To date, life course research in maternal and child health has largely focused on elucidating fetal and early life influences on adult health and less on promoting the health of children with special health care needs (CSHCN). Consideration of life course theory (LCT) for CSHCN is especially important given their increasing prevalence and comorbidity, their disproportionate vulnerability to weaknesses or instability in the health care system, and the growing evidence linking child and adult health and quality of life. In this commentary we seek to advance the consideration of LCT for CSHCN. We (1) briefly summarize key issues and the importance of a life course approach for CSHCN; (2) present illustrative findings from population-based cross-sectional data that serve to generate hypotheses that can be more rigorously examined when population-based longitudinal data become available; and (3) discuss the application of life course principles as a driving force in the continued implementation and improvement of integrated systems of care for CSHCN.
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Based on an analysis of data from the 2008 Medical Expenditures Panel Survey (MEPS) by the authors. A standard two-part model was used to estimate health expenditures controlling for child’s age, sex, race, US geographic region, and family income.
Life course theory
Children with special health care needs
National Survey of Children’s Health
National Survey of Children with Special Health Care Needs
Emotional, behavioral or development problems
Maternal and Child Health Bureau
Standardized developmental and behavioral screening
Developmental, behavioral and/or social
Individualized Family Services Plan
Individualized Education Plan
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Conflict of interest
The authors have no conflicts of interest to disclose.
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Bethell, C.D., Newacheck, P.W., Fine, A. et al. Optimizing Health and Health Care Systems for Children with Special Health Care Needs Using the Life Course Perspective. Matern Child Health J 18, 467–477 (2014). https://doi.org/10.1007/s10995-013-1371-1
- Life course
- Children with special health care needs
- Health care quality
- Medical home