A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease
- 752 Downloads
Findings from the field of Developmental Origins of Health and Disease (DOHaD) suggest that some of the most pressing public health problems facing communities today may begin much earlier than previously understood. In particular, this body of work provides evidence that social, physical, chemical, environmental, and behavioral influences in early life play a significant role in establishing vulnerabilities for chronic disease later in life. Further, because this work points to the importance of adverse environmental exposures that cluster in population groups, it suggests that existing opportunities to intervene at a population level may need to refocus their efforts “upstream” to sufficiently combat the fundamental causes of disease. To translate these findings into improved public health, however, the distance between scientific discovery and population application will need to be bridged by conversations across a breadth of disciplines and social roles. And importantly, those involved will likely begin without a shared vocabulary or conceptual starting point. The purpose of this paper is to support and inform the translation of DOHaD findings from the bench to population-level health promotion and disease prevention, by: (1) discussing the unique communication challenges inherent to translation of DOHaD for broad audiences, (2) introducing the First-hit/Second-hit Framework with an epidemiologic planning matrix as a model for conceptualizing and structuring communication around DOHaD, and (3) discussing the ways in which patterns of communicating DOHaD findings can expand the range of solutions considered and encourage discussion of population-level solutions in relation to one another, rather than in isolation.
KeywordsDevelopmental Origins of Health and Disease (DOHaD) Epigenetics Message framing Mother-blame Community-blame First-hit/Second-hit Framework
The project described was supported in part by the National Institute of Diabetes and Digestive and Kidney Diseases, award number K01 DK102857-02 (JBH).
We would like to thank Ms. Jocelyn Wegman for her thoughtful review of earlier drafts.
Compliance with Ethical Standards
Conflict of Interest
Liana Winett, Lawrence Wallack, Dawn Richardson, Janne Boone-Heinonen, and Lynne Messer declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not report any new studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 24••.Winett LB, Wulf AB, Wallack L. Framing strategies to avoid mother-blame in communicating the origins of chronic disease. Am J Public Health. 2016;106(8):1369–73. doi: 10.2105/AJPH.2016.303239. This paper focuses on the risk of mother-blame in DOHaD communications and offers specific framing and metaphoric language to help avoid that problem
- 26.Gitlin T. The whole world is watching: mass media in the making and unmaking of the new left. Berkeley: University of California Press; 1980.Google Scholar
- 27.Gamson WA, Modigliani A. The changing culture of affirmative action. In: Burstein P, editor. Equal employment opportunity: labor market distribution and public policy. Piscataway: Aldine Transaction Publishers; 1994. p. 373–94.Google Scholar
- 30.Lakoff G. Moral politics: what conservatives know that liberals don’t. Chicago: University of Chicago Press; 1999.Google Scholar
- 31.Ryan C. Prime time activism: media strategies for grassroots activism. Boston: South End Press; 1991.Google Scholar
- 34••.Richardson S, Daniels C, Gillman M, Golden J, Kukla R, Kuzawa C, Rich-Edwards J. Don’t blame the mothers. Nature. 2014;512:131–2 .This paper focuses on the potential for mother-blame in communicating DOHaD science, and calls for targeted communication work to help eliminate that risk CrossRefPubMedGoogle Scholar
- 38.Fillmore C. Frame semantics. In: Linguistic Society of Korea, editor. Linguistics in the morning calm. Seoul: Hanshin Publishing Co; 1982. p. 111–37.Google Scholar
- 42.Bernstein J. All together now: common sense for a fair economy. San Francisco: Berrett-Koehler Publishers; 2006.Google Scholar
- 43.Haidt J. The righteous mind: why good people are divided by politics and religion. New York: Pantheon Books; 2012.Google Scholar
- 44.Goffman E. Stigma: notes on the management of a spoiled identity. Prentice Hall: Englewood Cliffs; 1963.Google Scholar
- 50.Ettema JS, Peer L. Good news from a bad neighborhood: toward an alternative to the discourse of urban pathology. J Mass Commun. 1996;73:835–56.Google Scholar
- 51.Syme SL. The social-environment and health. Daedalus. 1994;123(4):79–86.Google Scholar
- 53.Rose G. The strategy of preventive medicine. New York: Oxford University Press; 1992.Google Scholar
- 54.Chavez V, Duran B, Baker QE, Avila MM, Wallerstein N. The dance of race and privilege in CBPR. In: Minkler M and Wallerstein N, editors. Community-based participatory research for health: from process to outcomes (2nd ed.). San Francisco: Jossey-Bass; 2008.Google Scholar
- 55.Duran B, Wallerstein N, Minkler M, Foley K. Developing and maintaining partnerships with communities. In: Israel BA, Eng E, Schulz AJ, Parker EA, Satcher D, editors. Methods in community-based participatory research for health. San Francisco: Jossey-Bass; 2005.Google Scholar
- 56.Wallack L, Woodruff K, Dorfman L, Diaz I. News for a change: an advocate’s guide to working with the media. Thousand Oaks: Sage Publications; 1999.Google Scholar
- 62.Nader R. Unsafe at any speed: the designed-in dangers of the Amercian automobile. New York: Grossman Publishers; 1965.Google Scholar
- 63••.Messer LC, Boone-Heinonen J, Mponwane L, Wallack L, Thornburg KL. Developmental programming: priming disease susceptibility for subsequent generations. Curr Epidemiol Rep. 2015;2(1):37–51 .This paper provides an in-depth discussion of how first and second hit effects may accumulate over multiple generations, manifesting as persistent intergenerational health disparities CrossRefPubMedPubMedCentralGoogle Scholar
- 64••.Boone-Heinonen J, Messer LC, Fortmann SP, Wallack L, Thornburg KL. From fatalism to mitigation: a conceptual framework for mitigating fetal programming of chronic disease by maternal obesity. Prev Med. 2015;81:451–9 .This paper provides an in-depth discussion of how the first and second hits framework can be applied to mitigating fetal priming effects within the domain of public health CrossRefPubMedGoogle Scholar
- 74.Van den Hove DL, Leibold NK, Strackx E, Martinez-Claros M, Lesch KP, Steinbusch HW, et al. Prenatal stress and subsequent exposure to chronic mild stress in rats; interdependent effects on emotional behavior and the serotonergic system. Eur Neuropsychopharmacol. 2014;24(4):595–607.CrossRefPubMedGoogle Scholar
- 87.Williams A. The Haddon matrix: its contribution to injury prevention and control. In: McClure R, editor. Third national conference on injury prevention and control. Queensland: Brisbane; 1999.Google Scholar
- 91.Wall LL. Preventing obstetric fistulas in low-resource countries: insights from a Haddon matrix. Obstet Gynecol Surv. 2012;67(2):111–21.Google Scholar