It's hard to imagine discussing welfare policy without discussing race, yet all too often this uncomfortable factor is avoided or simply ignored. Sometimes the relationship between welfare and race is treated as so self-evident as to need no further attention; equally often, race in the context of welfare is glossed over, lest it raise hard questions about racism in American society as a whole. Either way, ducking the issue misrepresents the facts and misleads the public and policy-makers alike. Many scholars have addressed specific aspects of this subject, but until now there has been no single integrated overview. Race and the Politics of Welfare Reform is designed to fill this need and provide a forum for a range of voices and perspectives that reaffirm the key role race has played--and continues to play--in our approach to poverty. The essays collected here offer a systematic, step-by-step approach to the issue. Part 1 traces the evolution of welfare from the 1930s to the sweeping Clinton-era reforms, providing a historical context within which to consider today's attitudes and strategies. Part 2 looks at media representation and public perception, observing, for instance, that although blacks accounted for only about one-third of America's poor from 1967 to 1992, they featured in nearly two-thirds of news stories on poverty, a bias inevitably reflected in public attitudes. Part 3 discusses public discourse, asking questions like "Whose voices get heard and why?" and "What does 'race' mean to different constituencies?" For although "old-fashioned" racism has been replaced by euphemism, many of the same underlying prejudices still drive welfare debates--and indeed are all the more pernicious for being unspoken. Part 4 examines policy choices and implementation, showing how even the best-intentioned reform often simply displaces institutional inequities to the individual level--bias exercised case by case but no less discriminatory in effect. Part 5 explores the effects of welfare reform and the implications of transferring policy-making to the states, where local politics and increasing use of referendum balloting introduce new, often unpredictable concerns. Finally, Frances Fox Piven's concluding commentary, "Why Welfare Is Racist," offers a provocative response to the views expressed in the pages that have gone before--intended not as a "last word" but rather as the opening argument in an ongoing, necessary, and newly envisioned national debate. Sanford Schram is Visiting Professor of Social Work and Social Research, Bryn Mawr Graduate School of Social Work and Social Research. Joe Soss teaches in the Department of Government at the Graduate school of Public Affairs, American University, Washington, D.C. Richard Fording is Associate Professor in the Department of Political Science, University of Kentucky.

Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.