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Integrating the Life Course Perspective into a Local Maternal and Child Health Program

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Abstract

For many decades, early access to prenatal care has been considered the gold standard for improving birth outcomes. In Contra Costa County, a diverse urban and suburban county of over one million people in the San Francisco Bay Area, the Family Maternal and Child Health Programs of Contra Costa Health Services (CCHS) have seen high rates of early entry into prenatal care since 2000. Yet despite our best efforts to increase access to quality prenatal care, our rates of low birth weight and infant mortality, especially among African Americans, continue to be high. When we were introduced to the Life Course Perspective in 2003 as an organizational framework for our programmatic activities, we recognized that emerging scientific evidence in the literature demonstrated the importance of social and environmental factors in determining health and health equity, and supported a general impression in the field that prenatal care was not enough to improve birth outcomes. The Life Course Perspective suggests that many of the risk and protective factors that influence health and wellbeing across the lifespan also play an important role in birth outcomes and in health and quality of life beyond the initial years. In this article, we describe the Life Course Perspective and how one local Maternal and Child Health Program adopted and adapted this paradigm by creating and launching a Life Course Initiative to guide our programs and services. The Life Course Initiative implemented by CCHS is designed to reduce inequities in birth outcomes, improve reproductive potential, and change the health of future generations by introducing a longitudinal, integrated, and ecological approach to implementing maternal and child health programs.

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Acknowledgments

The authors want to thank the following individuals for their insights, suggestions, and critical review of this article: Wendel Brunner, MD, PhD; Debbie Casanova, MPH; Dawn Dailey, RN, PhD; Chuck McKetney, PhD, MPH; Michael C. Lu, MD, MPH; Milton Kotelchuck, PhD, MPH; the Contra Costa Health Services Writers Group, Meredith Minkler, DrPH, MPH, and Amy Fine, MPH. Funding for the writing of this article was provided by the Public Health Institute’s Adeline Hackett Innovation Award; Contra Costa Health Services; and California Department of Public Health, Maternal, Child and Adolescent Health Program.

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Authors and Affiliations

  1. School of Public Health, University of California, Berkeley, 279 University Hall, Berkeley, CA, 94720, USA

    Cheri Pies

  2. Family Maternal and Child Health Programs, 597 Center Avenue, Suite 365, Martinez, CA, 94553, USA

    Padmini Parthasarathy

  3. Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, MS85, Atlanta, GA, 30341, USA

    Samuel F. Posner

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  1. Cheri Pies
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  2. Padmini Parthasarathy
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  3. Samuel F. Posner
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Correspondence to Cheri Pies.

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Pies, C., Parthasarathy, P. & Posner, S.F. Integrating the Life Course Perspective into a Local Maternal and Child Health Program. Matern Child Health J 16, 649–655 (2012). https://doi.org/10.1007/s10995-011-0800-2

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  • DOI: https://doi.org/10.1007/s10995-011-0800-2

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