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Translating Life Course Theory to Clinical Practice to Address Health Disparities

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Abstract

Life Course Theory (LCT) is a framework that explains health and disease across populations and over time and in a powerful way, conceptualizes health and health disparities to guide improvements. It suggests a need to change priorities and paradigms in our healthcare delivery system. In “Rethinking Maternal and Child Health: The Life Course Model as an Organizing Framework,” Fine and Kotelchuck identify three areas of rethinking that have relevance to clinical care: (1) recognition of context and the “whole-person, whole-family, whole-community systems approach;” (2) longitudinal approach with “greater emphasis on early (“upstream”) determinants of health”; and (3) need for integration and “developing integrated, multi-sector service systems that become lifelong “pipelines” for healthy development”. This paper discusses promising clinical practice innovations in these three areas: addressing social influences on health in clinical practice, longitudinal and vertical integration of clinical services and horizontal integration with community services and resources. In addition, barriers and facilitators to implementation are reviewed.

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References

  1. Fine, A., & Kotelchuck, M. (2010) Rethinking MCH: The MCH life course model as an organizing framework. US DHHS, HRSA, Maternal and Child Health Bureau. Accessed at http://mchb.hrsa.gov/lifecourse/rethinkingmchlifecourse.pdf. on 7-29-11.

  2. Halfon, N., & Hochstein, M. (2002). Life course health development: An integrated framework for developing health, policy and research. Milbank Quarterly, 80(3), 433–479.

    Article  PubMed  Google Scholar 

  3. Danis, M., Kotwani, N., Garrett, J., Rivera, I., Davies-Cole, J., & Carter-Nolan, P. (2010). Priorities of low-income urban residents for interventions to address the socio-economic determinants of health. Journal of Health Care for the Poor and Underserved, 21, 1318–1339.

    PubMed Central  PubMed  Google Scholar 

  4. American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College of Physicians (ACP), & American Osteopathic Association (AOA). (2007) Joint principles of the patient-centered medical home, March 2007. http://practice.aap.org/public/pmo_document302_en.pdf. Accessed 6-7-12.

  5. Starfield, B. (1992). Primary care: Concept, evaluation and policy. New York: Oxford University Press.

    Google Scholar 

  6. Garg, A., Butz, A. M., Dworkin, P. H., Lewis, R. A., & Serwint, J. R. (2009). Screening for basic social needs at a medical home for low-income children. Clinical pediatrics (Phila), 48(1), 32–36.

    Article  Google Scholar 

  7. Lindstrom Johnson, S., Jones, V., & Cheng, T. L. (2012) Creating “healthy futures”: Results from a motivational interviewing intervention to promote future orientation and improve health outcomes. Pediatric Academic Societies Abstracts. #3455.8 http://www.abstracts2view.com/pas/.

  8. Gielen, A. C., McDonald, E. M., Wilson, M. E. H., Hwang, W. T., Serwint, J. R., Andrews, J. S., et al. (2002). Effects of improved access to safety counseling, products, and home visits on parents’ safety practices. Archives of Pediatrics and Adolescent Medicine, 156, 33–40.

    Article  PubMed  Google Scholar 

  9. Garg, A., Marino, M., Vikani, A. R., & Solomon, B. S. (2012). Addressing families’ unmet social needs within pediatric primary care: the health leads model. Clinical Pediatrics, March 2012 Epub ahead of print.

  10. Garg, A., Sarkar, S., Marino, M., Onie, R., & Solomon, B. S. (2010). Linking urban families to community resources in the context of pediatric primary care. Patient Education and Counseling, 79, 251–254.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Kornfeld, B. D., Bair-Merritt, M. H., Frosch, E., & Solomon, B. S. (2012). Postpartum depression and intimate partner violence in urban mothers: co-occurrence and child healthcare utilization. J Pediatr, Epub ahead of print.

  12. Braveman, P., & Barclay, C. (2009). Health disparities beginning in childhood: A life-course perspective. Pediatrics, 124, S163–S175.

    Article  PubMed  Google Scholar 

  13. Kuh, D., & Ben-Shlomo, Y. (Eds.). (1997). A life course approach to chronic disease epidemiology. New York, NY: Oxford University Press.

    Google Scholar 

  14. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14, 245–258.

    Article  CAS  PubMed  Google Scholar 

  15. Centers for Disease Control and Prevention. Adverse childhood experiences (ACE) study. http://www.cdc.gov/ace/index.htm. Accessed 9-29-12.

  16. Heckman, J. J. (2006). Skill formation and the economics of investing in disadvantaged children. Science, 312(5782), 1900–1902.

    Article  CAS  PubMed  Google Scholar 

  17. Halfon, N., DuPleissis, H., & Barrett, E. (2008). Looking back at pediatrics to move forward in obstetrics. Current Opinion in Obstetrics and Gynecology, 20, 566–573.

    Article  PubMed  Google Scholar 

  18. Centers for Disease Control and Prevention, Recommendations to improve preconception health and health care—United States (2006). A report of the CDC/ATSDR preconception care work group and the select panel on preconception care. MMWR, 55(RR06):1–23.

  19. Cheng, T. L., Guyer, B., & Kotelchuck, M. (2012). Preconception women’s health and pediatrics: An opportunity to address infant mortality and family health. Academic Pediatrics, 12(5), 357–359.

    Article  PubMed  Google Scholar 

  20. Akinbami, L., Cheng, T. L., & Balbus Kornfeld, D. (2001). Review of the effectiveness of teen-tot programs: Comprehensive care for young parents and their children. Adolescence, 36, 381–393.

    CAS  PubMed  Google Scholar 

  21. Beers, L. S., & Hollo, R. E. (2009). Approaching the adolescent-headed family: A review of teen parenting. Current Problems in Pediatric and Adolescent Health Care, 39(9), 216–233.

    Article  Google Scholar 

  22. England, M. J. & Sim, L. J., (eds) (2009). Committee on depression, parenting practices, and the healthy development of children; National Research Council; Institute of Medicine. Depression in parents, parenting, and children: Opportunities to improve identification, treatment, and prevention. Washington, DC: The National Academies Press.

  23. Whitney, C. G., Farley, M. M., Hadler, J., et al. (2003). Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. New England Journal of Medicine, 348, 1737–1746.

    Article  PubMed  Google Scholar 

  24. Collins, J., & Koplan, J. P. (2009). Health impact assessment: A step toward health in all policies. JAMA, 302(3), 315–317.

    Article  CAS  PubMed  Google Scholar 

  25. Quigley, R., den Broeder, L., Furu, P., Bond, A., Cave, B., & Bos, R. (2006). Health impact assessment international best practice principles. Fargo, ND: International association for impact assessment; 1. Special Publication Series 5.

  26. Thornton, R. L. J., Fichtenberg, C. M., Greiner, A., Feingold, B., Ellen, J. M., Jennings, J. M., et al. (2010). Zoning for a healthy Baltimore: A health impact assessment of the transform Baltimore comprehensive zoning code rewrite. Baltimore, MD: Johns Hopkins University Center fo Child and Community Health Research.

    Google Scholar 

  27. National Opinion Research Center (NORC) (2011) Improving children’s health and well-being by integrating children’s programs. Feb 1, 2011, http://www.firstfocus.net/library/reports/improving-children's-health-and-well-being-by-integrating-children's-programs. Accessed 5-29-12.

  28. Institute of Medicine. (2012). Primary care and public health: Exploring integration to improve population health. Washington, DC: The National Academies Press.

    Google Scholar 

  29. Sarasohn-Kahn, J. & California HealthCare Foundation (2011). Primary care, everywhere: Connecting the dots across the emerging health landscape. http://www.chcf.org/publications/2011/11/primary-care-everywhere. Accessed 9-28-12.

  30. United Kingdom Department for Education. http://www.education.gov.uk/childrenandyoungpeople/earlylearningandchildcare/delivery/surestart/a0076712/sure-start-children's-centres. Accessed 6-4-12.

  31. National Evaluation of Sure Start esearch Team. The impact of sure start local programmes on 3 year olds and their families. http://www.ness.bbk.ac.uk/impact/documents/42.pdf. Accessed 6-4-12.

  32. Anning, A., & The National Evaluation of Sure Start Team. Understanding variations in effectiveness amongst sure start local programmes: Lessons for sure start children’s centres. https://www.education.gov.uk/publications/eOrderingDownload/NESS2007SF024.pdf. Accessed 6-4-12.

  33. Lexau, C. A., Lynfield, R., Danila, R., et al. (2005). Changing epidemiology of invasive pneumococcal disease among older adults in the era of pediatric pneumococcal conjugate vaccine. JAMA, 294, 2043–2051.

    Article  CAS  PubMed  Google Scholar 

  34. Fine, A., & Kotelchuck, M., (2010). Rethinking MCH: The MCH life course model as an organizing framework. U.S. DHHS, HRSA, Maternal and Child Health Bureau. http://mchb.hrsa.gov/lifecourse/rethinkingmchlifecourse.pdf. Accessed 7-29-11.

  35. Schor, E. L., Berenson, J., Shih, A., Collins, S. R., Schoen, D., Riley, P., & Dermody, C., (2011) Ensuring equity: A post-reform framework to achieve high performance health care for vulnerable populations, The Commonwealth Fund, Oct 2011, http://www.commonwealthfund.org/Publications/Fund-Reports/2011/Oct/Ensuring-Equity.aspx. Accessed 6-4-12.

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Acknowledgments

This publication was supported by the National Institute of Child Health and Human Development Grant Number K24HD052559 (Cheng) and the DC-Baltimore Research Center on Child Health Disparities P20MD000198 from the National Institute on Minority Health and Health Disparities. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the funding agencies.

Conflict of interest

None. Authors do not have any affiliation, financial agreement, or other involvement with any company whose product figures prominently in the submitted manuscript.

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  1. Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N Wolfe Street #2055, Rubenstein Building, Baltimore, MD, 21287, USA

    Tina L. Cheng & Barry S. Solomon

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  1. Tina L. Cheng
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  2. Barry S. Solomon
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Correspondence to Tina L. Cheng.

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Cheng, T.L., Solomon, B.S. Translating Life Course Theory to Clinical Practice to Address Health Disparities. Matern Child Health J 18, 389–395 (2014). https://doi.org/10.1007/s10995-013-1279-9

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