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The Case for Child Development as a Determinant of Health

Le développement de l’enfant comme déterminant de la santé

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Abstract

The complex relationship between life course and social/economic-psychosocial conditions in a given society has a powerful determining effect on human health. The socioeconomic gradient emerges from a complex mixture of psychosocial and material influences operating at various levels of social aggregation and, also, a series of biological responses whose character and significance vary over the life course. Biological embedding and the “latency” and “pathways” model incorporate the notion of a critical period in development; the pathways model emphasizes the cumulative effect of life events and the ongoing importance of social/economic-psychosocial conditions throughout the life cycle. The models, although conceptually complementary, result in ideological conflict and lend themselves to different policy directions.

Abrégé

Les liens complexes entre le cours de la vie et les conditions socio-économiques et psychosociales dans une société donnée ont un puissant effet déterminant sur la santé humaine. D’un mélange complexe d’influences psychosociales et matérielles qui s’exercent à divers niveaux de l’agrégation sociale, ainsi que d’une série de réponses biologiques dont le caractère et l’importance varient au cours de la vie, émerge un gradient socioéconomique de l’état de santé. L’enchâssement biologique et les modèles de la «latence» et des «cheminements» intègrent la notion d’une période critique dans le développement; le modèle des cheminements met l’accent sur l’effet cumulatif des événements vécus et sur l’importance soutenue des conditions socio-économiques et psychosociales pendant toute la vie. Les deux modèles, malgré leur complémentarité théorique, sont incompatibles sur le plan idéologique et se prêtent à des programmes d’action différents.

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Authors and Affiliations

  1. Département des soins de santé et d’épidémiologie, Faculté de médecine, édifice James Mather, 5804, avenue Fairview, Vancouver, C.-B., V6T 1Z3, Canada

    Clyde Hertzman MD, MSc, FRCPC (Professeur)

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  1. Clyde Hertzman MD, MSc, FRCPC
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Correspondence to Clyde Hertzman MD, MSc, FRCPC.

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Hertzman, C. The Case for Child Development as a Determinant of Health. Can J Public Health 89 (Suppl 1), S16–S21 (1998). https://doi.org/10.1007/BF03405090

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