From Fatalism to Mitigation: a Conceptual Framework for Mitigating Fetal Programming of Chronic Disease by Maternal Obesity

Prenatal development is recognized as a critical period in the etiology of obesity and cardiometabolic disease. Potential strategies to reduce maternal obesity-induced risk later in life have been largely overlooked. In this paper, we first propose a conceptual framework for the role of public health and preventive medicine in mitigating the effects of fetal programming. Second, we review a small but growing body of research (through August 2015) that examines interactive effects of maternal obesity and two public health foci – diet and physical activity – in the offspring. Results of the review support the hypothesis that diet and physical activity after early life can attenuate disease susceptibility induced by maternal obesity, but human evidence is scant. Based on the review, we identify major gaps relevant for prevention research, such as characterizing the type and dose response of dietary and physical activity exposures that modify the adverse effects of maternal obesity in the offspring. Third, we discuss potential implications of interactions between maternal obesity and postnatal dietary and physical activity exposures for interventions to mitigate maternal obesity-induced risk among children. Our conceptual framework, evidence review, and future research directions offer a platform to develop, test, and implement fetal programming mitigation strategies for the current and future generations of children

Building a Social Justice Narrative for Public Health

Public health is the place where science, policy, politics, and activism converge. Each public health issue is a snapshot where we can see the unfolding of the collective processes that define who we are, what we believe, and what we value as a society. Our professional strength is our commitment to community and social justice values, but we are challenged to effectively communicate these values in an individualistic, market-dominated society. It is this language of community, and the values it represents, that must be the core of the narrative animating a more just and healthier society. A public health perspective characterized by social justice argues that public health problems are primarily socially generated and can be predicted based on the level of injustice and inequality in a society. Thus, the solutions to such problems must be through progressive social and public health policies and are best understood as a collective responsibility shared across the various levels of society. When we can develop a narrative that effectively communicates the social justice values that are the foundation of this perspective, ours will be a society that better understands the meaning of public health and responds more appropriately to its challenges. We will then be collectively more effective in better translating our values into caring, and more effective, public policy. This will not be easy, but it will be necessary

The Social Roots of Health and Disease

Health Matters: Is your ZIP code more important to your health than your genetic code? That\u27s the intriguing question explored by Lawrence Wallack, director of PSU\u27s Center for Public Health Studies.https://pdxscholar.library.pdx.edu/pdxtalks/1009/thumbnail.jp

Talking About Public Health: Developing America’s “Second Language”

The mission of public health—improving the health of populations—is difficult to advance in public discourse because a language to express the values animating that mission has not been adequately developed. Following on the work of Robert Bellah, Dan Beauchamp, and others, we argue that the first “language” of American culture is individualism. A second American language of community—rooted in egalitarianism, humanitarianism, and human interconnection—serves as the first language of public health. These values resonate with many Americans but are not easily articulated. Consequently, reductionist, individualistic understandings of public health problems prevail. Advancing the public health approach to the nation’s health challenges requires invigorating America’s second language by recognizing the human interconnection underlying the core social justice values of public health

Moving From Them to Us -- Challenges in Reframing Violence Among Youth

Synthesizes research on how news coverage frames youth, race, and crime; how race affects portrayals of youth and crime; and how views of government affect support for violence prevention. Outlines implications for policy makers and prevention programs

Developmental Origins, Epigenetics, and Equity: Moving Upstream

The Developmental Origins of Health and Disease and the related science of epigenetics redefines the meaning of what constitutes upstream approaches to significant social and public health problems. An increasingly frequent concept being expressed is When it comes to your health, your zip code may be more important than your genetic code . Epigenetics explains how the environment-our zip code-literally gets under our skin, creates biological changes that increase our vulnerability for disease, and even children\u27s prospects for social success, over their life course and into future generations. This science requires us to rethink where disease comes from and the best way to promote health. It identifies the most fundamental social equity issue in our society: that initial social and biological disadvantage, established even prior to birth, and linked to the social experience of prior generations, is made worse by adverse environments throughout the life course. But at the same time, it provides hope because it tells us that a concerted focus on using public policy to improve our social, physical, and economic environments can ultimately change our biology and the trajectory of health and social success into future generations

A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease

Findings from the field of Developmental Origins of Health and Disease (DOHaD) suggest that some of the most pressing public health problems facing communities today may begin much earlier than previously understood. In particular, this body of work provides evidence that social, physical, chemical, environmental, and behavioral influences in early life play a significant role in establishing vulnerabilities for chronic disease later in life. Further, because this work points to the importance of adverse environmental exposures that cluster in population groups, it suggests that existing opportunities to intervene at a population level may need to refocus their efforts “upstream” to sufficiently combat the fundamental causes of disease. To translate these findings into improved public health, however, the distance between scientific discovery and population application will need to be bridged by conversations across a breadth of disciplines and social roles. And importantly, those involved will likely begin without a shared vocabulary or conceptual starting point. The purpose of this paper is to support and inform the translation of DOHaD findings from the bench to population-level health promotion and disease prevention, by: 1) Discussing the unique communication challenges inherent to translation of DOHaD for broad audiences, 2) Introducing the First-hit/Second-hit Framework with an epidemiologic planning matrix as a model for conceptualizing and structuring communication around DOHaD, and 3) Discussing the ways in which patterns of communicating DOHaD findings can expand the range of solutions considered, and encourage discussion of population-level solutions in relation to one another, rather than in isolation