title: Translating Life Course Theory to clinical practice to address health disparities.
abstract: Life Course Theory (LCT) is a framework that explains health and disease across populations and over time and in a powerful way, conceptualizes health and health disparities to guide improvements. It suggests a need to change priorities and paradigms in our healthcare delivery system. In "Rethinking Maternal and Child Health: The Life Course Model as an Organizing Framework," Fine and Kotelchuck identify three areas of rethinking that have relevance to clinical care: (1) recognition of context and the "whole-person, whole-family, whole-community systems approach;" (2) longitudinal approach with "greater emphasis on early ("upstream") determinants of health"; and (3) need for integration and "developing integrated, multi-sector service systems that become lifelong "pipelines" for healthy development". This paper discusses promising clinical practice innovations in these three areas: addressing social influences on health in clinical practice, longitudinal and vertical integration of clinical services and horizontal integration with community services and resources. In addition, barriers and facilitators to implementation are reviewed.
authors.affiliation: Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N Wolfe Street #2055, Rubenstein Building, Baltimore, MD, 21287, USA, tcheng2@jhmi.edu.
authors.forename: Tina L
authors.initials: TL
authors.lastname: Cheng
authors.forename: Barry S
authors.initials: BS
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D015142:Baltimore; D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000592:standards; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration* / Q000592:standards; D003159:Community-Institutional Relations; D005192:Family Health; D006291:Health Policy / Q000331:legislation & jurisprudence; D054624:Health Status Disparities; D006803:Human Development; D006801:Humans; D007223:Infant; D020380:Needs Assessment; D019982:Organizational Case Studies; D058991:Patient Protection and Affordable Care Act / Q000592:standards; D018802:Patient-Centered Care / Q000331:legislation & jurisprudence / Q000458:organization & administration* / Q000592:standards; D064890:Social Determinants of Health; D014481:United States