Introduction: social work’s contribution to tackling lesbian, gay, bisexual and trans health inequalities

Summary

The international mandate for social work's role in tackling health inequalities

The social conditions of people's lives have a cumulative impact on their health and wellbeing. A child born in Sierra Leone may live to the age of 40, while a child born in Japan can expect to live to 83 years (Bywaters et al, 2009). Such differences in life expectancy are known as health inequalities; these ‘lost’ years of life are a consequence not solely of poor health services, but also of people's social and material circumstances (for example, diet, education, the quality of housing and the nature of employment).

Health inequalities emerged as a global concern in the early 21st century, notably in the work of Marmot (for example, CSDH, 2008; Marmot, 2010) and Wilkinson and Pickett (2009). However, social work's contribution to addressing them has been only recently acknowledged, for example in the Rio Declaration 2011 – a commitment by 125 governments worldwide to take action against health inequalities – and in the Global Agenda for Social Work and Social Development - in which over 3,000 social work practitioners, educators and researchers launched a global movement to meet joint aspirations for social justice (IFSW et al, 2012). Together with the International Federation of Social Workers’ (IFSW) policy statement on health (IFSW, 2008), social work practice and education have made explicit commitment to the highest attainable standard of health as a fundamental human right and a matter of social justice. Mitigating the impact of poverty and social disadvantage is a core concern of social work around the globe; supporting people to manage the tasks of daily living and maintain their family and support networks makes a key contribution to their social care outcomes and, consequently, to their health. As the IFSW statement articulates, social workers ‘in all settings are engaged in health work whether in creating the conditions for improved health chances or working alongside people to manage the impact of poor health on themselves or those close to them’ (IFSW, 2008).

But it is not only the material conditions of people's lives that influence their physical health and mental wellbeing; the effects of discrimination and oppression arising from people's social position, including their gender, ethnicity, age or disability, are recognised as having a profound impact on their quality of life.