Movers and Shakers


The Life Course Perspective: Improving Health Outcomes across the Lifespan

 By Cheri Pies, MSW, DrPH  

Over the past four decades, millions of dollars have been directed to large-scale national efforts to ensure that every woman, regardless of her ability to pay, has access to quality prenatal care services. Despite the successful implementation of comprehensive prenatal care services, significant and substantial disparities in birth outcomes between racial and ethnic groups still persist. A broad new paradigm is emerging in MCH among some leading practitioners, academics, and MCH policy advocates that has the potential to expand our practice, with a focus on addressing racial-ethnic disparities in birth outcomes and the broad environmental determinants of health.  

This Life Course Perspective (LCP) offers a new way of looking at an individuals’ health over their life span, not as disconnected stages (infancy, latency, adolescence, childbearing years) unrelated to each other, but as an integrated whole. It suggests that a complex interplay of biological, behavioral, psychological, social and environmental factors contribute to health outcomes across the span of a person’s life and builds on recent social science and public health literature that posits that each life stage influences the next.  

In 2006, Michael Lu, Milton Kotelchuck, Padmini Parthasarathy, and Cheri Pies formed the Life Course Work Group (LCWG), to examine the application of the Life Course approach for the MCH field. In June 2008, with funding from The California Endowment, we brought together 25 national MCH experts for a two-day meeting to begin a substantive dialogue about the application of the LCP to MCH and identify how five distinct MCH areas – theory, research, practice, policy, and education and training – would need to change and evolve in order to utilize the LCP in the field.  

There are several concrete outcomes that will be developed as a result of the National MCH Life Course Work Group meeting. One outcome of interest to AMCHP is the Life Course Perspective Toolbox. This will be a web-based toolkit (on the CityMatCH site beginning in 2009) which will include a full report of the National meeting, as well as a policy briefings, a Life Course bibliography, and tools for agenda setting for MCH research and policy arenas. In addition, it will contain PowerPoint presentations and related educational materials about the Life Course Perspective and it’s integration into MCH for use by academics and practitioners in classroom and on-the-job settings.  

For more information about the Life Course perspective and the work being done in Contra Costa County, California, visit here.