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Estimates project that one in three US adults may have diabetes in 2050. Until very recently, type 2 diabetes mellitus (T2DM) was a disease diagnosed in adults, but as the childhood obesity epidemic has spread, the diagnosis of T2DM in adolescents has become more common. Early indicators suggest that the disease may be more severe and more difficult to manage when diagnosed in adolescents. It is projected that adolescents with T2DM will lose approximately 15 years of life. The economic burden of T2DM rises significantly as the years with disease increase. This grim forecast highlights that not only will the disease burden be significant but the economic burden will be high. The risk for developing T2DM begins in utero. Individual health development trajectories build from this starting point, the result of multiple factors that accumulate across time and are the result of biological conditioning during sensitive developmental periods. A major aim of this chapter is to demonstrate that a life course health development approach to pediatric T2DM is critical to a sound national strategy to prevent and treat pediatric T2DM. We review major factors known to influence the development of pediatric T2DM and track these across childhood. While these factors will likely change over the next decade, what will not change is the importance of placing these factors into context and recognizing that T2DM development is highly sensitive to the timing and social structures of multiple environmental exposures. Research recommendations are discussed through a life course lens.

Life course health development (LCHD) incorporates theories and empirical evidence from the biological, physical, and social sciences to formulate a framework that explains how health develops over the life course. The life course health development conceptual framework can be applied to autism spectrum disorders (ASD) to help prioritize a research agenda and improve health development across the lifespan for individuals with ASD, their families, and communities. The following chapter highlights some issues and findings that are pertinent to an understanding of ASD using the lens of the life course health development principles. The chapter begins with a description of the clinical phenotype, followed by epidemiology of the disorder, and reviews changes in classification and diagnosis over time. Pathogenesis of the disorder is discussed, including information pertaining to hereditability, genetic and nongenetic factors, epigenetics, biomarkers, and genotype-phenotype correlations. Long-term follow-up outcome studies of adult independence and quality of life are reviewed, including examination of predictors of outcome, as well as stability of the diagnosis, symptom presentation, and cognitive functioning over time. Areas of key transitions over the life course are discussed from childhood to later adulthood. In addition, the importance of mental health status and care are highlighted. Finally, a number of research, data/methods, and translational priorities are offered that may help lead to a better understanding of life course health development in ASD.

Self-regulation has been shown to have important implications for individual trajectories of health and well-being across the life course. The present chapter examines the development of self-regulation from a life course health development (LCHD) perspective. Using the seven principles of LCHD and the relational developmental systems (RDS) framework, the chapter focuses on the importance of self-regulation for health and well-being over time and across contexts and examines the pathways of self-regulation including the individual, contextual, and sociocultural factors that influence the development of these skills over time, methods for studying self-regulation, and translational issues. The chapter concludes by providing recommendations for future research and for better integrating the principles of LCHD and RDS within the study of self-regulation.

This chapter outlines major concepts and principles embodied in the Life Course Health Development framework, examines evidence relating various aspects of major oral health-related conditions to this framework, and includes recommendations for advancing research and policy concerning oral health. LCHD provides a highly useful approach for understanding oral health determinants, disparities, and influences on general health and well-being and for advancing knowledge, policies, and programs to optimize health across individuals and populations. Substantial gaps exist in our current knowledge concerning how oral health is developed and influenced across the lifespan and the —pathways and trajectories, early programming, critical or sensitive periods, cumulative impact, and risk and protective factors—can help further our understanding of the determinants of oral health and disease and oral health disparities. LCHD also can serve as a valuable guide for developing a more contemporary conceptualization and definition of oral health which represents oral health as a more integral and integrated component of overall health and well-being of the individual.

Long-term survival for infants born extremely prematurely (<28 weeks of gestation) and extremely low birth weight (<1000 g) has increased dramatically due to obstetrical and neonatal advances. However, poverty, inequality, and resulting health disparities are significant contributors to women who give birth to preterm infants and also impact their children’s healthy development and education. While the vast majority of survivors of extreme prematurity do not have the most severe forms of neurodevelopmental disability (i.e., cerebral palsy, blindness, sensorineural hearing loss >55 dB, and intellectual disability), half of survivors can be expected to require special education services at kindergarten entry and during their school years. In addition, there are also high rates of health disparities in the prevalence of preterm birth across the spectrum of gestations including very preterm (28–31 weeks), moderate preterm (32–33 weeks), and late preterm births (34–36 weeks). Life course health development offers a valuable framework for examining how complex medical and social adversities that impact a mother’s health can also impact their child’s health and developmental trajectories. A better understanding of the cumulative impact of protective factors and other buffers that can support prenatal and postnatal parental and child health will provide important insights into how to promote greater resiliency and optimal health development. This population-based information can provide ongoing data for thriving developmental health trajectories for vulnerable preterm survivors with respect to physical, behavioral, and social health outcomes. Though premature infants who receive comprehensive early intervention and preschool educational supportive services have improved outcomes at kindergarten entry, school-age survivors, even those escaping major neurodevelopmental diagnoses, have challenges which impact attention, behavioral regulation, academic achievement, and social skills compared to their full-term peers. Unfortunately, many essential services that can contribute to better outcomes are unnecessarily fragmented and not systematically implemented to provide preventive interventions that optimize health, learning, executive function, social, and adaptive competencies. These cumulative medical, developmental, and social risks among preterm survivors adversely impact long-term adult physical and behavioral health, educational attainment, and social participation. In order to address these disparities, more precise, population-based, health development interventions aimed at optimizing physical and behavioral health, educational achievement, and adaptive competencies will be required. We recommend research strategies to inform our efforts for improving life course outcomes.

Challenges to hearing health are a significant public health problem. At least ten million Americans have a hearing loss that interferes with the understanding of normal speech. If lesser degrees of loss are included, the number rises to 28 million. Although there have been considerable advances in understanding the etiology of hearing loss, with genetic causes now thought to account for up to 50% of congenital losses, in many individual cases, the cause of hearing loss remains unknown. This lack of knowledge of the basic pathophysiology of hearing difficulties hampers prevention and treatment efforts. Growing interest in life course theory has led to suggestions that it could prove useful to apply a life course lens to the study of hearing loss, and of hearing health, throughout the life span. In this paper we consider the implications of the Life Course Health Development model for understanding the mechanisms, pathways, and determinants of hearing ability. We consider the implications of early hearing loss for health development over the life course and the factors through the life course that contribute to hearing ability in adult life. We consider the concept not just of hearing loss but of “hearing health” and how to achieve it, the research priorities that are suggested by this review, and the implications for policy and practice.

Chronic kidney disease (CKD) reflects life events that range from maternal-fetal influences to geriatric exposures. The global direct and indirect costs of CKD are high and include maternal-neonatal hospitalization and treatment, acute kidney injury, dialysis and transplant, missed work, and medications, to name a few. The impact of poor diet, adverse childhood experiences, medication use, and failure to follow consistent public health standards are increasingly appreciated as key influences in the development of CKD. Socioeconomic factors can significantly influence the timing and phenotypic expression in people at risk for developing CKD, although more research is needed to understand these mechanisms. In general, biomedicine has been focused on treating well-established CKD morbidity. This strategy has been short sighted and costly. A more cost-effective approach would focus on early life interventions that hold the potential for mitigating CKD risk and its sequelae. This chapter applies the life course health development principles to review determinants and pathways for CKD evolution and identifies of the gaps in our knowledgebase. We also discuss several research strategies for evaluating the life course health development of CKD.

Physical growth is an emergent process integrating a complex network of social, biological, and environmental interactions. The global diversity of body shapes and sizes reflects developmental plasticity in response to environmental exposures, both advantageous and adverse, and depicts an evolutionarily robust strategy for species’ survival. Epidemiologic surveillance efforts demonstrate that early life skeletal growth and body composition trajectories are associated with and predict adult chronic disease risks. Both human and animal studies have provided an evidentiary base for the physiological mechanisms by which differences in growth processes manifest as cell- and organ-level changes that influence disease susceptibility across the life course. This chapter leverages a systems biology approach to describe macro- and micropathways affecting growth from a global perspective, reflecting on auxology’s place in theoretical frameworks that help us to understanding past, present, and future health trends. Methodological challenges that face the field are considered, and recommendations to guide future research and policy efforts are offered with the aim of advancing the science of growth biology and its contributions to life course health development.

Nutrition is a young science. For thousands of years, foods and herbs were a major component in the armamentarium of the physician and his predecessors.

Socioeconomic disadvantage (SED) has adverse impacts on physical (Adler and Rehkopf 2008; Blair and Raver 2012; Braverman and Egerter 2008; Cohen et al. 2010; Poulton et al. 2002) and psychological (Adler and Rehkopf 2008; Bradley and Corwyn 2002; Grant et al. 2003) health development. SED is similar to low socioeconomic status (SES) which is based on occupation, income, and education or a composite of more than one of these indicators (McLoyd 1998). However, we conceptualize SED more broadly than socioeconomic status to also include subjective perception of social position and contextual indicators of disadvantage, such as neighborhood deprivation. One of the most commonly used SED indicators is poverty, which is calculated using income that falls below an annually adjusted federal poverty line. Some studies suggest independent effects of different SED variables, but each variable tends to be highly correlated with the others; thus, it is often nearly impossible to disentangle independent effects. Therefore, in this chapter, we will review findings on different SED variables but discuss the impact of SED inclusively. In adulthood, SED is assessed based on factors in an individual’s own background such as income, occupation, and education level, whereas in childhood, SED is typically assessed based on these factors for the parents.