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Strengthen the Evidence for Maternal and Child Health Programs

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.

Timing. Health trajectories are particularly affected during critical or sensitive periods.

Early Programming. Early experiences can "program" an individual's future health and development.

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.



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.

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.

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

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.