Life Course Health Development: An Integrated Framework for Developing Health, Policy, and Research


Neal Halfon, M.D., M.P.H., UCLA School of Public Health, Box 951772, Los Angeles, CA 90095-1772 (e-mail:


This article describes the Life Course Health Development (LCHD) framework, which was created to explain how health trajectories develop over an individual's lifetime and how this knowledge can guide new approaches to policy and research. Using recent research from the fields of public health, medicine, human development, and social sciences, the LCHD framework shows that

  • Health is a consequence of multiple determinants operating in nested genetic, biological, behavioral, social, and economic contexts that change as a person develops.
  • Health development is an adaptive process composed of multiple transactions between these contexts and the biobehavioral regulatory systems that define human functions.
  • Different health trajectories are the product of cumulative risk and protective factors and other influences that are programmed into biobehavioral regulatory systems during critical and sensitive periods.
  • The timing and sequence of biological, psychological, cultural, and historical events and experiences influence the health and development of both individuals and populations.

The life course health development (LCHD) framework organizes research from several fields into a conceptual approach explaining how individual and population health develops and how developmental trajectories are determined by interactions between biological and environmental factors during the lifetime. This approach thus provides a construct for interpreting how people's experiences in the early years of life influence later health conditions and functional status. By focusing on the relationship between experiences and the biology of development, the LCHD framework offers a better understanding of how diseases occur. By suggesting new strategies for health measurement, service delivery, and research, as well as for improving health outcomes, this framework also supports health care-purchasing strategies to develop health throughout life and to build human health capital.