Document Detail

Framework as metaphor: the promise and peril of MCH life-course perspectives.
MedLine Citation:
PMID:  14509410     Owner:  NLM     Status:  MEDLINE    
Life-course analytic frameworks expressly link the determinants of health and illness across the lifespan. Such frameworks could serve as a foundation for integrating child and adult health policies by emphasizing the potential that social and biologic processes early in life can find clinical expression as adult-onset disease. However, there are elements of these frameworks that can be misinterpreted in ways that obscure scientific processes and fragment rather than integrate health policies. First, casting early life influences as determining rather than merely influencing adult health obscures the complexity of social and biologic etiologies over a lifetime and diminishes the impact of events in adolescence and adult life. Second, oversimplifying the impact of early influences on adult disease tends to imply that such processes are particularly unamenable to clinical and public health interventions, a suggestion without an empirical basis and likely to undermine pleas for enhanced access to such interventions. Third, exaggerating early life events as being highly deterministic of adult illness in order to shift societal resources from the elderly towards children can generate unnecessary antagonisms between potentially allied constituencies. Together, these considerations suggest that the utility of life-course frameworks will depend upon cautious interpretation and an ongoing process of active refinement.
Paul H Wise
Publication Detail:
Type:  Comment; Journal Article    
Journal Detail:
Title:  Maternal and child health journal     Volume:  7     ISSN:  1092-7875     ISO Abbreviation:  Matern Child Health J     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-25     Completed Date:  2004-01-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9715672     Medline TA:  Matern Child Health J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-6     Citation Subset:  IM    
Department of Pediatrics, Boston Medical Center, 91 East Concord Street, MAT 4, Boston, Massachusetts 02118, USA.
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MeSH Terms
Age of Onset
Child Welfare*
Health Policy*
Health Status*
Life Change Events*
Maternal Welfare*
Sociology, Medical
United States
Comment On:
Matern Child Health J. 2003 Mar;7(1):5-11   [PMID:  12710796 ]
Matern Child Health J. 2003 Mar;7(1):13-30   [PMID:  12710797 ]

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