Life Course Approaches to the Causes of Health Disparities

Abstract

Reducing health disparities requires an understanding of the mechanisms that generate disparities. Life course approaches to health disparities leverage theories that explain how socially patterned physical, environmental, and socioeconomic exposures at different stages of human development shape health within and across generations and can therefore offer substantial insight into the etiology of health disparities. Life course approaches are informed by developmental and structural perspectives. Developmental perspectives emphasize how socially patterned exposures to risk factors during sensitive life stages shift health trajectories, whereas structural perspectives emphasize how social identity and position within socially patterned environments disproportionately allocate risk factors and resources, resulting in altered health trajectories. We conclude that the science of health disparities will be advanced by integrating life course approaches into etiologic and intervention research on health disparities. The following 4 strategies are offered to guide in this process: (1) advance the understanding of multiple exposures and their interactions, (2) integrate life course approaches into the understanding of biological mechanisms, (3) explore transgenerational transmission of health disparities, and (4) integrate life course approaches into health disparities interventions.

Rural–urban health disparities for mood disorders and obesity in a midwestern community

“…Many population studies have utilized agelimited data sources (e.g., Medicare). Consistent with a life-course perspective for understanding health disparities [34], our agestratified findings add to the assessment of the effect of urban locality on burden of mood disorder and obesity prevalence. Another strength is that the prevalence of obesity and mood disorder diagnoses was based on documented provider clinical diagnosis and electronic medical record data, in contrast to reliance on selfreport.…”

“…We build on previous work by accounting for the effects of HCU and SES derived from housing features, when examining the role of rural-urban geography on disease burden. Recent attention has focused on a lifecourse perspective to understanding health disparities [34]. Our age-stratified analyses suggest that the strongest effects for urban locality on burden of mood disorders and obesity were seen for those in middle age (46-65 years).…”

A Luta Continua1: Next Steps for Racism Research Among Black American Youth

“…Sensitive periods are developmental periods in which the interaction between age and exposure to racism may have a greater impact on subsequent health (Jones et al, 2019). Adolescence may be a sensitive period because experiences of racial discrimination in adolescence have been positively associated with physical deterioration (e.g., allostatic load) and dysregulated activity in the hypothalamic–pituitary–adrenal axis (HPA) in adulthood (Adam et al, 2015; Brody et al, 2014).…”

Pandemic Superimposed on Epidemic: Covid-19 Disparities in Black Americans

“…The impact of these environmental challenges may dramatically influence an affected individual's health over the course of their life. 1 In metropolitan areas, the difference of several miles and a change of zip codes may be associated with an increase in the prevalence of chronic disease and consequent shortened lifespans amongst the residents of poorer communities. 2…”