Jennifer S. Pitonyak, Mackenzi Pergolotti, Jyothi Gupta; Understanding Policy Influences on Health and Occupation Through the Use of the Life Course Health Development (LCHD) Framework. Am J Occup Ther 2020;74(2):7402090010. https://doi.org/10.5014/ajot.2020.742002
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© 2020 American Occupational Therapy Association
Life course health development (LCHD) is a framework that considers the transactional nature of risks and protective factors along the life trajectory and how this context influences health. Public policies, from health care to education to social services to labor laws, have many goals, including lessening and eliminating health disparities, yet inequities in health services and outcomes remain. Policy is a contextual factor that may be overlooked when examining influences on health and occupation. As such, the LCHD framework may assist occupational therapy practitioners in understanding the influences of policy—both successes and failures—on occupation. In this article, we introduce the principles of LCHD and use this framework to illustrate analysis of a policy example of paid family leave, demonstrating how gaps in or unintended consequences of policy may contribute to disparities in health and occupation for certain populations.
Timing: The perinatal period is a time-sensitive period (Halfon & Forrest, 2018) not only for attachment but also for LCHD and the prevention of chronic disease among both infants and women (Jou et al., 2018; Pitonyak et al., 2016).
Plasticity: Research continues to elucidate the important relationship among stable, loving, early relationships; their implications for brain development (Halfon & Forrest, 2018); and later mental health. At the same time, recommendations for breastfeeding are based on extensive evidence of its life course health benefits (HHS, 2011). Given this evidence, policy that enables parents to perform early family occupations essential for bonding and attachment helps to foster health development and actualization of occupational routines and roles.
Thriving: Early family social participation fosters attachment and the foundations of mental health, illustrative of the principle of thriving, which posits that optimal health development promotes well-being and disease prevention (Halfon & Forrest, 2018).
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