UCLA faculty part of international effort to advance “life course approach” to human health, from birth to death

A team of UCLA medical and public health researchers have been instrumental in pioneering work by the World Health Organization (WHO) to demonstrate how lifelong health and well-being depends greatly on an individual’s earliest years.

The research initiative, which has culminated in the publication of the 190-page WHO report “Framework to implement a life course approach in practice,” is a clear example of how international research powers progress towards positive outcomes, for both healthy and at-risk populations, and in the U.S. and globally, said Dr. Ritu Sadana, a UCLA Fielding School alum (MS, ’87) who led the WHO project.

“We must recognize the value and need to invest in every stage of life including older people, and how the returns on investments are accumulated across the life course and, importantly, for the next generation,” said Sadana, a global leader in public health for more than three decades. “Evidence shows that early intervention in critical periods - including efforts focused on maternal and child health - can build up physical and mental capacities and reserves for later life.”

The theme for 2026’s World Health Day on Tuesday, April 7 is “Together for health. Stand with science,” which ties directly with the work done by UCLA scholars, who have used research in California, the United States, and the Western Hemisphere to inform their contribution to the WHO initiative, said Dr. Neal Halfon, founding director of the UCLA Center for Healthier Children, Families and Communities, and a major contributor to the WHO report.

“It’s vital that we have access to healthcare at every stage of life, and that we understand there are different healthcare needs at different ages, but adopting a life course approach goes beyond considerations of health coverage alone,” said Halfon, a physician and professor in UCLA Fielding’s Department of Health Policy and Management. “The life course approach to health development promotes early intervention in sensitive developmental periods, such as during early childhood or adolescence, or before and during pregnancy, as these can reduce lifelong risks for several prevalent but preventable conditions and disease. It requires a whole of community response to put a life course approach into action to reliably set children on the course to life-long health.”

Of particular significance to the UCLA contributors’ input were recent research efforts with partners ranging from the City of Pomona, California, to the state of New Mexico, to a decades-long research partnership with Chilean health officials through the Pan-American Health Organization (PAHO), the authors said.

“Poor fetal growth - reflected in low birth weight, for example - is associated with higher risks of coronary heart disease, stroke, type 2 diabetes and reduced cognitive and physical function in adulthood,” said Dr. Shirley Russ, a physician and senior project scientist with UCLA's Center for Healthier Children, Families, and Communities. “Yet we need to go beyond simply preventing problems to actively supporting optimal early development .Access to children’s healthcare is vital but so too is supporting parents’ mental health, access to nature, safe neighborhoods- improvements across the whole of children’s developmental ecosystems.

The centers work on life course health development has informed the development of the WHO “Framework,” and is active in WHO’s network of collaborators engaging more than 25 centers worldwide, across low-, middle-, and high-income countries and involving the WHO’s seven main offices spanning the globe, including PAHO in Washington, D.C., civil society organizations, and engaging Ministries of Health and policy makers in Burundi, Colombia, Dominican Republic, Egypt, India, Japan, Lao People’s Democratic Republic, Portugal, and Sierra Leone.

Along with Halfon and Russ, Dr. Emily Hotez, a developmental psychologist and assistant professor in the Department of Medicine at UCLA and the Department of Health Policy and Management at UCLA Fielding, is leading a scoping review of healthy aging interventions for individuals with intellectual and developmental disabilities (I/DDs). She is collaborating with the WHO to ensure alignment with the work and goals of the WHO Framework. 

Dr. Kathryn Kietzman, a researcher with UCLA Fielding’s Department of Community Health Sciences, also contributed to the WHO project. Keitzman’s work, which focuses primarily on the long-term health and social care needs of vulnerable populations, including older adults, demonstrates the significance of the “life course” approach across an individual’s lifespan, including into adulthood and the end of life.

“A key aspect of the life course approach is to identify opportunities to engage with subgroups who may be overlooked, including older people, in relation to services offered to meet their development and health needs,” Kietzman said. “A significant element of that is creating age-friendly environments  that enable people of all ages to actively participate in their communities, maintain their health, and live with dignity and independence as they age.”

Hotez, whose research has included field work in Chile - funded by the UCLA Global Health Program - collaborates with interdisciplinary groups in Santiago and UCLA to align practice and policy with life course science. This work includes identifying opportunities to promote the health and well-being of individuals with I/DDs, such as autism, across Chile.

“Life course science has taught us so much about human development. We now have an opportunity to apply life course science to enhance systems to support individual and family thriving at every life stage,” Hotez said. “It doesn’t have to be complicated or costly; there are many small things that can be done with few or no resources to improve the quality of healthcare for individuals - both with and without I/DDs.” 

FUNDING

This work was supported by the WHO, the Swiss foundation Velux Stiftung, and the contributors’ institutions. Any opinions, findings, conclusion, or recommendations expressed in the published “Framework” report do not necessarily reflect the views of any organization or agency that provided support for the project.