Life Course and Social Determinants
Professional Resource Brief
Life Course Theory (LCT) approaches health as an integrated continuum rather than as disconnected and unrelated stages. It posits that there is a "complex interplay" of social and environmental factors mixed with biological, behavioral, and psychological issues that help to define health outcomes across the course of a person's life. In this perspective, each life stage exerts influence on the next stage; social, economic, and physical environments also have influence throughout the life course. All these factors impact individual and community health.
Social determinants of health are factors such as income, education, occupation, employment, housing, child care, family structure, and neighborhood characteristics, which are thought to have powerful effects on health and yet are beyond the reach of medical care.
MCH Digital Library Resource Guides as Tools for Life Course Theory
LCT can be explained by four key concepts -- timeline, timing, environment, and equity -- as defined in Rethinking MCH: The Life Course Model as an Organizing Framework. These concepts can be used to address questions of (1) why health disparities persist across population groups and (2) what factors exist that influence the capacity of individuals and populations to be healthy.
Click below to access MCH Digital Library resource guides that can be used as tools for MCH professionals as they relate to these key concepts of LCT:
Timeline. Today's experiences and exposures influence tomorrow's health.
Pathways or Trajectories. Health pathways or trajectories are built – or diminished – over the lifespan. These resource guides address long-term exposures, experiences, and needs of the MCH community.
- Autism Spectrum Disorder
- Children and Adolescents Exposed to Violence
- Health and Wellness for Adolescent Girls and Women with Mental and Behavioral Health Conditions
- Family Resources
- Family Health History
- Fertility and Infertility
- Home Visiting
- Intimate Partner Violence
- Sleep in Infants, Children, Adolescents, and Pregnant Women
- Women's Health
Timing. Health trajectories are particularly affected during critical or sensitive periods.
Early Programming. Early experiences can "program" an individual's future health and development.
- Assisted Reproductive Technologies
- Breastfeeding and Working Mothers
- Depression During and After Pregnancy
- Fetal Alcohol Spectrum Disorders (FASDs)
- Maternal Distress in the Perinatal Period and Child Outcomes: Professional Resource Guide. Family Resource Brief
- Nutrition During Preconception and Pregnancy
- Preconception and Pregnancy
- Tobacco, Alcohol, and Substance Use During Preconception and Pregnancy
Critical or Sensitive Periods. While adverse events and exposures can have an impact at any point in a person's life course, the impact is greatest at specific critical or sensitive periods of development.
- Infant Mortality and Pregnancy Loss
- Infant Mortality Toolkit: Resources for a Public Health Approach
- Asthma in Children and Adolescents
- Child Maltreatment
- Child Safety
- Children and Youth with Special Health Care Needs
- Diabetes in Children and Adolescents
- Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents
- Lead Poisoning Prevention
- Nutrition in Children and Adolescents
- Overweight and Obesity in Children and Adolescents
- Physical Activity and Children and Adolescents
- School Health
- Social and Emotional Development in Children and Adolescents
Adolescents (see also Resource Guides listed under "Children" for topics that cover both childhood and adolescence)
Environment. The broader community environment strongly affects the capacity to be healthy.
Encompassing Definition of Environment. Environment is broadly defined to include not only physical factors (e.g., safe housing, areas for recreation, availability of nutritious foods, clean air and water, etc.), but also social and economic factors (e.g., racism, poverty status of families and communities, job opportunities, community or family violence, maternal stress, etc. ), and the capacity of the community to engage in change.
- Community Services Locator
- Environmental Health
- Health Information Technology
- Reaching Out to Children and Youth Following Disasters
- Rural Health
Risk and Protective Factors. Risk and protective factors are not limited to individual behavioral patterns or receipt of medical care and social services, but also include factors related to family, neighborhood, community, and social policy.
Equity. Inequality in health reflects more than genetics and personal choice.
LCT speaks to the importance of focusing on health equity from the perspective of population and place and tells us that broad population-level and systems-level changes are needed.
- Cost-Effectiveness and Cost-benefit Analysis in MCH
- Culturally Competent Services
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid
- Health Insurance and Access to Care for Children and Adolescents
- Health Literacy
- Non-English Languages
- Racial and Ethnic Disparities in Health
- Spanish-Language Health Resources
Special Health Care Needs
External Electronic and Print Resources
Find peer-reviewed and other journal articles in English using an automated PubMed search.
MCH Life Course Toolbox. Online resource to share information, innovative strategies, and tools to integrate the Life Course perspective into MCH at the local, state, and national levels. Developed by CityMatCH, Contra Costa Health Services, and the California Endowment with funding from the Centers for Disease Control and Prevention.
Halfon N, Kandyce L, et al. Lifecourse Health Development: Past, Present and Future. Published online August 22, 2013. MCH Journal.
Russ SA, Larson K, et al. A Lifecourse Approach to Health Development: Implications for the Maternal and Child Health Research Agenda. Published online August 17, 2013. MCH Journal.
Fine A, Kotelchuck M. Rethinking MCH: The Life Course Model as an Organizing Framework. 2010. U.S. Maternal and Child Health Bureau.
Maternal and Child Health Life Course Research Network (MCH LCRN). The goal of the MCH LCRN is improve an understanding of how health develops over the life course by providing researchers, practitioners, policymakers and consumers with a transdisciplinary, translational and transformative mechanism for interacting, sharing information and tools, and engaging in collaborative and innovative projects. The site contains research articles, announcements, webinars, expert interviews, a newsletter and a user guide.
AMCHP Life Course. Core principles of the life course approach and current projects: Life Course Metrics Project and state Life Course Resource Center, including state tools and resources, best practices, families, and research.
Healthy People 2020: Social Determinants of Health. Goal, overview and description, examples, the Healthy People 2020 approach, emerging strategies, and references.
CDC: Social Determinants of Health. Resources, publications, FAQs, links to related sites.
World Health Organization. Tools, training resources, final report by Commission on Social Determinants of Health.
Data Systems and Social Determinants of Health. 2011. Public Health Reports v. 126, suppl. 3. This special issue addresses the need to do more in using data systems to address social determinants of health and provides examples of innovative uses and analyses of data for state, local, and national governments and organizations.
Contra Costa Health Services Life Course Initiative. The initiative's mission is to reduce disparities in birth outcomes and change the health of the next generation in Contra Costa County by achieving health equity, optimizing reproductive potential, and shifting the paradigm of the planning, delivery, and evaluation of maternal, child, and adolescent health services. It utilizes a 12-Point Plan to Close the Black-White Gap in Birth Outcomes as its road map and includes a Selected MCH Life Course Bibliography.
For the Public's Health: The Role of Measurement in Action and Accountability. 2010. Institute of Medicine's report states that social and environmental factors are the most powerful shapers of life expectancy and health-related quality of life, yet the United States lacks a cohesive national strategy and appropriate measurement tools to track and respond to these critical influences.
External Multimedia Resources
MCH Navigator: Lifecourse Theory and Social Determinants of Health. Webinars, videos, and online courses from the MCH Navigator training database.
Authors: John Richards, M.A., Olivia K. Pickett, M.S., M.L.S., NCEMCH, Breanne C. Wilhite, B.S.
October 2011; Updated October 2013, May 2015, May 2017