social work helped me learn it’s not just one person who is responsible, like a city manager; there are all these other leadership structures and committees in the government.” Micro social work skills have also proven beneficial, helping her set boundaries and avoid burnout.
Additionally, Avila’s studies in environmental health have helped her view the problem through an environmental justice lens. “Communities of color will be most impacted by climate change, and I feel that the flooding in Chelsea is a red flag,” she said. “Chelsea’s community health balance is tipped towards one side: development. Has Chelsea gotten better? Well, how do you define better? We have all these fancy new buildings. But there is more traffic, more flooding, a decrease in green space.”
Avila is continuing her work in Chelsea, driven by a sense of urgency and a desire to improve her hometown for all residents. She also wants to help her neighbors feel more empowered to address their concerns. “What’s the point of getting an education at a university if you’re not going to share what you’ve learned?”
Article and photo by Nilagia McCoy of the Center for Innovation in Social Work & Health.
Friday, September 20, 2019
8:30 a.m. – 4:30 p.m.
Boston College, Corcoran Commons Heights Room
Campanella Way, Chestnut Hill, MA
Experts in the mental health field will share their experiences and research findings addressing disparities in service provision to Hispanic and Latino populations living in the United States. The focus of the event is to recognize and address the intersection between acculturation, trauma and mental health among Hispanic and Latino populations. After this event, participants will be able to:
Identify the main cultural idioms of distress and values within Hispanic and Latino communities that may influence help-seeking behaviors and engagement in mental health services.
Address the intersection between trauma experiences and acculturation among Hispanic and Latino populations.
Describe trauma-informed mental health services and their implications for Hispanic and Latino cultures.
Guests will have access to visitor parking at any of the garages on campus. The Commonwealth Garage is the closest. View parking rates and regulations.
Lunch There are several lunch options: There are three cafeterias on campus that are easily accessible. There are two cafeterias at the site of the event: Addie’s and Lower Live. There is also Hillside, which is a short walk across campus, next to the bookstore.
Off-campus restaurants that are walking distance include:
Boston University School of Social Work’sCenter for Innovation in Social Work & Health (CISWH) announces the funding and launch of a new pilot research project, Epi AWARE, to investigate the relationship between stress and physical health in Asian American women.
Epi AWARE will assess Asian American women’s experiences of childhood trauma, perceived racism, and stressors related to disempowering parenting, as well as markers of pre-diabetes. Childhood trauma and perceived discrimination have previously been shown to adversely impact metabolic health in other populations, yet studies focused specifically on Asian Americans are rare. The study is a collaboration between CISWH,Boston University’s School of Social Work (BUSSW), andSchool of Public Health (BUSPH), and builds upon BUSSW’sAWARE (Asian Women’s Action for Resilience and Empowerment) project, which addresses mental health.
“Asian Americans are twice as likely to develop diabetes as compared to the general U.S. population, despite having lower BMIs—but we don’t completely understand why,” saidHyeouk Chris Hahm, co-principal investigator, director of AWARE Lab and Associate Professor at BUSSW. “There is comparatively little research on Asian Americans, despite their being the fastest growing population in the U.S. Combine this with the harmful stereotype of being a ‘model minority,’ and Asian Americans’ physical and mental health disparities often go overlooked.”
“We have learned from the long-runningBlack Women’s Health Study, that socioeconomic status and experiences of discrimination are linked to poorer health outcomes for African American women, including type 2 diabetes,” saidYvette Cozier, co-principal investigator, Associate Professor of Epidemiology, and Assistant Dean for Diversity and Inclusion at BUSPH. “I look forward to collaborating with my colleagues at BUSSW to shed light on how we might improve the health of minority populations in the U.S.”
The study will begin recruiting participants in fall 2019. The one-year pilot period will conclude in 2020, after which initial findings will be released. The researchers hope to continue and expand the study beyond 2020.
“Both the fields of public health and social work seek to address health inequities and social determinants of health. This research is a perfect example of how our disciplines can collaborate at the intersection of health and social justice, particularly around issues of trauma and racism,” said BUSPH DeanSandro Galea and BUSSW Dean and CISWH DirectorJorge Delva in a joint statement. “We anticipate that the findings from this study will have practical applications for both public health and social work practitioners.”
About CISWH
The Center for Innovation in Social Work & Health (CISWH) is dedicated to expanding the impact of social work in health care and public health in order to improve the health and well-being of vulnerable populations nationally and globally. CISWH seeks to improve outcomes, patient experience, and population health; reduce costs; and promote health equity and social justice. The Center supports social work leadership in health through cross-sector collaboration with public health, medicine, health economics, technology, and other relevant disciplines. The Center accomplishes its mission through research, community partnerships, policy development, and by providing technical assistance and educational opportunities. Learn more at bu.edu/ciswh.
Media Contact:
Nilagia McCoy Communications Manager, Center for Innovation in Social Work & Health [email protected] | 617-358-1889
Christina Lee, PhD, a licensed psychologist, has been appointed associate professor with tenure at BUSSW, effective August 1, 2019. Dr. Lee’s pioneering research on immigrant health and the reduction of risky behaviors by tailoring evidence-based interventions is advancing the science of treating substance use disorders and improving mental health outcomes for culturally diverse populations. Her expertise will also inform her new role as inaugural director of the Research Cluster at BUSSW’s Center for Innovation in Social Work & Health.
As Community Health Workers (CHWs) are used in more health settings, questions have emerged about the role of CHWs, how the CHW role is different from others on the care team, and best practices for integrating CHWs into care teams. In this webinar, participants will hear the lessons learned and best practices for implementing a CHW program in HIV care, beginning with the roles and skills that CHWs need to be effective in their work.
Presenters from Boston University’s Center for Innovation in Social Work & Health (CISWH); the McGregor Clinic, an AIDS service organization, in Fort Myers, FL; and CrescentCare, a Federally Qualified Health Center in New Orleans, LA, will discuss the role of the CHW on the care team and share lessons learned from a three-year initiative on topics such as establishing program systems and infrastructure, hiring, training, job retention, and supervision. Staff from the McGregor Clinic and CrescentCare will also share their experience with developing a CHW program and integrating CHWs into their HIV care team. There will be an extensive period for questions and discussion.
Resources and considerations for healthcare providers addressing the fear and trauma of family separation
Attachment and relationships are crucial for a child’s brain and emotional development. There is a body of evidence supporting the notion that one of the worst possible traumatic events that can happen to a young child is sudden, forceful separation from a primary caregiver. It can have immediate negative effects on their functioning as well as long-term consequences.
As immigration raids increase in the U.S. and a recently announced “public charge” policy change restricts which immigrants can apply for green cards and citizenship, undocumented parents and mixed-immigration status families are facing the unsettling question of how to plan for their children’s care and well-being in the case of forced separation.
Children, even at a young age, can sense the changes and fear the implications for their families, reports Ivys Fernández-Pastrana, JD, the family navigation program manager for Boston Medical Center (BMC)’s pediatrics department. Children of immigrant parents may ask their parents about a future where they might be separated, and they may experience physical manifestations of fear, such as stomachaches. When families turn to providers for help in alleviating these anxieties or finding answers, though, they’ve often left empty-handed.
“A mom asked me, ‘Would you stay with our child if la migra takes us? I don’t want her to end up in foster care,’” recalls Carmen Rosa Noroña, LCSW (SSW’12), social worker and clinical services and training lead for BMC’s Child Witness to Violence Project. Noroña’s patient, a four-year-old girl, was a member of a mixed-status family who had been forced into the shadows for fear of being separated. “As a therapist, it was a very sobering moment. The best I could offer was to begin thinking and speaking about the ‘unspeakable,’ which was planning for who should care for their child in the event of detainment or deportation.”
At the time, there were few resources available to help families prepare for such a situation, Noroña discovered, which sent her on the path to build comprehensive supporting information.
To assist the mixed-status families they serve, Noroña and Fernández-Pastrana collaborated with Kara Hurvitz, JD, MSW, legal advisor at MLPB (formerly known as Medical Legal Partnership Boston), to create a resource that helps families in the event of an emergency separation.
“Most of the parents we see here are raising U.S. citizens who are being raised with a lot of trauma that their peers are not. The burden they carry is incredible,” says Fernández-Pastrana. “It’s almost like we have two kinds of citizens in this country. We have a duty to those children.”
Implementing a plan
The resulting Family Preparedness Plan details how to designate a caregiver for a child, what documentation to have available in case of separation, and how to talk to young children about separation. It also provides forms to document a child’s medical and educational needs, as well as the child’s routines. It helps families develop a reunification plan, making space for the understanding that the trauma of separation can have lasting effects on a child’s behavior and functioning.
The plan is freely available for any healthcare or social service provider to use.
Left to right: Kara Hurvitz, Carmen Rosa Noroña, and Ivys Fernández-Pastrana.
Providers interested in using the plan should also be sure to use the accompanying facilitator’s guide, which lends guidance on appropriate support and facilitation, as well as sensitivity in addressing a disconcerting subject.
“You have to actively work with the family,” says Hurvitz, who explains that sending a family to complete the plan on their own has the potential to be really damaging.
The preparedness plan is particularly valuable for providers who do home visits and work closely with families but who may or may not have received training to approach these issues.
“Having more tools in the toolbox really does help providers in a lot of contexts. It gives them a starting place,” says Hurvitz. A social worker on Noroña’s team was able to use the plan to help a mother secure a passport for her child, and providers are using the resource at other Massachusetts organizations. The BMC team encourages providers across the country to use the plan and adapt it to incorporate their own state laws.
“There are things these families cannot change, like immigration policies,” says Fernández-Pastrana, “but at least in a plan like this they can take agency in the little things that they can control, and that’s powerful.”
How to confront a difficult topic
Immigration is complicated and overwhelming, and what is happening is so visceral, says Fernández-Pastrana. Providers can feel discouraged even before starting to have a conversation because training and support in this area is often lacking.
The interest in increased training focused on immigration was evident at an August 13 symposium held by BMC and the Boston University Center for Innovation in Social Work & Health. Attended by more than 100 social workers, community health workers, patient navigators, nurses, and doctors, the training covered the current immigration landscape and policies, considerations for working with immigrant populations, trauma-informed care, and how to help patients use the preparedness plan and other resources.
Noroña emphasizes the need for healthcare organizations to provide support to staff who serve populations affected by immigration policy, as confronting these issues can take a toll on a provider’s well-being, hope, and sense of agency and cause secondary traumatic stress.
Although the situation for undocumented immigrants is daunting, Noroña encourages healthcare professionals to form alliances to provide support for their clients and each other — and to face difficult conversations head-on. “You might think, I am not going to ask about immigration or trauma because I don’t know what to do, or I will feel overwhelmed,” Noroña says. But she asks providers to think about it from a relationship perspective: “Validating that what these families are experiencing is not okay, or that what they are experiencing is overwhelming—that is something you can do.”
Article and photos by Nilagia McCoy. This article is part of a series in partnership with BMC’s HealthCity that highlights social workers working in healthcare and public health to address the nonmedical factors that impact health, known as social determinants of health. Know of a healthcare team that’s doing innovative work involving social workers? Contact us — we want to hear your story.
A new brief from the Center for Innovation in Social Work & Health (CISWH)’s HIV, Housing & Employment Project provides guidance on how to integrate navigators into health care organizations to assist people living with HIV. “Navigator” is a broadly used term encompassing a number of staff titles such as Community Health Worker, Peer Navigator, and Patient Advocate. Navigators are typically non-medical roles within a clinic/agency that focus on identifying and addressing client barriers to care and other immediate needs. Navigators can work on a variety of interventions, engage people living with HIV into care, support adherence to care plans and medications, and help patients achieve viral suppression. Navigators, like other community health workers, are able to serve as a bridge between the health care system and the patient to address social service needs such as housing and employment in addition to medical needs.
This brief covers delineation of roles and responsibilities, electronic health records access, clinical supervision, and more. Read the brief at the Target HIV website.
Boston University School of Social Work (BUSSW) is seeking applications from mid-career academics for a Tenured Associate Professor Position beginning in the 2020-2021 academic year. Read more.
Emily Shea, MSW, MPH, Commissioner, Age Strong Commission, City of Boston, MA
Emily Shea is a 1998/1999 graduate of the Boston University MSW/MPH Program. She majored in Clinical Practice with a focus on gerontology at the School of Social Work and Health Services Administration at the School of Public Health. Emily focused on clinical practice so she could better prepare for her career in health administration and has found her clinical background has helped her understand human behavior, mental health, the ethics of professional boundaries, and how to work effectively one-on-one with people.
She became an administrator early on in her career. “For the past seven years, I have worked as the Commissioner for the Age Strong Commission at the City of Boston,” says Emily. “My office serves as Boston’s Area Agency on Aging and Boston’s Council on Aging. We assess needs, plan and fund an aging services network of grassroots agencies, and provide direct services for older adults in the city. It is our job to make sure older adults in our city have access to the supports they need (both health and social determinants of health). But we also work to ensure that we, as a city, recognize all that elders have to offer and contribute. I use the skills I learned in school every day. I keep my clinical knowledge in the back of my mind as I work on individual situations and issues or when moving larger projects forward. I love my job because I get to work on a policy level, systems change level, and individual level, so it is never boring, and it is definitely public health social work!”
“I love my job because I get to work on a policy level, systems change level, and individual level, so it is never boring, and it is definitely public health social work!”
Emily notes that she has benefited from having the MSW/MPH degree combination and a public health social work orientation. “I think my work lends itself to both social work and public health, so it’s been easy to integrate. In fact, it would be hard to do the role without the integration of the two…Much of what we do is geared toward health care and the social determinants of health.” But she also observes that many of her colleagues don’t know about or understand public health social work or how her background makes her better at the job. She observes, “I’m often asked about my work, but I tend to speak about it in terms of the aging field, not necessarily public health social work. However, if those of us actually doing this work could look for more opportunities to raise public health social work’s visibility, that might be a good thing, especially given that more of us are graduating every year.” Emily recommends the development of public health social work talking points to help brand the work. “This is hard, because there is so much variability in what we do, but it would be helpful for practitioners and students alike to strengthen their identities as public health social workers.”
Emily’s advice for students: “There is a growing emphasis on the social determinants of health and their impact on health care costs. This represents one of the biggest opportunities for MSW/MPH graduates.”
