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Introducing public health
Introducing public health

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5 Life-course effects

The influences on health operate throughout the life-course. In the next activity, you’ll consider the importance of taking a life-course perspective in public health.

Activity 5: Public health practitioners discussing the importance of life-course perspective

Timing: Allow 20 minutes

Watch Film 2, in which a number of public health workers in Powys, Wales discuss the importance of life-course interventions, and answer the questions below in the word document provided.

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Transcript: Film 2 Life-course interventions – health practitioners from Powys, Wales (© The Open University)

Shelley Davies
Early intervention helps support individuals, families to have better outcomes, better life chances, achieve their potential in life. If we don’t get in early and help with those little additional needs, they can escalate into something else and escalate into something else, by which time we’re up against statutory services which, yes, are high-cost, but also that doesn’t deliver the best outcomes for that individual because they’re having to have much more intrusive intervention.
Andrea Jones
Early interventions are really important with families, particularly from a health visiting perspective really, because we’re working with under-fives. So one of the main changes, really, in the last ten years is the recognition of brain development and the importance of interacting with families to enable them to understand the process of the brain development within the baby and child. And that we know that brain development occurs really rapidly in the first year of life, therefore a lot of our work is done in the first year of life to engage the parents in that process.
Wendy Moss
For me, when I look at early intervention I suppose I’m thinking antenatally, where the baby is developing within the womb, because there’s so much that can be done there around the mother’s health and that impacting on the baby in early life. And where you may have a parent with a mental health issue or postnatal depression, perinatal mental health has a huge impact on that baby in early life. The more that you can do in those very early years to make it the so-called ‘normal’ ... so that any of the public health, healthy-child issues that we’re looking at – maybe childhood obesity – but through weaning parties, giving information to families, so that they can make the best possible choices for their children. More activity – so buggy walks, swimming, whatever, becomes normal everyday life, then provides a healthier outcome for those children as they grow up. And they maybe become used to having activity, used to eating healthily. So as they become adults they make those choices for themselves, as well.
Shelley Davies
It’s no good working with just the child if you’re not working with their environments – their family, their friends. Looking at how we shape the environment to deliver those better outcomes. And then that moves out into the community – again, a family exists within the community, so we need to make sure that our community are focusing on the right things. That it’s a positive place to be. That there’s good opportunities for them to be able to have choices, take the right path. And so we very much do try to take a whole-system, whole-community, approach to early intervention prevention.
End transcript: Film 2 Life-course interventions – health practitioners from Powys, Wales (© The Open University)
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Film 2 Life-course interventions – health practitioners from Powys, Wales (© The Open University)
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  • What period of the life-course do the public health practitioners in Film 2 see as important to have interventions in, and why?
  • Who do the practitioners see as important to include in these interventions?

Discussion

All the public health practitioners in Film 2 consider interventions early in life to be important. Andrea says this is because at this stage the individual is developing rapidly. Shelly considers childhood to be a critical period within which to intervene, since initial health inequality (unfair and adjustable differences in health between groups of people) has the potential to increase as people get older. Earlier life-experiences and life choices can determine individuals’ future pathways, and advantages and disadvantages can accumulate over the life-course. Wendy points out that individuals are exposed to social influences on health even before birth, due to the influence on fetal development from maternal factors such as nutrition during pregnancy.

Film 2 makes it clear that early-life interventions cannot focus on children alone, but need to involve parents as well as the wider community within which children live. Interventions need to tackle the environment and make sure that opportunities and choices exist.