T his article describes the Life Course Health Development (LCHD) framework, which was created to explain how health trajectories develop over an individual's lifetime and how this knowledge can guide new approaches to policy and research. Using recent research from the fields of public health, medicine, human development, and social sciences, the LCHD framework shows that

We analyzed data on 3,449 children under age 3 representing 15.7 million children from the United States, using the 1997 National Health Interview Survey. Our findings show that although most children under age 3 had a usual source of care, children at risk because of low income, minority status, or lack of insurance were 3 to 12 times more likely than children in the reference group (higher income, White, and insured) to be without a usual source of care, and 2 to 30 times more likely to have unmet needs for health care. Furthermore, young children in the at-risk groups had fewer visits to health professionals. We conclude that children in the at-risk groups continue to face substantial barriers in accessing basic health services.

The health development organization (HDO) is a new approach to the organization and delivery of children’s health and social services. The HDO would combine the best features of vertically integrated HMOs with horizontally integrated, child‐focused social services and longitudinally integrated health promotion strategies. Its mandate would be to develop the health of children in a community. The impetus for creating HDOs is a growing body of evidence in chronic disease epidemiology, developmental psychopathology, early intervention research, and life course cohort studies that point to childhood as the period of life during which adult health status is determined and the opportunities for health capital formation are highest. Thus, a new kind of health care organization or framework, like the HDO, is needed to integrate a full range of critical services for promoting children’s development.

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