Maternal and Child Health Journal

, Volume 18, Issue 2, pp 344-365

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Lifecourse Health Development: Past, Present and Future

  • Neal HalfonAffiliated withUCLA Center for Healthier Children, Families, and CommunitiesDepartment of Pediatrics, David Geffen School of Medicine, UCLADepartment of Health Services, School of Public Health, UCLADepartment of Public Policy, School of Public Affairs, UCLA Email author 
  • , Kandyce LarsonAffiliated withAmerican Academy of Pediatrics
  • , Michael LuAffiliated withHealth Resources and Services Administration, U.S. Department of Health and Human Services
  • , Ericka TullisAffiliated withUCLA Center for Healthier Children, Families, and Communities
  • , Shirley RussAffiliated withUCLA Center for Healthier Children, Families, and Communities


During the latter half of the twentieth century, an explosion of research elucidated a growing number of causes of disease and contributors to health. Biopsychosocial models that accounted for the wide range of factors influencing health began to replace outmoded and overly simplified biomedical models of disease causation. More recently, models of lifecourse health development (LCHD) have synthesized research from biological, behavioral and social science disciplines, defined health development as a dynamic process that begins before conception and continues throughout the lifespan, and paved the way for the creation of novel strategies aimed at optimization of individual and population health trajectories. As rapid advances in epigenetics and biological systems research continue to inform and refine LCHD models, our healthcare delivery system has struggled to keep pace, and the gulf between knowledge and practice has widened. This paper attempts to chart the evolution of the LCHD framework, and illustrate its potential to transform how the MCH system addresses social, psychological, biological, and genetic influences on health, eliminates health disparities, reduces chronic illness, and contains healthcare costs. The LCHD approach can serve to highlight the foundational importance of MCH, moving it from the margins of national debate to the forefront of healthcare reform efforts. The paper concludes with suggestions for innovations that could accelerate the translation of health development principles into MCH practice.


Lifecourse health development LCHD Epigenetics Systems biology Genomics Biopsychosocial DOHaD Complexity