Improving Maternal and Child Health Across the Life Course: Where Do We Go from Here?

In 2003 when Dr. Halfon and I published a commentary in this journal calling for a reconceptualization of racial–ethnic disparities in birth outcomes from a life-course perspective [1], few people in maternal and child health (MCH) were talking about life course. While certainly not new, it was hailed in an accompanying editorial as ‘‘a start in a new paradigm’’ in MCH [2].

The past decade has witnessed major advancements in the development of the life course theory and its application to MCH research, practice, and policy. In this issue, Halfon et al. [3] summarized new advances in the theory of life course health development (‘‘LCHD 2.0’’), while other articles provide a sample of the many innovative applications in our field. There are now websites, toolboxes, resource guides, and a research network devoted to MCH life course, and the federal Maternal and Child Health Bureau (MCHB) of the Health Resources and Services Administration is now using the life course theory as a strategic planning framework, guiding the work of the Bureau and its grantees and partners over the next decade [4]. There has been a paradigm shift in MCH, and as proclaimed in an editorial in 2009, ‘‘[t]he life course has come of age’’ [5].

So where do we go from here? The collection of articles in this issue of the MCH Journal provides a good roadmap. In this editorial, I will offer three further suggestions for how to advance life course research, practice, and policy in MCH. In research, we need to move beyond discovery to intervention research. In practice, we need to move from isolated to collective impact. In policy, we need to move beyond paying for remediation to investing in capacity formation.

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