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Placing Health Trajectories in Family and Historical Context: A Proposed Enrichment of the Life Course Health and Development Model

Abstract

Purpose This article offers constructive commentary on The Life Course Health and Development Model (LCHD) as an organizing framework for MCH research. Description The LCHD has recently been proposed as an organizing framework for MCH research. This model integrates biomedical, biopsychosocial, and life course frameworks, to explain how “individual health trajectories” develop over time. In this article, we propose that the LCHD can improve its relevance to MCH policy and practice by: (1) placing individual health trajectories within the context of family health trajectories, which unfold within communities and societies, over historical and generational time; and (2) placing greater weight on the social determinants that shape health development trajectories of individuals and families to produce greater or lesser health equity. Assessment We argue that emphasizing these nested, historically specific social contexts in life course models will enrich study design and data analysis for future developmental science research, will make the LCHD model more relevant in shaping MCH policy and interventions, and will guard against its application as a deterministic framework. Specific ways to measure these and examples of how they can be integrated into the LCHD model are articulated. Conclusion Research applying the LCHD should incorporate the specific family and socio-historical contexts in which development occurs to serve as a useful basis for policy and interventions. Future longitudinal studies of maternal and child health should include collection of time-dependent data related to family environment and other social determinants of health, and analyze the impact of historical events and trends on specific cohorts.

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Acknowledgements

The authors wish to acknowledge the Department of Family Science at the University Of Maryland School Of Public Health for creating an interdisciplinary environment that has fostered the development of this research. Professor Elaine Anderson, the department chair, and school deans Robert Gold and Jane Clark, have made it possible for scholars like Jones, a social historian and health policy scholar, to collaborate with scholars like Roy, a human development and social policy scholar who has conducted life course studies on fatherhood, under the umbrella of an accredited school of public health. The authors also thank the participants in the 2012 Theory Construction and Research Methodology Workshop at the National Council on Family Relations annual conference for their feedback on an earlier version of this proposal.

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Correspondence to Marian Moser Jones.

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Jones, M.M., Roy, K. Placing Health Trajectories in Family and Historical Context: A Proposed Enrichment of the Life Course Health and Development Model. Matern Child Health J 21, 1853–1860 (2017). https://doi.org/10.1007/s10995-017-2354-4

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  • DOI: https://doi.org/10.1007/s10995-017-2354-4

Keywords

  • Life course
  • Family
  • Policy
  • Social determinants of health