2 The ICOPE approach supports providing health and social care services by promoting governance and integrated service models that maintain or prevent avoidable declines in older people’s intrinsic capacity and functional ability. 9 17 In the context of providing integrated care for older people specifically, WHO has proposed the Integrated Care for Older People (ICOPE) approach to inform the application of the Framework on Integrated People-Centred Health Services in the context of older people and bridge the gap between what is presumed to be best practice care for older people and emerging evidence. 10 19–22 The WHO Framework on Integrated People-Centred Health Services provides a whole-of-system roadmap for policymakers to drive health system and service reform to better support integrated care and health across the life course by optimising the way services are designed, funded, managed and delivered. 11–18 However, the evidence for strategies to achieve care integration across micro, meso and macro levels remains limited. 6 10 Integration of health and social care is widely advocated as a way to improve person-centred and system-centred outcomes for the increasing numbers of older people with varying and sometimes complex health needs. 9 Accordingly, integrated care strategies can target different levels of service provision: clinical (micro) level, service/organisational (meso) level or system (macro) level. WHO defines integrated care as ‘services that are managed and delivered so that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease-management, rehabilitation and palliative care services, coordinated across the different levels and sites of care within and beyond the health sector, and according to their needs throughout the life course. WHO recommends that health and social care services should be targeted towards preventing and managing declines in intrinsic capacity and improving functional ability in older people, rather than supporting a siloed and often disjointed approach to management of individual health conditions. 2 8 Such reforms are critical and urgent in order to achieve the goals of the UN Sustainable Development Agenda, in particular the Sustainable Development Goal 3 for health and well-being, for which the foundation is universal health coverage. The World Health Organization (WHO) World Report on Ageing and Health and subsequent Global Strategy and Action Plan on Ageing and Health advocate for major reforms to health and long-term care systems to support healthy ageing. 6 7 This historical approach to healthcare no longer aligns with the current and future needs of the population. Rapid population ageing coupled with an increasing proportion of older people with significant loses in intrinsic capacity and long-term complex conditions creates major challenges for health systems, which have been historically designed to provide episodic and curative healthcare. 1 Further, older people commonly experience multimorbidity, particularly those who are socioeconomically disadvantaged. 2 An increasing proportion of the global burden of disease is now attributed to non-communicable physical, sensory and cognitive impairments increasing the disability burden experienced by older people, particularly in low- and middle-income settings. 2 While increased life expectancy may be a worthy aspiration, older people are not necessarily experiencing functional ability with longevity that is Healthy Ageing. 1 These changing health profiles are culminating in rapid population ageing-from 2015 to 2050, the proportion of the global population aged 60 years and over will nearly double. In particular, life expectancy is increasing and fertility rates are decreasing. Professionals in these careers might not be called “social workers” but it is from a social work foundation that they are able to be effective in what they do.Health and demographic profiles of the global population are changing rapidly. Students interested in macro practice end up as policy researchers, advocates, or analysts community organizers, educators, or outreach specialists research associates or analysts program development specialists and more. It is crucial that everyone in the social work field-even micro level social workers-understand macro practice, as it deals with the systems that affect clients every day. Macro practice explicitly embodies social work’s commitment to social justice and social change by promoting structural solutions to systemic inequalities and various forms of oppression that go beyond individual adaptation and resilience. Too often excluded from the idea of social work is macro practice, or the work that promotes systemic change. When most people think of social work, they picture clinical, individualized (micro) practice, but that only paints one picture of social work.
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