BMC Public Health. 2011 Sep 8;11:695. doi: 10.1186/1471-2458-11-695.
Although life course epidemiology is increasingly employed to conceptualize the determinants of health, the implications of this approach for strategies to reduce the burden of injuries have received little recognition to date.
The authors reviewed core injury concepts and the principles of the life course approach. Based on this understanding, a conceptual model was developed, to provide a holistic view of the mechanisms that underlie the accumulation of injury risk and their consequences over the life course.
A "lens and telescope" model is proposed that particularly draws on (a) the extended temporal dimension inherent in the life course approach, with links between exposures and outcomes that span many years, or even generations, and (b) an ecological perspective, according to which the contexts in which individuals live are critical, as are changes in those contexts over time.
By explicitly examining longer-term, intergenerational and ecological perspectives, life course concepts can inform and strengthen traditional approaches to injury prevention and control that have a strong focus on proximal factors. The model proposed also serves as a tool to identify intervention strategies that have co-benefits for other areas of health.
尽管生活史流行病学越来越多地被用于概念化健康决定因素,但迄今为止,这一方法对减少伤害负担的策略的意义尚未得到充分认识。
作者回顾了核心伤害概念和生活史方法的原则。在此基础上,制定了一个概念模型,为理解导致伤害风险积累的机制及其在整个生命过程中的后果提供了一个整体视角。
提出了一个“镜头和望远镜”模型,该模型特别借鉴了(a)生活史方法中固有的扩展时间维度,其中暴露和结果之间的联系跨越了许多年,甚至几代人,以及(b)生态视角,根据该视角,个人所处的环境至关重要,随着时间的推移,环境的变化也是如此。
通过明确考察更长期、代际和生态视角,生活史概念可以为以近端因素为重点的传统伤害预防和控制方法提供信息和支持。所提出的模型也可用作确定具有其他健康领域共同效益的干预策略的工具。