Please wait a minute...
J Zhejiang Univ (Med Sci)  2021, Vol. 50 Issue (4): 411-419    DOI: 10.3724/zdxbyxb-2021-0155
    
The life course health development model: a new approach to understanding human health
KE Yuye1,2(),CHAI Xiaoyun3,*()
1. Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan 442000, Hubei Province, China;
2. School of Nursing, Hubei University of Medicine, Shiyan 442000, Hubei Province, China;
3. Department of Applied Psychology, Hubei University of Medicine, Shiyan 442000, Hubei Province, China
Download: HTML( 33 )   PDF(2336KB)
Export: BibTeX | EndNote (RIS)      

Abstract  

The life course health development (LCHD) model is a cutting-edge theoretical model for the health science, which moves beyond the previous biomedical and biopsychosocial model. From the perspectives of “process, relationship and system”, it recognizes health as a dynamic ability to change over the course of life, and highlights the importance of optimizing individual health trajectories and health promotion. According to LCHD model, we should understand health from the perspective of development, which is characterized by unfolding, complexity, timing, plasticity, thriving and harmony. Health research and practice, therefore, should change ideas from the focus on accurate diagnosis, treatment and etiology previously to full using the relative plasticity of human development to enhance health development ability, enrich health resources and promote the healthy development of physiology, psychology, behavior and culture system; and to achieve a harmonious balance in the different stages of the life course. Based on the LCHD model, it is suggested for our country’s health service system (1) to strengthen the health education across the life-span and construct the health promotion model based on the social system; (2) to pay more attention to health promotion and disease prevention in early life; (3) to increase government spending on health promotion and prevention, not just on disease treatment.



Key wordsLife course health development model      Health      Health promotion      Disease prevention      Public health     
Received: 20 December 2020      Published: 01 November 2021
CLC:  R19-0  
Corresponding Authors: CHAI Xiaoyun     E-mail: jadeleaf_ke@163.com;xy_chai@hbmu.edu.cn
Cite this article:

KE Yuye,CHAI Xiaoyun. The life course health development model: a new approach to understanding human health. J Zhejiang Univ (Med Sci), 2021, 50(4): 411-419.

URL:

http://www.zjujournals.com/med/10.3724/zdxbyxb-2021-0155     OR     http://www.zjujournals.com/med/Y2021/V50/I4/411


生命历程健康发展模型及其启示

生命历程健康发展模型作为健康科学领域前沿的理论模型,超越了先前的生物医学和生物心理社会模型,其从“过程”、“关系”、“系统”等多个角度,将健康视为一种在生命历程中不断动态变化的能力,并突出了优化个体健康发展轨迹和健康促进的重要性。该模型认为,应该从发展的角度去理解健康,健康发展具有展开性、复杂性、时机性、可塑性、充分性以及和谐性等特征。因此,健康研究及实践应转变思路,由过去仅仅关注精准诊断和治疗、疾病溯源等转变为充分利用人类发展的相对可塑性,通过在生命历程的各个阶段,增强健康发展能力和丰富健康资源,促进生理、心理、行为和文化等健康发展系统和谐平衡。基于上述理论,建议我国现阶段卫生事业:①加强生命全周期的健康教育,构建符合我国实际的健康促进模式;②重视生命早期的健康促进和疾病预防;③加大对健康促进和健康教育的投入,而不仅仅是疾病治疗的投入。


关键词: 生命历程健康发展模型,  健康,  健康促进,  疾病预防,  公共卫生 
Figure 1 Evolution of conceptual models of health development
[1]   HALFON N, FORREST C B. The emerging theoretical framework of life course health development[M]//HALFON N, FORREST C B, LERNER R M, et al. Handbook of life course health development. Cham, Switzerland: Springer, 2018: 18-43
[2]   WHO. Constitution of the World Health Organization[A/OL]. (2006-10)[2021-05-26]. https://www.who.int/governance/eb/who_constitution_en.pdf
[3]   朱素蓉, 王娟娟, 卢 伟. 再谈健康定义的演变和认识[J]. 中国卫生资源, 2018, 21(2): 180-184
ZHU Surong, WANG Juanjuan, LU Wei. Re-recognition of health: evolution and definition[J]. Chinese Health Resources, 2018, 21(2): 180-184. (in Chinese)
[4]   HUBERM, KNOTTNERUSJ A, GREENL, et al.How should we define health?[J]BMJ, 2011, d4163.
doi: 10.1136/bmj.d4163
[5]   ZAUTRA A J, HALL J S, MURRAY K E. Resilience: a new definition of health for people and communities [M]//REICH J W.Handbook of adult resilience. New York: Guilford Press, 2010: 3-29
[6]   HALFONN, LARSONK, LUM, et al.Life course health development: past, present and future[J]Matern Child Health J, 2014, 18( 2): 344-365.
doi: 10.1007/s10995-013-1346-2
[7]   HALFONN, HOCHSTEINM. Life course health development: an integrated framework for developing health, policy, and research[J]Milbank Q, 2002, 80( 3): 433-479.
doi: 10.1111/1468-0009.00019
[8]   FORRESTC B. A living systems perspective on health[J]Med Hypotheses, 2014, 82( 2): 209-214.
doi: 10.1016/j.mehy.2013.11.040
[9]   LERNER R M, BRINDIS C D, BATANOVA M, et al. Adolescent health development: a relational developmental systems perspective[M]//HALFON N, FORREST C B, LERNER R M, et al. Handbook of life course health development. Cham, Switzerland: Springer, 2018: 109-121
[10]   MCDADET W, HARRISK M. The biosocial approach to human development, behavior, and health across the life course[J]RSF, 2018, 4( 4): 2-26.
doi: 10.7758/RSF.2018.4.4.01
[11]   DAWBERT R, KANNELW B, GORDONT. Coffee and cardiovascular disease[J]N Engl J Med, 1974, 291( 17): 871-874.
doi: 10.1056/NEJM197410242911703
[12]   BERKMANL F, SYMES L. Social networks, host resistance, and mortality: a nine-year follow-up study of alameda county residents[J]Am J Epidemiol, 1979, 109( 2): 186-204.
doi: 10.1093/oxfordjournals.aje.a112674
[13]   ENGELG L. The need for a new medical model: a challenge for biomedicine[J]Science, 1977, 196( 4286): 129-136.
doi: 10.1126/science.847460
[14]   ELDER JrG H. Time, human agency, and social change: perspectives on the life course[J]Soc Psychol Q, 1994, 57( 1): 4-15.
doi: 10.2307/2786971
[15]   LERNERR M. Developmental science: past, present, and future[J]Int J Dev Sci, 2012, 6( 1-2): 29-36.
doi: 10.3233/DEV-2012-12102
[16]   BALTESP B, SMITHJ. Lifespan psychology: from developmental contextualism to developmental biocultural co-constructivism[J]Res Human Dev, 2004, 1( 3): 123-144.
doi: 10.1207/s15427617rhd0103_1
[17]   KITANOH. Systems biology: a brief overview[J]Science, 2002, 295( 5560): 1662-1664.
doi: 10.1126/science.1069492
[18]   BOYCEW T, SOKOLOWSKIM B, ROBINSONG E. Toward a new biology of social adversity[J]Proc Natl Acad Sci U S A, 2012, 17143-17148.
doi: 10.1073/pnas.1121264109
[19]   ELKSC E, LOOSR J F, HARDYR, et al.Adult obesity susceptibility variants are associated with greater childhood weight gain and a faster tempo of growth: the 1946 British Birth Cohort Study[J]Am J Clin Nutr, 2012, 95( 5): 1150-1156.
doi: 10.3945/ajcn.111.027870
[20]   BARKERD J, OSMONDC, LAWC M. The intrauterine and early postnatal origins of cardiovascular disease and chronic bronchitis[J]J Epidemiol Community Health, 1989, 43( 3): 237-240.
doi: 10.1136/jech.43.3.237
[21]   OVERTONW F. A new paradigm for developmental science: relationism and relational-developmental systems[J]Appl Dev Sci, 2013, 17( 2): 94-107.
doi: 10.1080/10888691.2013.778717
[22]   OVERTON W F. Processes, relations, and relational-developmental-systems[M]//LERNER R M. Handbook of child psychology and developmental science. 7th ed, Hoboken: Wiley, 2015: 9-62
[23]   DAVIES J. Life unfolding: how the human body creates itself[M]. Oxford: Oxford University Press, 2014: 3-14
[24]   ELLISB J, BIANCHIJ M, GRISKEVICIUSV, et al.Beyond risk and protective factors: an adaptation-based approach to resilience[J]Perspect Psychol Sci, 2017, 12( 4): 561-587.
doi: 10.1177/1745691617693054
[25]   HENRICH J. The secret of our success: how culture is driving human evolution, domesticating our species, and making us smarter[M]. Princeton: Princeton University Press, 2015: 34-53
[26]   MOORE K L, PERSAUD T V N. Before we are born[M]. 6th ed, Philadelphia: Saunders, 2003: 1-5
[27]   CANTORP, OSHERD, BERGJ, et al.Malleability, plasticity, and individuality: how children learn and develop in context[J]Appl Dev Sci, 2019, 23( 4): 307-337.
doi: 10.1080/10888691.2017.1398649
[28]   O’RANDA M. The precious and the precocious: Understanding cumulative disadvantage and cumulative advantage over the life course[J]Gerontologist, 1996, 36( 2): 230-238.
doi: 10.1093/geront/36.2.230
[29]   STILOS A, GAYER-ANDERSONC, BEARDSS, et al.Further evidence of a cumulative effect of social disadvantage on risk of psychosis[J]Psychol Med, 2017, 47( 5): 913-924.
doi: 10.1017/S0033291716002993
[30]   BELSKYJ, PLUESSM. Beyond risk, resilience, and dysregulation: phenotypic plasticity and human development[J]Dev Psychopathol, 2013, 25( 4 pt 2): 1243-1261.
doi: 10.1017/S095457941300059X
[31]   BATESON P, GLUCKMAN P. Plasticity, robustness, development and evolution[M]. Cambridge: Cambridge University Press, 2011: 46-62
[32]   LERNERR M, TIRRELLJ M, DOWLINGE M, et al.The end of the beginning: evidence and absences studying positive youth development in a global context[J]Adolesc Res Rev, 2019, 4( 1): 1-14.
doi: 10.1007/s40894-018-0093-4
[33]   GESTSDOTTIRS, LERNERR M. Positive development in adolescence: the development and role of intentional self-regulation[J]Human Dev, 2008, 51( 3): 202-224.
doi: 10.1159/000135757
[34]   王 媛, 曹新西, 侯亚冰, 等. 1990和2017年中国与全球心血管病疾病负担研究[J]. 中国慢性病预防与控制, 2020, 28(11): 10-13, 19
WANG Yuan, CAO Xinxi, HOU Yabing, et al. Studyon Chinese and global cardiovascular diseases burden in 1990 and 2017[J]. Chinese Journal of Prevention and Control of Chronic Diseases, 2020, 28(11): 10-13, 19. (in Chinese)
[35]   曾 见. 论《基本医疗卫生与健康促进法》的健康扶贫政策[J]. 中国卫生事业管理, 2020, 37(11): 827-830
ZENG Jian. Discussing the health poverty alleviation policy based on Basic Health Care and Health Promotion Act[J]. Chinese Health Service Management, 2020, 37(11): 827-830. (in Chinese)
[36]   程勋杰, 胡国清. 人口老龄化所致健康影响研究进展[J]. 中华流行病学杂志, 2020, 41(11): 1915-1920
CHENG Xunjie, HU Guoqing. Progress in research of burden of disease attributed to population aging[J]. Chinese Journal of Epidemiology, 2020, 41(11): 1915-1920. (in Chinese)
[37]   李长宁, 李英华, 卢 永. 健康促进与教育事业发展70年巡礼[J]. 中国健康教育, 2019, 35(9): 771-774
LI Changning, LI Yinghua, LU Yong. An overview of 70 years of health promotion and education undertaking development [J]. Chinese Journal of Health Education, 2019, 35(9): 771-774. (in Chinese)
[38]   李长宁, 卢 永. 健康促进视角下的我国新冠疫情应对[J]. 中国健康教育, 2020, 36(9): 866-869
LI Changning, LU Yong. China’ s response for COVID-19 epidemic from the perspective of health promotion[J]. Chinese Journal of Health Education, 2020, 36(9): 866-869. (in Chinese)
[39]   HALFONN, LARSONK, RUSSS. Why social determinants?[J]Healthc Q, 2010, 14( sp1): 8-20.
doi: 10.12927/hcq.2010.21979
[40]   BEN-SHLOMOY, KUHD. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives[J]Int J Epidemiol, 2002, 31( 2): 285-293.
doi: 10.1093/ije/31.2.285
[41]   PALISANOR J, DI REZZEB, STEWARTD, et al.Life course health development of individuals with neurodevelopmental conditions[J]Dev Med Child Neurol, 2017, 59( 5): 470-476.
doi: 10.1111/dmcn.13402
[42]   HALFONN. Addressing health inequalities in the US: a life course health development approach[J]Soc Sci Med, 2012, 74( 5): 671-673.
doi: 10.1016/j.socscimed.2011.12.016
[43]   王晓赞, 杨燕国, 孔 琳, 等. 历史演进与政策嬗变: 从“增强体质”到“体教融合”——中国儿童青少年体育健康促进政策演进的特征分析[J]. 中国体育科技, 2020, 56(10): 3-10
WANG Xiaozan, YANG Yanguo, KONG Lin, et al. Historical evolution and policy change: from strengthening physical fitness to integration of sports and education——a characteristic analysis of the evolution of physical education and health promotion policies for children and adolescents in China[J]. China Sport Science and Technology, 2020, 56(10): 3-10. (in Chinese)
[1] SONG Linyang,WEN Wenzhi,LIU Jing,JIN Xiaobao,YANG Junhua. Inflammatory state and autism-like behavioral phenotype of offspring induced by maternal exposure to low-dose chemical mixtures during pregnancy in mice[J]. J Zhejiang Univ (Med Sci), 2021, 50(3): 279-289.
[2] CHEN Yunyan,WU Qi,ZHANG Lixia,CHEN Danqing,LIANG Zhaoxia. Relationship of abnormal mid-term oral glucose tolerance test and maternal weight gain with adverse pregnancy outcomes in women with gestational diabetes mellitus[J]. J Zhejiang Univ (Med Sci), 2021, 50(3): 313-319.
[3] QIN Jianfen,PAN Hongying,ZHANG Rongrong,TANG Leiwen,MAO Xiawen. Standardized sputum collection increases sputum sample collection rate for novel coronavirus nucleic acid detection[J]. J Zhejiang Univ (Med Sci), 2020, 49(5): 614-617.
[4] WANG Weidan,XU Fangzhong,XU Songquan,ZHANG Jianmin,ZHANG Ning. Impact of public health emergency on public psychology: analysis of mental health assistance hotlines during COVID-19 in Zhejiang province[J]. J Zhejiang Univ (Med Sci), 2020, 49(4): 409-418.
[5] LIU Chunfu,CHEN Hongmin. Relative security of health care big data protection[J]. J Zhejiang Univ (Med Sci), 2018, 47(6): 563-576.
[6] YANG Shengxu,WEI Jingjiao,HE Fan. Risk assessment indexes for shellfish poisoning outbreak caused by red tide[J]. J Zhejiang Univ (Med Sci), 2018, 47(2): 111-117.
[7] WU Jiabing,GONG Lei,CHEN Fang,SONG Dandan,MA Wanwan,HOU Sai. Establishment and application of public health risk assessment indexes for flood disaster[J]. J Zhejiang Univ (Med Sci), 2018, 47(2): 118-123.
[8] QI Xiaohua,WANG Xinyi,HE Fan,LIU Biyao,ZHANG Tao,LI Fudong,ZHAI Yujia,LIN Junfen. Risk assessment for emergency events of infectious disease in outlying areas of large-scale activities[J]. J Zhejiang Univ (Med Sci), 2018, 47(2): 124-130.
[9] CHEN Rong,HE Yongchao,ZHANG Fang,LU Yinhao,HE Yi. Establishing assessment indexes for emergency response capability of disease control and prevention institutions[J]. J Zhejiang Univ (Med Sci), 2018, 47(2): 137-142.
[10] HE Miao, TANG Xiaojun, LONG Qian, WEI Jie, SUN Zhenxing, YANG Xuewei, TANG Shenglan. Influencing factors of diabetic patients applying for specific disease health insurance and its treatment cost[J]. J Zhejiang Univ (Med Sci), 2016, 45(3): 323-329.
[11] . Epidemiology of Ebola virus disease[J]. J Zhejiang Univ (Med Sci), 2014, 43(6): 621-645.
[12] SHEN Xiao-si, ZHANG Ting-ting, CHEN Bei, CHEN Min-sheng. Design of a satisfaction evaluation indicator system based on patients′ experience of medical services[J]. J Zhejiang Univ (Med Sci), 2014, 43(2): 240-244.
[13] CHEN Bing-bing,CHEN Kun. Outcome mapping for decision-making in health system[J]. J Zhejiang Univ (Med Sci), 2014, 43(2): 245-251.
[14] WEI Bo,SHAO Yan-qi,MAO Shan-ying,DING Mei-ping. Clinical survey on neuropathic pain in neurological outpatient department[J]. J Zhejiang Univ (Med Sci), 2014, 43(1): 89-93.
[15] Wang Bingfu, Mao Yafei, Ruan Jun. Prevalence of Enterobius Vermicularis Infection in Kindergarten Children of Hangzhou City and the Role of Health Education in its Prevention[J]. J Zhejiang Univ (Med Sci), 1998, 27(1): 12-13.