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34 - Developmental origins of health and disease: public-health perspectives

Published online by Cambridge University Press:  08 August 2009

By
Catherine Law  and
Janis Baird
Edited by
Peter Gluckman  and
Mark Hanson
Catherine Law
Affiliation:
University College, London
Janis Baird
Affiliation:
University of Southampton
Peter Gluckman
Affiliation:
University of Auckland
Mark Hanson
Affiliation:
University of Southampton
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Summary

Introduction

The World Health Organization (WHO) describes public health as a social and political concept. It is based in ‘a comprehensive understanding of the ways in which lifestyles and living conditions determine health status, and a recognition of the need to mobilise resources and make sound investments in policies, programmes and services which create, maintain and protect health by supporting healthy lifestyles and creating supportive environments for health’ (World Health Organization 1998). From this, it follows that a public-health perspective on developmental origins of health and disease is focused on effecting change rather than dissection of the aetiology. Nonetheless, understanding of the mechanisms that underlie relationships between early life and adult disease would be helpful, though arguably not essential, in developing policies or programmes to improve public health.

The preceding chapters have illustrated the complexity of the human as a biological organism. In the biomedical science base the determinants of adult health include concepts such as gene expression, modulation of physiological systems and evolutionary pressures such as predictive adaptive responses (Hanson et al. 2004). Figure 34.1 shows a public-health view of the determinants of health. In this, the biological characteristics of individuals are central, but they are influenced by and interact with layers of influence deriving from their lifestyles, their social and community networks and the services (public and private) that they need or can access. All of these may be influenced by general economic, cultural and environmental conditions.

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Developmental Origins of Health and Disease , pp. 446 - 455
Publisher: Cambridge University Press
Print publication year: 2006

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