Early Life Experience + Health

Question 1

Describe the Lifecourse Approach to Epidemiology

Answer 1

-Proposes that the combination, accumulation and/or interaction of the social environments and biological insults experienced through the life course impact current and future events, environments, and health conditions and thus ultimately impact adult health

Question 2

Latent Effect Model

Answer 2

Considers how an earlier adverse events increases risk later in life, independent of later exposures

Question 3

Cumulative Model

Answer 3

Considers how physiological and psychological exposures accumulate over the life course to influence risk of disease

Question 4

Pathway & Chain of Risk Models

Answer 4

Considers the sequence of exposures that can increase or decrease risk for a negative outcome

• -Early experiences may place individuals onto a trajectory of risk
• -Overlaps with the accumulation model

With Additive Effect:
*each risk factor contributes to disease onsent
A –> B–> –>C –> outcome

With Trigger Effect:
*final link (C) is what determines disease onset
A –> B–> –>C –> outcome

Question 5

Intergenerational Risk

Answer 5

Example:

• -Maternal and paternal CVD mortality associated with birth weight of offspring
• -Low birth weight associated with risk of subsequent CVD

Important implications for population health: to improve health disparities, need to identify the time that the detrimental exposure occurs

Question 6

Relevance to Chronic Disease Prevention

Answer 6

1. Identify individuals in the greatest need of intervention to reduce risk
2. Evaluate whether prevention-oriented interventions are effective for reducing later risk for CVD.

Question 7

What are the empirical challenges of lifecourse data collection

Answer 7

• Longitudinal data = expensive to collect; may have to wait decades for outcomes
• Challenging to account for loss to follow-up
• Sequential complexity: requires knowledge of timing of exposure and outcome
• Requires detailed social and biological data to provide evidence for life course models

Question 8

Developmental Perspective

Answer 8

Chronicity of exposure
Timing of exposures

Ex: Males who moved before age 13 = profoundly better outcomes than males who moved after age 13

Question 9

Dimensional Approaches

Answer 9

different constructs affect outcomes in different ways

Ex: Experiences of threat vs Experiences of Deprivation, both affect emotional processing in different ways

Question 10

Evidence fo Effective Lifecourse Interventions

Answer 10

1. Individual/family interventions
   - -interventions to promote physiological improvements in stress-response physiology are EFFECTIVE
2. School-based interventions
   - -programs with daily classes, home visits saw increased hs graduations, employment rates over time
3. Policy interventions
   - -assisted housing for example. = improved blood lead levels