Building on early animal studies, 20th-century researchers increasingly explored the fact that early events—ranging from conception to childhood—affect a child’s health trajectory in the long-term. By the 21st century, a wide body of research had emerged, incorporating the original fetal origins hypothesis into the developmental origins of health and disease. Evidence from Organization for Economic Cooperation and Development (OECD) countries suggests that health inequalities are strongly correlated with many dimensions of socioeconomic status, such as educational attainment, and that they tend to increase with age and carry stark intergenerational implications. Different economic theories have been developed to rationalize this evidence, with an overarching comprehensive framework still lacking. Existing models widely rely on human capital theory, which has given rise to separate dynamic models of adult and child health capital within a production function framework. A large body of empirical evidence has also found support for the developmental origins of inequalities in health. On the one hand, studies exploiting quasi-random exposure to adverse events have shown long-term physical and mental health impacts of exposure to early shocks, including pandemics or maternal illness, famine, malnutrition, stress, vitamin deficiencies, maltreatment, pollution, and economic recessions. On the other hand, studies from the 20th century have shown that early interventions of various content and delivery formats improve life course health. Further, given that the most socioeconomically disadvantaged groups show the greatest gains, such measures can potentially reduce health inequalities. However, studies of long-term impacts as well as the mechanisms via which shocks or policies affect health, and the dynamic interaction among them, are still lacking. Mapping the complexities of those early event dynamics is an important avenue for future research.
Gabriella Conti, Giacomo Mason, and Stavros Poupakis
Cathleen A. Lewandowski
Infancy and young childhood are characterized by rapid cognitive, emotional, and physical development. Each year is marked by specific developmental tasks. Infants need positive parenting, a safe environment, and attention to their basic physical needs. A strong bond with caregivers is also necessary, as this lays the foundation for trust, allowing infants to explore their world. Many of the risk factors, such as prenatal exposure to alcohol and drugs, malnutrition, and abuse and neglect, can be remedied. Interventions such as home visiting, family leave, and nutrition programs are inexpensive and effective, and should receive more attention from social work. Infancy and young childhood are the most crucial periods in a child's development. There is a dynamic and continuous interaction between biology and experience that shapes early human development. Human relationships are the building blocks of healthy development, and children are active participants in their own development.
Stephen J. Bright
In the 21st century, we have seen a significant increase in the use of alcohol and other drugs (AODs) among older adults in most first world countries. In addition, people are living longer. Consequently, the number of older adults at risk of experiencing alcohol-related harm and substance use disorders (SUDs) is rising. Between 1992 and 2010, men in the United Kingdom aged 65 years or older had increased their drinking from an average 77.6 grams to 97.6 grams per week. Data from Australia show a 17% increase in risky drinking among those 60–69 between 2007 and 2016. Among Australians aged 60 or older, there was a 280% increase in recent cannabis use from 2001 to 2016. In the United States, rates of older people seeking treatment for cocaine, heroin, and methamphetamine have doubled in the past 10 years. This trend is expected to continue. Despite these alarming statistics, this population has been deemed “hidden,” as older adults often do not present to treatment with the SUD as a primary concern, and many healthcare professionals do not adequately screen for AOD use. With age, changes in physiology impact the way we metabolize alcohol and increase the subjective effects of alcohol. In addition, older adults are prone to increased use of medications and medical comorbidities. As such, drinking patterns that previously would have not been considered hazardous can become dangerous without any increase in alcohol consumption. This highlights the need for age-specific screening of all older patients within all healthcare settings. The etiology of AOD-related issues among older adults can be different from that of younger adults. For example, as a result of issues more common as one ages (e.g., loss and grief, identity crisis, and boredom), there is a distinct cohort of older adults who develop SUDs later in life despite no history of previous problematic AOD use. For some older adults who might have experimented with drugs in their youth, these age-specific issues precipitate the onset of a SUD. Meanwhile, there is a larger cohort of older adults with an extensive history of SUDs. Consequently, assessments need to be tailored to explore the issues that are unique to older adults who use AODs and can inform the development of age-specific formulations and treatment plans. In doing so, individualized treatments can be delivered to meet the needs of older adults. Such treatments must be tailored to address issues associated with aging (e.g., reduced mobility) and may require multidisciplinary input from medical practitioners and occupational therapists.
Shridevi Rao, Nadya Pancsofar, and Sarah Monaco
A rich literature on family-professional collaboration with families and caregivers of children and youth with disabilities has developed in the United States. This literature identifies key barriers that impede family-professional relationships including deficit-based perceptions of families and children with disabilities, narrow definitions of “family” that limit the participation of some members such as fathers or grandparents, and historical biases that constrain the participation of culturally and linguistically diverse (CLD) families. Principles for building collaborative relationships with families include honoring the strengths of the family, presuming competence in the child and the family, valuing broad definitions of “family,” and understanding the ecology of family routines and rituals. Practices that help facilitate family-professional relationships are building reciprocal partnerships with various caregivers in the family including fathers as well as extended family members, adopting a posture of cultural reciprocity, using a variety of modes of communication with families, and involving families in all aspects of the special education process such as assessment, planning, prioritizing of skills, and identification of interventions. Pivotal moments in the family’s journey through their child’s schooling, including early intervention and transition to post-school environments, provide opportunities to build and strengthen family-professional relationships. Each of these moments has the potential to involve families in a variety of processes including assessment, planning, and articulating the goals and vision for their child/youth. A focus on strengths, collaborative partnerships, and family agency and voice is at the core of strong family-professional relationships.