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A Life Course Approach Resource Guide Developed by the MCH Training Program


The life course approach to conceptualizing health care needs and services evolved from research documenting the important role early life events play in shaping an individual’s health trajectory.  The interplay of risk and protective factors, such as socioeconomic status, toxic environmental exposures, health behaviors, stress, and nutrition, influence health throughout one’s lifetime. 

This emerging science on gene-environment interactions touches on several aspects of public health, including health disparities, fetal origins of adult disease, and outcomes related to prenatal and preconception health and health care.  Since introduced, life course has become a prominent framework for conceptualizing health, and scholars and practitioners are exploring application to MCH practice.

A number of key resources are identified below in the hopes that MCH Training Programs will partner with MCHB in exploring the implications of life course perspectives for our collective efforts to improve the health and well-being of all women, children, youth and families now, and over future generations.  Stay tuned – as new studies and program efforts are continually emerging, MCHB will provide updated information on resources from time to time.

MCHB Life Course Concept Paper

Rethinking MCH: The Life Course Model as an Organizing Framework: A Fine, M Kotelchuck

MCH Life Course Research Network

MCH Life Course Recorded Webinar

Federal Overview: MCHB’s Current and Future Life Course Activities
Thursday, May 19, 2011
1:15pm Eastern

Fact Sheets and Policy Briefs

Halfon N. 2009. “Life Course Health Development: A New Approach for Addressing Upstream Determinants of Health and Spending.” Expert Voices, NIHCM Foundation, Washington, DC.

Fine A, Kotelchuck M, Adess N, Pies C. 2009.  Policy Brief. A New Agenda for MCH Policy and Programs: integrating a Life Course Perspective.; Martinez, CA. Contra Costa Health Services.

Shonkoff JP 2009. Mobilizing science to revitalize early childhood policy. Issues Sci Technol 2009; 26(1): Retrieved from

Pies C, Parthasarathy P, Kotelchuck M, Lu M. 2009. Making a Paradigm Shift in Maternal and Child Health;: A Report on the National MCH Life Course Meeting. Martinez, CA. Contra Costa Health Services.

Grason H and Misra D. 2006. Application of a Lifecourse and Multiple Determinants Framework to Improve Maternal Health. Baltimore, MD. Women’s and Children’s Health Policy Center. Johns Hopkins Bloomberg School ofPublic Health.

The Impact of Early Adversity on Children’s Development, 2009. Cambridge, MA. Harvard Center on the Developing Child.

Peer-Review Journal Articles


Hertzman C, Boyce T. How experience gets under the skin to create gradients in developmental health. Annu Rev Public Health, 2010.31:329-347.

Power C, Hertzman C. Social and biological pathways linking early life and adult disease. British Medical Bulletin 1997,53(No 1):210-221.

Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of in uero and early-life conditions on adult health and disease. N Engl J Med 359;1.

Kuh D, Ben-Shlomo Y, Lynch J, Hallqvist J, Power C. Life course epidemiology. J Epidemiol Community Health 2003;57:778-783.

Ben-Shlomo Y, Kuh D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives.

International Journal of Epidemiology 2002;31:285-293. 

Additional Articles of Interest

Halfon N Hochstein M. Life course health development: An integrated framework for developing health policy, and research The Milbank Quarterly 2002;80(3):433-479.

Misra D, Guyer B, Allston A.  Integrated perinatal health framework: a multiple determinants model with life span approach. American Journal of Preventive Medicine 2003;25(1):65-75.

Lu M, Halfon N. Racial and ethnic disparities in birth outcomes: a life course perspective. Maternal and Child Health Journal 2003:7(1):13-30.

Kotelchuck, M. Building on Life-Course Perspective in Maternal and Child Health

Maternal and Child Health Journal 2003;7(1): 1-74

Wise PH. Framework as Metaphor: The promise and peril of MCH life-course perspectives.

Maternal and Child Health Journal 2003;7(3): 151-156

Forrest CV, Riley AW Childhood origins of adult health: A basis for life-course health policy. Health Affairs 2004;23(5): 155-64.

Misra DP, Grason H. Achieving safe motherhood: Applying a life course and multiple determinants perinatal health framework in public health. Women’s Health Issues 2006;6:159-175.

Guyer B, Ma S, Grason H, Frick K, Perry D, Sharkey A, McIntosh J. Early childhood health promotion and its life course health consequences. Academic Pediatrics 2009;9(3), 142-149.

Braveman P, Barclay C. Health disparities beginning in childhood: A life-course perspective. Pediatrics 2009; 124 Supplement: S163-S175.

Wise PH. Confronting social disparities in child health: A critical appraisal of life-course science and research. Pediatrics 2009; 124 Supplement: S203-S211.

Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: Building a new framework for health promotion and disease prevention. JAMA 2009; 301(21): 2252-2259.

Shonkoff JP. Building a new biodevelopmental framework to guide the future of early childhood policy. Child Dev 2010; 81(1): 357-367.

Harris KM. An integrative approach to health. Demography. 2010; 47(1): 1-22.

Lu MC, Kotelchuck M, Hogan V, Jones L, Wright K, Halfon N. Closing the black-white gap in birth outcomes: A life-course approach. Ethn Dis 2010; 20(1) Supplement 2: S2-62-76.

Kotelchuck M. Evaluating the Healthy Start program: A life course perspective. Matern Child Health J. 2010 14:649-653.

Miller WD, Sadegh-Nobari T, Lillie-Blanton M. Healthy starts for all. Policy Prescriptions. Am J Prev Med 2011;40(1S1)S19-S37.

Presentations and Course Lecture Series

Moving Theory to Practice: Life Course, Social Determinants, and Health Equity Framework. The Maternal and Child Health Life Course Model. Milto Kotelchuck presentarion Video, Slides

The Science of Child Development and the Future of Early Childhood Policy. 2008. Jack Shonkoff, Center on the Developing Child, Harvard University.  Presentation from the National Symposium on Early Childhood Science and Policy. Video (73 minutes)   

Foundations of Lifelong Health. National Scientific Council on the Developing Child and the National Forum on Early Childhood Policy and Programs. Video (7 minutes)  

Life Course Health Development: A Framework to Guide Research, Practice, and Health Reform. 2008. Neal Halfon. CityMatCH Emerging Issues in MCH (EMCH) Webcast.  

The Intersection of Life Course, Health Equity and Social Determinants of Health: Translation to Action. 2009. Vijaya Hogan. MCHB Federal/State Partnership Meeting October 25-27, 2009 Webcasts. 

Audio Lecture Series (13) and Course Readings.
Health Across the Life Span. Johns Hopkins Bloomberg School of Public Health. K Mmari & H Mosley, Instr.

Health Disparities Free OnLine Training Courses from the National Network of Public Health Training Centers   

Eliminating Health Disparities and achieving equity: a framework for advancing the health, safety and well-being of adolescents (1.5 hrs, webinar) 

Web Resources and Toolkits

Harvard Center on the Developing Child —  

CityMatCH Life Course Toolbox —  

Community Health and Program Services (CHAPS) resources —  

Examples of Local Initiatives

Northern Manhattan Perinatal Partnership

Harlem Children’s Zone

Contra Costa (CA) Health Department and 12 point plan fact sheet

Wisconsin Department of Health Services