Life Course Approach to Public Health Flashcards
What is the life course approach - define?
Each life stage influences the next - & together the social, economic & physical environments we live in have a profound influence on our health & the health of our community
What does the life course approach encompass - & so what does this mean this approach is described as?
-Bio factors
-Beh factors
-Psych factors
-Soc factors
-Env factors
–> over life course = shapes health outcomes
= integrated continuum determines health (isn’t stand alone)
Why is the life course approach a useful way of understanding what determines health?
-Takes temporal, societal - perspectives of people’s health
-Recognises all stages of someone’s life = intricately intertwined
What does it mean for health if a life course approach is adopted?
-Take ACTION EARLY in life-course:
–> & APPROPRIATELY during life transitions (from e.g., adolescence - to adulthood)
–> & TOGETHER as a whole society
What is life course epidemiology?
Study of: behavioural, biological & psychosocial processes linking adult health & disease to physical or social exposures during gestation, childhood, adolescence, young adulthood & midlife –> as these affect chronic disease risk & health outcomes in later life
–> aims to identify underlying bio, beh & psychosocial processes across life span
What is the broad scope - of life course epidemiology?
Interdisciplinary research area on human health & ageing - psych, cog, bio research on developmental processes from conception -> death
What is the fetal origins hypothesis
Env exposures e.g., under-nutrition during critical periods of growth & development in utero can = long term effects on adult chronic disease risk by “programming” structure/function of organs, tissues, or body systems
(i.e., what happens in utero programmes - determines - what happens in later life)
What does the life course approach incorporate?
*Fetal origins hypothesis
*Critical periods (when are vulnerable)
*Sensitive developmental stages
*Long term consequences of bio & soc experiences
*–> add risk OR act interactively
*Cohort effect
What 2 approaches is life-course epidemiology built on?
-Bio programming
-‘Life-style’
What is biological programming?
Adult behs (e.g., smoking, diet, exercise) = affect onset & progression of diseases in adulthood
–> i.e., people are programmed biologically
What is the ‘life-style’ approach?
Summarise what life-course epidemiology is built upon?
Bio & soc factors throughout life = independently
cumulatively & interactively influence health & disease in adult life
What are the 4 conceptual models of the life course?
1 = stage in life where are particularly vulnerable - e.g., folic acid & furaldehyde in pregnancy (in utero)
2 = health in spec time determines health in later life - e.g., daughter - mother had gestational diabetes in pregnancy - more likely daughter will get in pregnancy too - or get type II diabetes
3 = girl with absent father or step-father - later menstruation
4 = obesity - chain of events
Give a schematic for the interlinking biological & psychosocial exposures acting across life course that may influence lung function and/or respiratory disease.
a = bio pathway
b = soc pathway
c = socio-bio pathway - soc circumstances lead to bio outcomes
d = bio-soc pathway - if not well = don’t attend school
Explain pathways a-d.
a = bio pathway - impaired fetal development of lung structure = linked to future resp illness from infections & higher susceptibility to impaired lung function as adult &/OR COPD
b = soc pathway - adverse childhood socioeconomic position influences adverse childhood exposures & adult socioeconomic position & smoking beh
c = socio-bio - adverse childhood socioeconomic position - linked to post-natal lung function - so poor adult lung function - due to affects on imm syst & likely exposure to infection
d = bio-social pathway - repeated childhood infections = adverse educational attainment (not @ school) & lower adult socioeconomic position
Give a schematic for the possible influences of hierarchical & life-course exposures on disease risk across 3 related individuals.
Explain the schematic for the possible influences of hierarchical & life-course exposures on disease risk across 3 related individuals.
-Grandparents, parents & children = linked across generations by common genetic &/or social influences
-Potential role of household, neighbourhood & national influences = act across time & across
individuals
–> e.g., adverse neighbourhood conditions could affect mother & child (A)
–> e.g., war time rationing - may be specific to a single population cohort (B) OR period effects may be experienced by all individuals (C)
What are protective & risk factors within the life course approach?
What are the different life stages within the life-course approach?
Compare rates of mortality from respiratory disease, cardiovascular disease, preventable diseases & suicide across different age groups - between the most & least deprived?
Compare causes of mortality across different life-stages.
Give some examples of acting appropriately in terms of the life-course approach?
Give some examples of acting together in terms of the life-course approach?
What allows for the perpetuation of health inequalities across the life-course & across generations?
If grow up in env w/ many risk factors (instead of protective factors)
(VS if grow up in env w/ more protecting factors & few risk factors)
How can actions be taken to promote health equity & tackle health inequalities across the life-course?
Are places encouraging/allowing people to live healthy lives
What is the model to express all of the intertwining factors influencing health - graded into levels?
Ecological Model of Health (= essentially the rainbow model - but this one also encompasses life course stages)
—> shows the cumulative effects determining how we age
—> shows the dynamic interrelations among various personal & env factors
Summarise the life-course approach in terms of the Minsk Declaration (one which focussed on this life-course approach in PH - targeting health inequalities)?
