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Historically, research examining health status disparities between members in different socioeconomic status and racial/ethnic groups often focused on adults and the concurrent lifestyle factors that might explain health differentials. Recent years have witnessed an explosion of interest in the developmental origins of adult health and disease, and life course-oriented research has proliferated across the social, biological, and health sciences. This chapter describes how an integrated life course health development framework can be applied to advance our understanding of the dynamic and multilevel processes contributing to health disparities across lifetimes and even generations. Examples of recent research that has examined health status disparities from a life course perspective are provided, and research gaps and challenges are reviewed. The chapter concludes with a set of recommendations for a more strategic and responsive life course-informed research agenda that not only can fill in gaps in current knowledge, but also pave the way for the translation of this knowledge into improvement in practice, programs, and policy aimed at alleviating health disparities.

The complexity of life course health development research demands rigorous methodology and analytics. Advanced techniques, improved estimation algorithms, and user-accessible software/hardware developments signal what I see as a paradigm shift in how life science research will be conducted now and in the future. Although techniques such as structural equation modeling (SEM), multilevel modeling (MLM), and mixture distribution modeling have permeated the research agenda in many fields, the capability of these tools has hardly been fully utilized. The craft of life course health development methodology and analytics requires dedication, sophistication, and a knack for molding the analysis tool to the research question at hand. For life course health development research to be at its most effective, utilizing the expertise of collaborative teams is essential. The days of one person being both expert theoretician and methodologist are waning. Partnering with dedicated experts on the various issues that I have outlined here will bring the needed sophistication and knack to execute research at its finest and most impactful levels. In this chapter, I highlight many of the issues that life course health development researchers will need to address and practices to adopt.

The central focus of life course epidemiology and life course approaches to health development is on the complex processes underlying the occurrence and accrual of risks at multiple levels and their impact on the developing individual. Reflecting the multilevel and integrated features of human health development that are at the centre of life course health-development (LCHD) principles, study designs seek better understanding of social, familial, and genetic contributions to the aetiology of health conditions, exploring the timing and interactions of different experiences and risks in relationship to the natural course of disorders in different populations and examining the time-specific and cumulative impacts of social and environmental factors. Many different study designs can advance a life course health-development framework. In this chapter we review common epidemiologic study designs including (i) cohort studies (general prospective cohort studies, perinatal/birth cohorts, twin studies, and high-risk cohort studies); (ii) case–control studies, including nested case–control studies within larger cohorts; (iii) cross-sectional studies; (iv) quasi-experimental designs; and (v) randomized controlled trials (RCTs). Although certain design strategies, namely, cohort studies, lend themselves more readily to the life course approach—examining the process of health development and its emphasis on emergent, person-context relations, and plasticity across the lifespan—we also describe other study designs that can be used to further our understanding of health and the development of different disorders and diseases from the life course perspective. The benefits and limitations of alternative design approaches are discussed using one study question as an example—investigating the relationship between traumatic experience and the development of a substance use disorder.

The National Longitudinal Surveys of Youth (NLSY) are a set of three separate US cohorts. Two of the cohorts, the NLSY79 and the NLSY97, are nationally representative, while the third, the NLSY79 Child and Young Adult cohort, follows the offspring born to female NLSY79 respondents. The NLSY79 began data collection in 1979 from an initial sample of 12,686 young men and women born between 1957 and 1964; the NLSY97 cohort, an initial group of 8984 young people born between 1980 and 1984, was first interviewed in 1997. Both the NLSY79 and NLSY97 cohorts have been interviewed annually or biennially since their inceptions. NLSY79 Child data were first obtained in 1986, when 4971 children were interviewed. Over 11,000 children have been born in total. The children have been regularly interviewed and/or assessed since 1986, many of them through their teens into their young adult years. Data for all three cohorts are remarkably suited for life course analysis due to the breadth of topical areas included in the interviews: health, education, employment, household information, family background, marital history, childcare, income and assets, attitudes, substance use, and criminal activity. The NLSY data also provide opportunities for multi-generational and kinship research. Data on health and recent research using NLSY health data are a focus of this chapter.

The Panel Study of Income Dynamics (PSID) is a nationally representative, longitudinal study of families in the USA that began in 1968. It is the longest-running household panel survey in the world. As of 2015, a total of 39 waves of data have been collected over 47 years. The study currently covers nearly 10,000 families and 25,000 individuals and has achieved reinterview response rates of 96–98% in virtually every wave. PSID interviews collect information on a wide range of economic, demographic, social, and health topics. The study has a genealogical design, and adult children of respondents who split off from their parents to form their own households are recruited into the study. In recent years, PSID has expanded its collection of data on children and young adults through the Child Development Supplement and Transition into Adulthood Supplement, which provide important opportunities to study the early life course. PSID data support research on poverty dynamics and its consequences for individual and family well-being, the intergenerational transmission of human and social capital and health status, and the family and contextual processes surrounding early human capital formation. PSID data and documentation are freely and publicly available on the Internet through the PSID Data Center. Restricted data with geocoded information and administrative data linkages are also available to authorized users under contract. PSID is a unique resource for answering many questions in life course health development research that can be answered with no other data source.

The Fragile Families and Child Wellbeing Study (FFCWS) is a nationally representative birth cohort study of approximately 4900 children born in large US cities between 1998 and 2000. Nonmarital childbearing increased dramatically in the second half of the twentieth century, raising questions about the capabilities of unmarried parents, the nature of parental relationships, and their implications for child health development and wellbeing. The FFCWS has become a leading source of information about unmarried parents and their children and about child health development more generally. The study contains biological and social indicators of children’s cognitive health development as well as social determinants of health and children’s broader social environment. This rich measurement, coupled with a longitudinal design and multilevel structure, makes it an ideal resource for life course health development research. This chapter describes the demographic, scholarly, and policy context in which the FFCWS was designed, as well as technical details that will enable new users to use the study effectively. We include details of sampling, data availability, variable structure and content, as well as features of the data that enable it to be used in longitudinal research. Finally, the chapter provides information about resources that will be available in the future and institutional resources available for users of the data.

Life course health science research is “connecting the dots” between child health development, adult patterns of premature morbidity and mortality, and more integrated notions of healthy aging. However, there are still many outstanding questions about the relationship between early experiences and lifelong health and well-being, as well as a growing need to understand how emerging knowledge can be applied to the development of evidence-based practice and policy that can reduce risks, minimize exposures, and optimize lifelong health. In 2010, the Maternal and Child Health Life Course Research Network (LCRN) initiated an inclusive research agenda-setting process that resulted in the Handbook of Life Course Health Development, which offers state-of-the-art reviews and analyses of life course health-development (LCHD) research focused on key life stages and a variety of health conditions, as well as recommendations pertaining to future research in these areas. In developing this concluding chapter and the research agenda it contains, we have attempted to synthesize the authors’ findings and recommendations in order to propose a more integrated set of research priorities and strategies that can advance the entire LCHD field. The resulting transdisciplinary research agenda focuses on foundational research, including research that addresses life course epidemiology, research that elucidates LCHD processes (e.g., sensitive periods, epigenetics), and research that identifies effective interventions, with a special emphasis on health disparities research and research on high priority conditions (e.g., obesity and mental health conditions) and specific vulnerable populations (e.g., children in foster care, premature infants, and children with medical complexity). It also considers essential research capacity-building activities focused on data, data systems, and methods, as well as strategies for building the human, technical, cultural, and financial capacity required to carry out this challenging work. Lastly, it addresses the importance of translational and intervention research that can speed the application of concepts and findings to the practice and policy arenas. We conclude with a discussion of advancing the overall LCHD research paradigm, including the framework and principles that have emerged from the research thus far and that are helping to define a robust explanatory and theoretical LCHD framework.