Roles, stresses, and challenges in health Social Work: An analysis of professional experience at a public Hospital in Hidalgo, Mexico

Abstract

The right to health faces inequalities associated with the social determinants of health, such as poverty, job insecurity, lack of social security coverage, cultural barriers, and insufficient access to healthcare services. In this context, social work within the hospital setting plays a strategic role in mediating between the social conditions of service users and the institutional functioning of healthcare services. The objective of this study is to analyze the activities, functions, methodologies, and challenges of social work in public hospitals considering healthcare demands. The methodology consists of a qualitative research study with an interpretative design and a phenomenological approach. Semi-structured interviews were conducted with three social workers employed in different public hospitals, selected through purposive sampling. The interviews were organized into five analytical dimensions: daily activities and periodic actions, functions according to levels of care, methodology, challenges, and deficiencies within hospital services. Additionally, a documentary analysis on the social determinants of health and social work was carried out to strengthen the theoretical interpretation through source triangulation. The findings show that hospital social work fulfills key functions in guidance, case management, social research, institutional mediation, and support for patients and families, with emphasis on record verification, resource management, and interinstitutional coordination. However, structural tensions were identified, including administrative overload, staff shortages, lack of medical supplies and medications, the financial burden on families, language barriers, and the absence of poshospital follow-up. It is concluded that social work in the hospital setting operates as an institutional mechanism linking the healthcare system with the social conditions of the population; however, it requires a strategic reorientation that strengthens prevention, socio-health follow-up, and recognition of its theoretical–methodological contribution to comprehensive healthcare.