With increased age comes increased likelihood of disability as people live longer and do not encounter fatal diseases. Unfortunately, this positive association between age and disability sometimes leads to a negative image of aging. Disability occurs when physical or mental health declines associated with aging, illness, or injury restrict ability to perform activities of daily living. This chapter discusses the effect of disability on biopsychosocial functioning throughout the lifespan, the effect of culture, race, and ethnicity on behaviors, attitudes, and identity, and the effects of discrimination and stereotypes on behaviors, attitudes, and identity. It describes the influence of sexual orientation on behaviors, attitudes, and identity, the impact of transgender and transitioning process on behaviors, attitudes, identity, and relationships, and the principles of culturally competent social work practice. The chapter ends with discussion of sexual orientation concepts and gender and gender identity concepts.

This chapter discusses the indicators of normal and abnormal physical, cognitive, emotional, and sexual development throughout the lifespan. Because growth and development are generally predictable, social workers should know the milestones of healthy development and the signs of potential delay or disability. The chapter presents the theories of sexual development, spiritual development, and racial, ethnic, and cultural development throughout the lifespan. It discusses the effects of physical, mental, and cognitive disabilities throughout the lifespan, the interplay of biological, psychological, social, and spiritual factors, and the principles of attachment and bonding. The chapter then discusses the effect of aging on biopsychosocial functioning, the impact of aging parents on adult children, parenting skills and capacities, the effects of addiction and substance abuse on individuals, families, groups, organizations, and communities, and the factors influencing self-image (e.g., culture, race, religion/spirituality, age, disability, trauma). It ends with discussion of psychoanalytic and psychodynamic approaches.

This chapter focuses on sources of evidence for evidence-based policy development. It explores some of the dilemmas with developing an evidence base and provides a range of empirical sources within the aging and disabilities arenas that can be used in building an evidence-based approach to policy development. The journey, however, will not be without struggle—since philosophical paradigms, and social and economic factors will interface and play a role in the development of evidence-based policy. The chapter helps the reader to be aware of healthy people 2020 benchmarks that are used to guide program planning and policy development. Benchmarks currently have been established in order to identify where health goals for the nation and individual states should be, and the program is evaluated routinely by local and state health departments. Healthy people 2020 is also used to gauge the impact of health policy.