Skip to main content

Advertisement

SpringerLink
Log in

An integrative approach to health

  • Published:
Demography

Abstract

In this article, I make the case for using an integrative approach to health, broadly defined as social, emotional, mental, and physical well-being; for studying health among the young as an important marker for future health and well-being across the life course; and for understanding health disparities among the young as both causes and consequences of social stratification. An integrative approach bridges biomedical sciences with social and behavioral sciences by understanding the linkages between social, behavioral, psychological, and biological factors in health. It is furthermore vital that integration occur in all steps of the research process: in theory, design, data collection, and analysis. I use the National Longitudinal Study of Adolescent Health, or Add Health, as an example of an integrative approach to health and of the importance of adolescence and the transition to adulthood years for setting health trajectories into adulthood. Evidence is also presented on the linkages between health trajectories during adolescence and the transition to adulthood and social stratification in adulthood.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adler, N.E., W.T. Boyce, M. Chesney, S. Folkman, and L. Syme. 1993. “Socioeconomic Inequalities in Health: No Easy Solution.” Journal of the American Medical Association 269: 3140–45.

    Article  Google Scholar 

  • Alba, R. and V. Nee. 2005. Remaking the American Mainstream: Assimilation and Contemporary Immigration. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • American Diabetes Association. 2007. “Diagnosis and Classification of Diabetes Mellitus.” Diabetes Care 30(S1): S42-S47.

    Article  Google Scholar 

  • Andersen, R.E., C.H. Crespo, S.J. Bartlett, L.J. Cheskin, and M. Pratt. 1998. “Relationship of Physical Activity and Television Watching With Body Weight and Level of Fatness Among Children: Results From the Third National Health and Nutrition Examination Survey.” Journal of the American Medical Association 279: 938–42.

    Article  Google Scholar 

  • Aram, V., G.L. Bakris, H.R. Black, W.C. Cushman, L.A. Green, J.L. Izzo, Jr., D.W. Jones, B.J. Materson, S. Oparil, J.T. Wright, Jr., E.J. Roccella, and the National High Blood Pressure Education Program Coordinating Committee. 2003. “Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.” Hypertension 42: 1206–52.

    Article  Google Scholar 

  • Bachman, J.G., K.N. Wadsworth, P.M. O’Malley, L.D. Johnson, and J.E. Schulenberg. 1997. Smoking, Drinking, and Drug Use in Young Adulthood. Mahwah, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Bergner, L. 1993. “Race, Health, and Health Services.” American Journal of Public Health 7: 939–41.

    Article  Google Scholar 

  • Bongaarts, J. and R.G. Potter. 1983. Fertility, Biology, and Behavior: An Analysis of the Proximate Determinants. New York and London: Academic Press.

    Google Scholar 

  • Centers for Disease Control and Prevention. 2008. National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2007. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

    Google Scholar 

  • Cleveland, H.H. and R.P. Wiebe. 2003. “The Moderation of Adolescent-to-Peer Similarity in Tobacco and Alcohol Use by School Levels of Substance Use.” Child Development 74: 279–91.

    Article  Google Scholar 

  • Cohen-Cole, E. and J.M. Fletcher. 2008 “Is Obesity Contagious? Social Networks vs. Environmental Factors in the Obesity Epidemic.” Journal of Health Economics 27: 1382–87.

    Article  Google Scholar 

  • Cole, T.J., M.C. Bellizi, K.M. Flegal, and W.H. Dietz. 2000. “Establishing a Standard Definition for Child Overweight and Obesity Worldwide: International Survey.” British Medical Journal 320: 1240–43.

    Article  Google Scholar 

  • Cook, S., M. Weitzman, P. Auinger, M. Nguyen, and W.H. Dietz. 2003. “Prevalence of a Metabolic Syndrome Phenotype in Adolescents.” Archives of Pediatrics & Adolescent Medicine 157: 821–27.

    Article  Google Scholar 

  • Coresh, J., D. Byrd-Holt, B.C. Astor, J.P. Briggs, P.W. Eggers, D.A. Lacher, and T.H. Hostetter. 2005. “Chronic Kidney Disease Awareness, Prevalence, and Trends Among U.S. Adults, 1999 to 2000.” American Society of Nephrology 16: 180–88.

    Article  Google Scholar 

  • Crimmins, E.M. and T. Seeman. 2000. “Integrating Biology Into Demographic Research on Health and Aging.” Pp. 9–41 in Cells and Surveys: Should Biological Measures Be Included in Social Science Research?, edited by C.E. Finch, J.W. Vaupel, and K. Kinsella; Committee on Population, Commission on Behavioral and Social Sciences and Education, National Research Council. Washington, DC: National Academies Press.

    Google Scholar 

  • Cubbin, C., J. Santelli, C.D. Brindis, and P. Braveman. 2005. “Neighborhood Context and Sexual Behaviors Among Adolescents: Findings From the National Longitudinal Study of Adolescent Health.” Perspectives on Sexual and Reproductive Health 37: 125–34.

    Article  Google Scholar 

  • Dion, M.R. 2005. “Healthy Marriage Programs: Learning What Works.” The Future of Children 15: 139–56.

    Article  Google Scholar 

  • Dublin, L.I., A.J. Lotka, and R.J. Horton. 1937. Twenty-Five Years of Health Progress. New York: Metropolitan Life Insurance Company.

    Google Scholar 

  • Duncan, G.E. 2006. “Prevalence of Diabetes and Impaired Fasting Glucose Levels Among US Adolescents: National Health and Nutrition Examination Survey, 1999–2002.” Archives of Pediatrics and Adolescent Medicine 160: 523–28.

    Article  Google Scholar 

  • Duncan, G.J., K.M. Harris, and J. Boisjoly. 2001. “Sibling, Peer, Neighbor and Schoolmate Correlations as Indicators of the Importance of Context for Adolescent Development.” Demography 38: 437–47.

    Article  Google Scholar 

  • Evans, R.G. and G.L. Stoddart. 1990. “Producing Health, Consuming Health Care.” Social Science and Medicine 31: 1347–63.

    Article  Google Scholar 

  • Furstenberg, F.F. Jr. 2000. “The Sociology of Adolescence and Youth in the 1990s: A Critical Commentary.” Journal of Marriage and the Family 62: 896–910.

    Article  Google Scholar 

  • Glass, D.V. 1973. The Development of Population Statistics. Farnborough, England: Greg International.

    Google Scholar 

  • Goldberg, J., W. Hayes, and J. Huntley. 2004. “Understanding Health Disparities.” Background paper (November). Health Policy Institute of Ohio, Columbus, OH.

    Google Scholar 

  • Guilamo-Ramos, V., J. Jaccard, R. Turrisi, and M. Johansson. 2005. “Parental and School Correlates of Binge Drinking Among Middle School Students.” American Journal of Public Health 95: 894–99.

    Article  Google Scholar 

  • Guo, G., Y. Tong, and T. Cai. 2008. “Gene by Social-Context Interactions for Number of Sexual Partners Among White Male Youths: Genetics-Informed Sociology.” American Journal of Sociology 114(Suppl.): S36-S66.

    Article  Google Scholar 

  • Halfon, N. and M. Hochstein. 2002. “Life Course Health Development: An Integrated Framework for Developing Health, Policy, and Research.” The Milbank Quarterly 80: 433–79.

    Article  Google Scholar 

  • Harris, K.M., P. Gordon-Larsen, K. Chantala, and J.R. Udry. 2006. “Longitudinal Trends in Race and Ethnic Disparities in Leading Health Indicators From Adolescence to Young Adulthood.” Archives of Pediatrics and Adolescent Medicine 160: 74–81.

    Article  Google Scholar 

  • Harris, K.M., C.T. Halpern, E. Whitsel, J. Hussey, J. Tabor, P. Entzel, and J.R. Udry. 2009. The National Longitudinal Study of Adolescent Health: Research Design. Available online at http://www.cpc.unc.edu/projects/addhealth/design.

  • House, J.S. 2002. “Understanding Social Factors and Inequalities in Health: 20th Century Progress and 21st Century Prospects.” Journal of Health and Social Behavior 43: 125–42.

    Article  Google Scholar 

  • House, J.S., K. Landis, and D. Umberson. 1988. “Social Relationships and Health.” Science 241: 540–45.

    Article  Google Scholar 

  • Khoury, M.J., T.H. Beaty, and B.H. Cohen. 1993. Fundamentals of Genetic Epidemiology. New York: Oxford University Press.

    Google Scholar 

  • Kimbro, R.T., S. Bzostek, N. Goldman, and G. Rodriguez. 2008. “Race, Ethnicity, and the Education Gradient in Health.” Health Affairs 27: 361–72.

    Article  Google Scholar 

  • Kington, R.S. and H.W. Nickens. 2001. “Racial and Ethnic Differences in Health: Recent Trends, Current Patterns, Future Directions.” Pp. 253–310 in America Becoming: Racial Trends and Their Consequences, Vol. II, edited by N.J. Smelser, W.J. Wilson, and F. Mitchell. Washington, DC: National Academies Press.

    Google Scholar 

  • Lavoie-Tremblay, M. 2004. “Creating a Healthy Workplace: A Participatory Organizational Intervention.” Journal of Nursing Administration 34: 469–74.

    Article  Google Scholar 

  • Lee, H., K.M. Harris, and P. Gordon-Larsen. 2009. “Life Course Perspectives on the Links Between Poverty and Obesity During the Transition to Young Adulthood.” Population Research and Policy Review 28: 505–32.

    Article  Google Scholar 

  • Lindau, S. Tessler, P. Schumm, E.O. Laumann, W. Levinson, C.A. O’Muircheartaigh, and L.J. Waite. 2007. “A National Study of Sexuality and Health Among Older Adults in the U.S.” New England Journal of Medicine. 357: 762–74.

    Article  Google Scholar 

  • Mahler, H. 1975. “Health for All by the Year 2000.” WHO Chronicle 29: 457–61.

    Google Scholar 

  • Marmot, M.. 2004. Status Syndrome. London: Bloomsbury.

    Google Scholar 

  • Marmot, M. and R.G. Wilkinson, eds. 2005. Social Determinants of Health. Oxford: Oxford University Press.

    Google Scholar 

  • McGinnis, J.M. and W.H. Foege. 1993. “Actual Causes of Death in the United States.” Journal of the American Medical Association 270: 2207–12.

    Article  Google Scholar 

  • Mokdad, A.H., J.S. Marks, D.F. Stroup, and J.L. Gerberding. 2004. “Actual Causes of Death in the United States, 2000.” Journal of the American Medical Association 291: 1238–45.

    Article  Google Scholar 

  • —. 2005. “Correction: Actual Causes of Death in the United States, 2000.” Journal of the American Medical Association 293: 293–94.

    Article  Google Scholar 

  • Muntner, P., J. He, J.A. Cutler, R.P. Wildman, and P.K. Whelton. 2004. “Trends in Blood Pressure Among Children and Adolescents.” Journal of the American Medical Association 291: 2107–13.

    Article  Google Scholar 

  • National Center for Health Statistics. 2002. Health, United States, 2002. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • —. 2009. Health, United States, 2008. Hyattsville, MD, National Center for Health Statistics.

    Google Scholar 

  • National Research Council. 1993. Losing Generations: Adolescents in High-Risk Settings. Panel on High-Risk Youth, Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academies Press.

    Google Scholar 

  • —. 2000. Cells and Surveys: Should Biological Measures Be Included in Social Science Research?, edited by C.E. Finch, J.W. Vaupel, and K. Kinsella; Committee on Population. Commission on Behavioral and Social Sciences and Education, National Research Council. Washington, DC: National Academies Press.

    Google Scholar 

  • —. 2001. New Horizons in Health: An Integrative Approach, edited by B.H. Singer, and C.D. Ryff; Committee on Future Directions for Behavioral and Social Science Research at the National Institutes of Health. Washington, DC: National Academies Press.

    Google Scholar 

  • —. 2004. Children’s Health, the Nation’s Wealth: Assessing and Improving Child Health. Committee on Evaluation of Children’s Health, Board on Children, Youth, and Families. Washington, DC: National Academies Press.

    Google Scholar 

  • —. 2008. Biosocial Surveys, edited by M. Weinstein, J.W. Vaupel, and K.W. Wachter; Committee on Advances in Collecting and Utilizing Biological Indicators and Genetic Information in Social Science Surveys, Committee on Population, Division of Behavioral and Social Sciences and Education. Washington, DC: National Academies Press.

    Google Scholar 

  • Nowlin, P.R., and C.R. Colder. 2007. “The Role of Ethnicity and Neighborhood Poverty on the Relationship Between Parenting and Adolescent Cigarette Use.” Nicotine & Tobacco Research 9: 545–56.

    Article  Google Scholar 

  • Palloni, A. 2006. “Childhood Health and the Reproduction of Inequalities.” Demography 43: 587–615.

    Article  Google Scholar 

  • Pamuk, E., D. Makuc, K. Heck, C. Reuben, and K. Lochner. 1998. Health, United States. Socioeconomic Status and Health Chartbook. Hyattsville, MD: National Center for Health Statistics.

    Google Scholar 

  • Pinhas-Hamiel, O., L.M. Dolan, S.R. Daniels, D. Standiford, P.R. Khoury, and P. Zeitler. 1996. “Increased Incidence of Non-Insulin-Dependent Diabetes Mellitus Among Adolescents.” Journal of Pediatrics 128: 608–15.

    Article  Google Scholar 

  • Plomin, R., J.C. DeFries, G.E. McClearn, and P. McGuffin. 2001. Behavioral Genetics. 4th ed. New York: Worth Publishers.

    Google Scholar 

  • Richmond, T.K. and S.V. Subramanian. 2008. “School Level Contextual Factors Are Associated With the Weight Status of Adolescent Males and Females.” Obesity 16: 1324–30.

    Article  Google Scholar 

  • Rindfuss, R.R. 1991. “The Young Adult Years: Diversity, Structural Change, and Fertility.” Demography 29: 493–512.

    Article  Google Scholar 

  • Rogers, R.G. 1992. “Living and Dying in the USA: Sociodemographic Determinants of Death Among Blacks and Whites.” Demography 2: 287–303.

    Article  Google Scholar 

  • Sampson, R.J. 2003. “The Neighborhood Context of Well-being.” Perspectives in Biology and Medicine 46: S53-S64.

    Google Scholar 

  • Satcher, D. and E.J. Higginbotham. 2008. “The Public Health Approach to Eliminating Disparities in Health.” American Journal of Public Health 98: 400–403.

    Article  Google Scholar 

  • Schulenberg, J., J.L. Maggs, and K. Hurrelmann, eds. 1997. Health Risks and Developmental Transitions During Adolescence. Cambridge: Cambridge University Press.

    Google Scholar 

  • Settersten Jr., R.A., F.F. Furstenberg Jr., and R.G. Rumbaut, eds. 2005. On the Frontiers of Adulthood: Theory, Research, and Public Policy. Chicago: University of Chicago Press.

    Google Scholar 

  • Smith, K.P. and N.A. Christakis. 2008. “Social Networks and Health.” Annual Review of Sociology 34: 405–29.

    Article  Google Scholar 

  • Trogdon, J.G., J. Nonnemaker, and J. Pais. 2008. “Peer Effects in Adolescent Overweight.” Journal of Health Economics 27: 1388–99.

    Article  Google Scholar 

  • Uhlenberg, P., ed. 2009. International Handbook of Population Aging. Dordrecht: Springer.

    Google Scholar 

  • U.S. Department of Health and Human Services. 2000. Healthy People 2010: Understanding and Improving Health. Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • —. 2002. National Institutes of Health Strategic Research Plan and Budget to Reduce and Ultimately Eliminate Health Disparities, Volume I, Fiscal Years 2002–2006. Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Waite, L.J. 1995. “Does Marriage Matter?” Demography 32: 483–508.

    Article  Google Scholar 

  • Waller, M.R. and R. Swisher. 2006. “Fathers’ Risk Factors in Fragile Families: Implications for ‘Healthy’ Relationships and Father Involvement.” Social Problems 53: 392–420.

    Article  Google Scholar 

  • Williams, D.R. and C. Collins. 1995. “US Socioeconomic and Racial Differences in Health: Patterns and Explanations.” Annual Review of Sociology 21: 349–86.

    Article  Google Scholar 

  • —. 2001. “Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health.” Public Health Reports 116: 404–16.

    Google Scholar 

  • Williams, D.R. and P. Jackson. 2005. “Social Sources of Racial Disparities in Health.” Health Affairs 24: 325–34.

    Article  Google Scholar 

  • Williams, D.R., H.W. Neighbors, and J.S. Jackson. 2003. “Racial/Ethnic Discrimination and Health: Findings From Community Studies.” American Journal of Public Health 93: 200–208.

    Article  Google Scholar 

  • World Health Organization (WHO). 1948. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, No. 2, p. 100) and entered into force on 7 April 1948.

  • Young, T., E. Shahar, F.J. Nieto, S. Redline, A.B. Newman, D.J. Gottlieb, J.A. Walsleben, L. Finn, P. Enright, and J.M. Samet. 2002. “Predictors of Sleep-Disordered Breathing in Community-Dwelling Adults: The Sleep Heart Health Study.” Archives of Internal Medicine 162: 893–900.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Carolina Population Center, CB# 8120, University Square, 123 W. Franklin Street, 27516, Chapel Hill, NC

    Kathleen Mullan Harris

Authors
  1. Kathleen Mullan Harris
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kathleen Mullan Harris.

Additional information

Presidential Address to the Population Association of America, Detroit, MI, May 1, 2009.

This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and funded by Grant P01-HD31921 from the National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harris, K.M. An integrative approach to health. Demography 47, 1–22 (2010). https://doi.org/10.1353/dem.0.0091

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1353/dem.0.0091

Search

Navigation