The Real Solution

by Jacob Demé

This article was originally published in the Fall 2016 issue of The Public Health Advocate.
For centuries, the treatment-based approach to overcoming the innumerable obstacles facing the health of people across the world has proven to be incapable of truly eliminating all health issues. By treating the medical problems that arise within a population, the immediate health of an individual or community can be maintained in many cases. However, these medical problems are merely symptoms of a more complex sickness; one rooted in social conditions and historical context.

While the treatment-based approach is unable to penetrate this wall of social and historical factors, life course theory, applied in the life course approach, addresses the source of health issues plaguing mankind that keep us from the healthy future that public health seeks to create. As opposed to the short-term benefits of the treatment-based approach, the life course approach has the potential to prevent health issues from reappearing in the generations to come.

The historical beginnings of the life course perspective can be traced to the early twentieth century, with its earliest forms emerging from a body of work known as the Chicago School.  While the Chicago School is considered to have lasted through the 1930’s, it was not until the 1960’s that the life course perspective was utilized again, by the University of California, Berkeley, in a longitudinal study, or the study of an individual throughout many years of their life.

During that time, however, its basis relied heavily on the social sciences, and it had yet to attract serious attention from researchers in the health field. In addition, the social sciences of that era were unable to extend their examination of life throughout the dynamic shifts that occur within a lifetime, and instead were limited to specific points in time. Throughout the next two decades, researchers began to consider the effects of major historical events, such as the stresses of the world wars, in their evaluations of the health of a population.

While the consideration of historical context was a major step in the progression of the life course perspective, it was not until the 1990’s that this theory was valued as a viable body of work in the eyes of health professionals. This revaluation owes much of its success to a researcher named Glen H. Elder, whose paper, Children of the Great Depression, is considered to be the initial work of the modern version of the life course perspective.

thumbnailThis paper would not have been possible, were not for the aging American population. Many of the people who had experienced the explosive social turmoil in the twentieth century reached an age that began to express the health issues stemming from such a dynamic society. This inspired researchers to study the effects these changes in society could have on a population that had seen and experienced so much. Now, the world has become more globalized, more aware of the effects of the environment on health, and finds itself amidst immense social turmoil once again, and in the need of the life course approach more than ever before.

The life course refers to the stages of one’s life as a cohesive period of growth and development, not a cluster of disjointed experiences. From this perspective, the health of the individual can be seen as a product of their exposure to their physical, economic, and cultural environments, and the changes in those environments.

In fact, Cheri Pies, the executive director of a community health organization, called Best Babies Zone, utilizes the life course approach in order to reduce birth outcome disparities in locations across the United States. Pies says “health is an outcome,” of the biological stress that these factors place on an individual and their children. In contrast to the traditional school of thought, “health care and access is a package, not a panacea.”

In order to take on the responsibility of determining and addressing the source of a health issue from such a broad, complex perspective, the life course approach utilizes faculties from a wide spectrum of academic fields, such as biology, demography, psychology, sociology, political science, etc. Through the cooperation of professionals from these fields, the life course perspective has been implemented in order to address the major health problems of the modern world with a fittingly modern approach.

Health issues surrounding birth outcome (the health of a child at birth) are major subjects for the life course approach. From the life course perspective, the birth outcome is not just a result of the health of the mother during pregnancy, but also a result of the conditions of the mother’s entire life. Due to factors such as poverty, exposure to adverse environmental conditions, and access to health or maternal care, major disparities in birth outcome have emerged. Luckily, there are organizations, armed with the life course approach, that aim to alleviate the disparities stemming from racial and economic factors.

One of the leading organizations taking on this task, Best Babies Zone, is located on UC Berkeley’s campus. By focusing their efforts on the unit of the community as opposed to larger populations, Best Babies Zone is able to coordinate existing community groups to become active in bettering their own community. By empowering the community rather than imposing upon it, the prominent issues can be revealed and assessed by those who know them best.

The success of implementing the life course approach has been noteworthy, to say the least, and life course theory could very likely could result in a “paradigm shift” according to Pies, where the most important goal of public health will be “addressing the structural and institutional racism” that has produced the severe health disparities burdening our nation.

Jacob is a third year political economy major concentrating in global health disparity. After completing his undergraduate degree, he hopes to pursue graduate level education and receive a master’s degree in public health and in social work. Jacob wants to use his education in order to combat the socioeconomic foundations of health inequalities faced both in the United States and around the world.

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