Jennifer S. Pitonyak, PhD, OTR/L, SCFES, is Associate Professor and Associate Director, School of Occupational Therapy, University of Puget Sound, Tacoma, WA;
Mackenzi Pergolotti, PhD, OTR/L, is Director of Research, ReVital Cancer Rehabilitation, Select Medical, Fort Collins, Colorado, and Adjunct Assistant Professor, Department of Occupational Therapy, Colorado State University, Fort Collins.
Am J Occup Ther. 2020 Mar/Apr;74(2):7402090010p1-7402090010p6. doi: 10.5014/ajot.2020.742002.
Life course health development (LCHD) is a framework that considers the transactional nature of risks and protective factors along the life trajectory and how this context influences health. Public policies, from health care to education to social services to labor laws, have many goals, including lessening and eliminating health disparities, yet inequities in health services and outcomes remain. Policy is a contextual factor that may be overlooked when examining influences on health and occupation. As such, the LCHD framework may assist occupational therapy practitioners in understanding the influences of policy-both successes and failures-on occupation. In this article, we introduce the principles of LCHD and use this framework to illustrate analysis of a policy example of paid family leave, demonstrating how gaps in or unintended consequences of policy may contribute to disparities in health and occupation for certain populations.
人生历程健康发展（LCHD）是一个框架，它考虑了沿着生命轨迹的风险和保护因素的交互性质，以及这种环境如何影响健康。从医疗保健到教育到社会服务到劳动法，公共政策都有许多目标，包括减少和消除健康差距，但健康服务和结果仍然存在不平等。在研究对健康和职业的影响时，政策可能是一个被忽视的背景因素。因此，LCHD 框架可以帮助职业治疗师理解政策的影响——包括成功和失败——对职业的影响。在本文中，我们介绍了 LCHD 的原则，并使用该框架来举例说明对带薪家庭假政策的分析，展示了政策中的差距或意外后果如何导致某些人群的健康和职业差异。
