From the CEO

Looking Across the Life Course

By Michael R. Fraser, PhD, CAE

Over the past several years, there has been a great deal of attention on the life course perspective in maternal and child health. Certainly from a theoretical level the perspective makes a great deal of sense: those things that influence our health as children certainly have an impact on our health as adults. One only need watch the first installment of the new HBO series The Weight of the Nation for an excellent example of how being overweight in childhood leads to future health problems as those kids grow to adulthood (diabetes, hypertension, etc). Clearly, working across the life course and understanding the social, as well as the behavioral, factors that impact health is a core part of maternal and child health practice.

I recently came across a billboard that does a great job describing the life course perspective from a graphical perspective. The commercial, part of Evian water’s "Live Younger" campaign, shows three adults wearing white t-shirts with an image of a baby on the front. Because of the way the t-shirt is printed, the head of the infant is the head of the adult so it looks like the image is a baby picture of the adults on the billboard (click here to see the image). It’s pretty cool!

I like the ad because it does a nice job illustrating what I see as a central tenet of the life course perspective: we carry though life things from our childhood that have an impact on our health as adults. But what I also like about the image is that you can also think about your own reproductive potential and how we pass on those things in our lives to future generations should we choose to have children. While that is an emerging area of science (epigenetics, etc.), it is definitely interesting and relevant to MCH leaders. It gives a generational spin to the life course perspective, which I think is very compelling.

After several years of thinking about the life course perspective from a theoretical perspective, we are hearing from members that they want to know more about how to implement the perspective in their work at the state and community level. What does it mean to operationalize the life course perspective in the day to day work of Title V programs? What changes? How is work organized differently? We know of several states that have embarked on a journey to re-engineer their work to maximize the cross-cutting and integrative potential of the life course perspective and we are working to collect their stories so we can share them with all states programs and partners. As we learn more about the life course perspective, we will continue to feature educational opportunities and events for members to learn more.

Do you have something you want to share, or want to talk more specifically about what the life course perspective means in your work? Definitely let us know (e-mail us at! We want to learn from you and work with you to support your life course work in the states.