Life Course Approaches to the Causes of Health Disparities

TLDR

Life course approaches link socially patterned physical, environmental, and socioeconomic exposures across development to health disparities by combining developmental and structural perspectives that explain how sensitive life stages and social positioning shape health trajectories within and across generations. The study argues that incorporating life course perspectives into etiologic and intervention research will advance the science of health disparities. To operationalize this integration, the authors propose four strategies: deepen understanding of multiple exposures and their interactions, embed life course concepts into biological mechanisms, investigate transgenerational transmission of disparities, and apply life course insights to health disparity interventions.

Abstract

Reducing health disparities requires an understanding of the mechanisms that generate disparities. Life course approaches to health disparities leverage theories that explain how socially patterned physical, environmental, and socioeconomic exposures at different stages of human development shape health within and across generations and can therefore offer substantial insight into the etiology of health disparities. Life course approaches are informed by developmental and structural perspectives. Developmental perspectives emphasize how socially patterned exposures to risk factors during sensitive life stages shift health trajectories, whereas structural perspectives emphasize how social identity and position within socially patterned environments disproportionately allocate risk factors and resources, resulting in altered health trajectories. We conclude that the science of health disparities will be advanced by integrating life course approaches into etiologic and intervention research on health disparities. The following 4 strategies are offered to guide in this process: (1) advance the understanding of multiple exposures and their interactions, (2) integrate life course approaches into the understanding of biological mechanisms, (3) explore transgenerational transmission of health disparities, and (4) integrate life course approaches into health disparities interventions.