Draft:Life course epidemiology

Life course epidemiology is a field of study that analyzes how biological, behavioral, and psychosocial exposures across the lifespan can influence later health and disease development.^[1][2] Specifically, it explores exposures during pregnancy, childhood, adolescence, or even across generations, which can lead to patterns in chronic disease risk.^[3] This field focuses on the long-term processes that unfold with poor health rather than immediate emergence of diseases, and it draws upon various scientific fields (i.e. sociology, epidemiology, psychology, biology…) to create stronger associations.^[4][5]

Development of the field

The field of life course epidemiology first started to be explored as a framework for understanding adult chronic disease development in a way that goes beyond only adult risk factors.^[6][7] The major early influences included Barker’s Theory of Fetal Development, which argued that undernutrition during pregnancy could lead to the later development of adult diseases, such as diabetes and hypertension.^[8][9] The field also grew separately in the social sciences with experts interested in understanding the impacts that the social and health impacts that the Great Depression had on California babies.^[10] Yet, the term, “life course epidemiology” was only coined in 1997 with the publication of the first edition of A Life Course Approach to Chronic Disease Epidemiology.^[11]

Methods

Life course models for study were defined by Elder and Shanahan who argued that there are five basic principles for understanding of the field: lifespan development, agency, time and place, timing, and linked lives.^[12]Together, these principles emphasize that health is developed across one’s lifetime, is shaped by individual choices and social constraints, depends on historical and geographical contexts, varies according to when exposure occurs, and is influenced by interactions with others. Since the field depends on developments over time, it relies mostly on longitudinal data with a special focus on birth cohorts and prospective cohort studies with repeated measurements and observations.^{[13] [14]}This approach allows researchers to look at early-life development and early exposures to assess if the later health outcomes can be explained by it. Analysis and association are then concluded through four possible models: the sensitive period model, which determines that exposure has a stronger effect at a particular time in life; the accumulation model, which concludes that effects of disadvantage build up over time; the pathway model, which affirms one exposure increases likelihood of later exposures that shape health outcome; and the social mobility model, which considers how social changes and behavior affect disease risk later in life.^[15][16]

References

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