In 2012, under the leadership of Mario Drummonds and Kiko Malin, the Public Health Work Group (PHWG) set a series of objectives to achieve over two years. One was to explore the relationship between adult chronic illnesses and maternal and child health (MCH). Research has consistently strengthened the hypothesis that chronic conditions have their antecedents in the fetal and early postnatal period. In addition, there is a substantial body of evidence that links maternal health development across the life course to pregnancy outcomes and as a predictor of adult chronic illnesses. 

Dr. Michael Lu's and Dr. Neal Halfon's 2003 MCH Journal paper "Racial & Ethnic Disparities in Birth Outcomes:  A Life-Course Perspective" ushered in a new period of discussion and debate on how MCH services are developed, connected, and delivered.  The life course framework became a disruptive technology urging professionals to rethink or reinvent MCH in America.   

While many hospital executives, health department directors and private MCH agency leaders were excited about life course theory and its potential implications to practice, they have expressed a need for more information as to how to operationalize the theory within their day-to-day practice at the health department level and within the community. Leaders need assistance in transforming their organizational structures, developing new corporate strategies that integrate the life course framework, and learning how to break down departmental silos so women receive seamless services no matter what stage of the life course they entered care. There is also a need for developing new longitudinal data systems to track women and infant across the life course. Life course theory provides leaders with a theoretical and strategic rationale for encouraging internal divisions within health departments to partner and share core competencies to improve the health of women across their lifespan. The current challenge is to match theory with tools  and evidence-based practice. 

In 2013 in partnership with the HRSA MCH Bureau, the Public Health Work Group launched a webinar series titled Linked by Life to begin to address the training needs described above. The series highlights health departments who have begun to operationalize life course theory within and outside of their agencies.   The series will continue through 2014. If your agency or program has had success in applying the life course theory to your work, please contact Mario Drummonds.

Two webinars currently are archived and available for study:   

Promising Practice From the Field

Founded in 2011, Every Woman Southeast (EWSE) is a coalition of 9  Southern states building multi-layered partnerships to improve the health of women and infants in this region.  EWSE is working to engage a wide range of stakeholders to build and sustain an equity-focused, life course approach to women's wellness. They are promoting program and policy strategies to support women and men in creating and actualizing their reproductive life goals.  EWSE is also working to give voice to the ideas, needs, and vision of women in this region.

With support from the W.K. Kellogg Foundation, EWSE is funding 8 pilot projects that utilize the life course approach to address reproductive health. All of the projects include teams that are interdisciplinary and include at least one non-traditional partner. The projects are spread across seven states and engaged in working with communities that run from very rural to a major metropolitan area. Some of the strategies the projects are employing include: peer health advocacy and education through churches and colleges; community linkages for high-risk populations; multimedia approaches to community education; systems support for young men; whole-community, inter-generational education on the Life Course and the needs of young adults; and transportation and urban planning to increase access to reproductive health services.

EWSE members have been working together to educate leaders in their states about the life course approach through a speaker's bureau, webinars, promoting the use of City MatCH Life Course game and actively outreaching to partners who have not traditionally seen their connection with women and children's health. After decades of falling behind the rest of the nation, the South needs a new paradigm. The life course approach opens the door for challenging health inequity and building wellness for generations now and to come. Please visit the EWSE website to learn more about the Coalition and access our resources. You can also sign up for our monthly newsletters and follow our blog.

Promising Practice From the Field

Best Babies Zone (BBZ), a three-year pilot initiative funded by the W.K. Kellogg Foundation, is housed at the School of Public Health at the University of California, Berkeley. The vision for the BBZ is that all babies are born healthy and into communities that enable them to thrive and reach their full potential. The Initiative is focused on community transformation to improve birth and early childhood outcomes for babies born in specific geographic zones in three U.S. cities - Cincinnati OH, New Orleans LA, and Oakland CA. The BBZ Initiative is working with local community groups to develop, evaluate, and implement a model for cross-sector collaboration. Key national partners and leading MCH consultants are providing leadership and technical assistance for the Initiative.  

By the end of the three-year grant period, the work of these initial sites will serve as a blueprint for future site development and implementation in other cities around the U.S. This will be accomplished by: 1) Identifying a geographic area within a city (a specific "zone") where change is greatly needed and resources are aligned in an effort to produce and measure impact; 2) Establishing a broad collaborative to work across four key sectors - health, economic development, early care and education, and community systems - to achieve collective impact; and 3) Cultivating a public health social movement within each city to rally community action to address the social determinants of health, to improve birth and early childhood outcomes and improve the quality of life overall.

Opportunities to achieve improved health must begin where community residents live, work, learn and play. The BBZ will implement strategies not only to improve access to quality health care, but also to transform educational, economic, and community systems in each of its zones. Special attention will be paid to the influence of the social determinants of health and to the importance of building environments that promote and sustain health equity. For more information, please see BBZ's website.