RESUMO
This study explores toxic stress and youth disconnection from work and school using data from the Detroit Jobs for Michigan's Graduates (JMG) program. A secondary cross-sectional analysis was conducted using a program census of 1934 youth participating in JMG between 2014 and 2019. Youth with criminal justice contact, parenting responsibilities, and toxic stress barriers showed the greatest disparity in graduating or become employed following participation in the JMG program. Youth without toxic stress-aligned barriers were 1.87 times the odds more likely of successful program outcomes when controlling for program enrollment year, program type, Detroit residency, gender, and age. Toxic stress is associated with disconnection from education and employment before and after participation in the JMG program. This indicates that expanding trauma-informed systems and community approaches in youth-serving programs can play a role in mitigating the impact of toxic stress exposure on connection to opportunity for Detroit youth.
Assuntos
Emprego , Estresse Psicológico , Evasão Escolar , Adolescente , Cidades/epidemiologia , Direito Penal/estatística & dados numéricos , Estudos Transversais , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Michigan/epidemiologia , Poder Familiar , Avaliação de Programas e Projetos de Saúde , Estresse Psicológico/epidemiologia , Evasão Escolar/estatística & dados numéricosRESUMO
This article describes the role of social workers in addressing the needs of people with heart failure. Although previous studies have explored the role of social workers in health care settings, few studies have addressed the challenges of specific chronic diseases such as heart failure. To address this gap in the literature, this study used qualitative interviews with health care social workers (n = 8) to obtain in-depth information about activities and challenges related to heart failure care. Findings suggest that health care social workers perceive heart failure as characterized by an uncertain illness trajectory, frequent hospitalizations, and difficulties accessing formal and informal care. These findings suggest the importance of what we term illness-informed social work, a practice that combines heart failure knowledge with social work competencies to address the complex psychosocial issues in heart failure care.