Online Program

Panel Discussion

Health disparities among racial/ethnic and socioeconomic groups are well recognized as key dimensions of public health and social justice. Glaring disparities among groups within total populations and within specific age groups have been well documented. Their causes, however, remain incompletely understood. Among the factors often considered are unequal access to resources for prevention and treatment, the impact of social status per se, and differences among groups and individuals in health literacy (or related cognitive ability). The usefulness of incorporating a life course perspective into our understanding of health disparities is increasingly recognized. For example, adult health in midlife is the product of cumulative, sequenced relations between persons and environments. Antecedents of health disparities in midlife are often evident in early childhood, and in turn, some of the causes of these childhood antecedents might be related to exposures prior to birth. Yet few studies have the requisite data to examine these processes across the life course, at multiple levels, and to test competing hypotheses about the reasons for the emergence of disparities that are evident in midlife. It is also increasingly recognized that a lifecourse perspective on disparities is as important to low and middle income countries as it is to high income countries (where most lifecourse research has been done until quite recently). This session will include two presentations from a unique study that followed a pregnancy cohort born 1961-1963 up to about age 50. These presentations will examine the evidence for disparities overall, and for disparities in specific health domains, in terms of competing hypothese about how disparities emerge over the life course. A third presentation will use an extraordinary set of data from India to examine the relation of socioeconomic status and cardiovascular disease, risk factors, and mortality, and further to investigate the hypothesis that maternal nutritional conditions during pregnancy may have effects offspring cardiovascular disease risk in adulthood. Finally, the discussant will provide an overview that ties together the presentations and poses unanswered questions.

Session Objectives: Competing theories about the causes of health disparities The relevance of lifecourse approaches for elaborating and testing these theories New evidence from lifecourse studies and their implications for causes of disparities

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)