Considering the individual in context for better health

A new book from APHA Press, Moving Life Course Theory into Action: Making Change Happen, maximizes opportunities to improve maternal and child health. Public Health Newswire asked the book’s editor, Sarah Verbiest, DrPH, a few questions about the new release.

Q: What is Life Course Theory?

A: The United States faces major systems of inequity, poorer health outcomes than other industrialized countries, significant wealth/health gaps, violence (in schools and on streets) and emerging crises, such as the opiate epidemic sweeping the country.

Disparities in outcomes and indicators across the maternal and child health spectrum illuminate the need for adaptive and courageous leadership, coupled with new approaches to address the complexity of these challenges and their solutions.

Life Course Theory offers a framework to prompt strategic thinking and action. It elevates the person in the context of his/her/their environment and community. The theory requires a consideration of the intergenerational impact a program may have. Interventions provided during sensitive periods of development may influence well-being over generations.

This approach recognizes that the accumulation of stress, lack of resources and systematic inequitable distribution of opportunity leads to disparities. LCT offers the chance for leaders to ask hard questions about current strategies and create an opening for doing things differently.

Q: What challenges did you face and discoveries did you make when putting together this book?

A: The book includes 38 co-authors representing a variety of fields and perspectives. Authors include social workers, public health leaders, clinicians, researchers, policy experts, activists, communications specialists and many others from a variety of settings, stages of career and experience. While corralling the many moving parts was a challenge, weaving the different voices and perspectives together to create a guide for emerging and seasoned professionals was rewarding.

While targeted toward a maternal and child health (MCH) audience, this work makes a case for engaging in systems outside of normal “swim lanes.” For instance, the chapter on Health in All Policies is an excellent reminder that policies are neither created in a vacuum, nor is their impact only felt in one arena. A theme that emerged from the book was the importance of developing new relationships with colleagues from different sectors and industries.

Q: How can the public health field best address the social context of health behaviors?

A: There are many ways that our field can do better – first by considering the individual in context. We recognize, for example, that it is difficult to eat a healthier diet, quit smoking and not bed share with an infant when a person lives with a family where resources are limited (and the cook likes to use butter), has friends who smoke and must nighttime parent alone. Considering family interventions and prescriptions, instead of those for individuals, would be a good place to start.

The chapter in the book on place-based initiatives provides numerous examples of ways in which public health practitioners centered their work directly within communities. Likewise, practitioners who may now focus on secondary and tertiary prevention for older adults with chronic conditions may wish to consider chronic disease patterns in families. That way, they can then broaden their strategies to include grandparents, children and grandchildren.

Q: How can Life Course Theory promote health equity and social justice?

A: Equity is a lifeline principle that runs across all chapters in the book. The second chapter offers a series of recommendations for the application of LCT to equity work, including a focus on staff development; resilience; and the way institutional, inter-personal and internalized “isms,” such as racism, function in public health today. The book underscores the opportunities available when the community/family/person are engaged as co-creators in programs and services.

Book information: Moving Life Course Theory into Action: Making Change Happen, ISBN: 978-0-87553-295-0, softcover, list price: $65 plus shipping and handling (APHA member price $45.50). To order, call toll-free 888-320-APHA; email [email protected]; or visit www.aphabookstore.org. Requests for a review copy should be sent by email to David Hartogs at [email protected].