Search

A life-course approach to health encompasses strategies across individuals' lives that optimize their functional ability (taking into account the interdependence of individual, social, environmental, temporal and intergenerational factors), thereby enabling well-being and the realization of rights. The approach is a perfect fit with efforts to achieve universal health coverage and meet the sustainable development goals (SDGs). Properly applied, a life-course approach can increase the effectiveness of the former and help realize the vision of the latter, especially in ensuring health and well-being for all at all ages. Its implementation requires a shared understanding by individuals and societies of how health is shaped by multiple factors throughout life and across generations. Most studies have focused on noncommunicable disease and ageing populations in high-income countries and on epidemiological, theoretical and clinical issues. The aim of this article is to show how the life-course approach to health can be extended to all age groups, health topics and countries by building on a synthesis of existing scientific evidence, experience in different countries and advances in health strategies and programmes. A conceptual framework for the approach is presented along with implications for implementation in the areas of: (i) policy and investment; (ii) health services and systems; (iii) local, multisectoral and multistakeholder action; and (iv) measurement, monitoring and research. The SDGs provide a unique context for applying a holistic, multisectoral approach to achieving transformative outcomes for people, prosperity and the environment. A life-course approach can reinforce these efforts, particularly given its emphasis on rights and equity. Une approche sanitaire fondee sur le parcours de vie englobe des strategies tout au long de la vie des indivldus qui optimisent leur capacite fonctionnelle (en prenant en compte l'interdependance de facteurs individueis, sociaux, environnementaux, temporels et intergenerationnels), assurant ainsi le bien-etre et l'exerdce des droits. Cette approche s'inscrit parfaitement dans les efforts deployes pour parvenira une couverture sanitaire universelle et atteindre les objectifs de developpement durable (ODD). Lorsqu'elle est correctement appliquee, une approche fondee sur le parcours de vie peut accroitre l'efficacite de la premiere et aider a concretiser l'ambition des seconds, en assurant notamment la sante et le bien-etre pour tous a tous les ages. Sa mise en ceuvre exige une comprehension commune par les individus et les societes de la maniere dont la sante est fagonnee par de multiples facteurs tout au long de la vie et d'une generation a l'autre. La plupart des etudes realisees ont porte sur des maladies non transmissibles et le vieillissement des populations dans les pays a revenu eleve, ainsi que sur des aspects epidemiologiques, theoriques et cliniques. L'objectif de cet article est de montrer que l'approche sanitaire fondee sur le parcours de vie peut etre elargie a toutes les tranches d'age, toutes les questions de sante et tous les pays en s'appuyant sur une synthese des donnees scientifiques existantes, les experiences de differents pays et l'avancement des strategies et programmes en matiere de sante. Un cadre conceptuel de l'approche est presente ainsi que les consequences de sa mise en qeuvre sur: (i) la politique et l'lnvestissement; (ii) les services et systemes de sante; (iii) les actions locales, multisectorielles et multipartites; et (iv) les mesures, la surveillance et la recherche. Les ODD fournissent un contexte unique pour l'application d'une approche globale et multisectorielle en vue d'obtenlr des resultats porteurs de transformation pour les individus, la prosperite et l'environnement. Une approche fondee sur le parcours de vie peut renforcer ees efforts, notamment parce qu'elle met l'accent sur les droits et l'equite. Un enfoque basado en la salud para toda la vida engloba estrategias durante la vida de las personas, que optimizan su capacidad funcional (teniendo en cuenta la interdependencia de los factores individuales, sociales, ambientales, temporales e intergeneracionales), permitiendo asi el bienestar y la realizacion de los derechos. El enfoque encaja perfectamente con los esfuerzos por lograr una cobertura sanitaria universal y cumplir los objetivos de desarrollo sostenible (ODS). SI se aplica correctamente, un enfoque para toda la vida puede aumentar la eficacia del primero y ayudar a alcanzar la vision de este ultimo, especialmente para garantizar la salud y el bienestar en todas las edades. Su aplicacion requiere una comprension compartida entre individuos y sociedades sobre como la salud depende de multiples factores presentes a lo largo de la vida y entre generaciones. La mayoria de los estudios se han centrado en las enfermedades no contagiosas, en el envejecimiento de la poblacion en los paises con ingresos altos y en cuestiones epidemiologicas, teoricas y clinicas. El objetivo de este articulo es mostrar como el enfoque basado en la salud para toda la vida se puede extender a todos los grupos de edades, temas de salud y paises, mediante la creacion de una sintesis de las pruebas cientificas existentes, la experiencia en diferentes paises y los avances en estrategias y programas de salud. Se presenta un marco conceptual del enfoque junto con las implicaciones para la aplicacion en los siguientes campos: (i) politica e inversion; (ii) servicios y sistemas de salud; (iii) accion local, multisectorial y de varias partes Interesadas; y (iv) medicion, supervision e investigacion. Los ODS proporcionan un contexto unico para aplicar un enfoque holistico y multisectorial a fin de alcanzar unos resultados transformadores para las personas, la prosperidad y el medio ambiente. Un enfoque para toda la vida puede intensificar estos esfuerzos, sobre todo por su enfasis en los derechos y la equidad., Introduction The right to the highest attainable standard of health for all people, is enshrined in the World Health Organization's (WHO) constitution and in the United Nations' (UN's) human rights [...]

The "World Report on Disability" was requested by the World Health Assembly, the governing body of the World Health Organization (WHO). Because disability is broader than health, WHO partnered with the World Bank. The "World Report" was published in 2011 and provides a comprehensive scientific analysis on the global situation of people with disability that can support the implementation of the United Nations Convention on the Rights of Persons with Disability. Progress since the global launch of the Report in June 2011 has shown areas of awareness raising, policy development, funding, research, and technical support. Yet gaps exist, and there is a need to better inform policy and practice with particular reference to intellectual disability. The "World Report on Disability" makes nine recommendations: enable access to mainstream policies, systems, and services; invest in specific programs and services for people with disabilities; adopt a national disability strategy and plan of action; involve people with disabilities; improve human resource capacity; provide adequate funding and improve affordability; increase public awareness and understanding of disability; improve disability data collection; and strengthen and support research on disability. The "World Report on Disability" has increased awareness and understanding of issues affecting people with disability, and is serving to focus government attention on policies and programs that will support the implementation of the United Nations Convention on the Rights of Persons with Disability, 2006. Particularly in the world's poorest countries, people with intellectual disabilities are disproportionately disadvantaged. The "World Report" is an important tool to build a global commitment to the promotion of inclusion for all persons with disabilities, and especially those with intellectual disability. (Contains 1 footnote.)

The World Health Organization (WHO) defines ageism as the stereotyping, prejudice and discrimination towards people on the basis of age. (1) Ageism cuts across the life-course and stems from the [...]

Abstract Introduction Women represent a growing proportion of older people and experience increasing disability in their longer lives. Using a universally agreed definition of disability based on the International Classification of Functioning, Disability and Health, this paper examines how, apart from age, social and economic factors contribute to disability differences between older men and women. Methods World Health Survey data were analyzed from 57 countries drawn from all income groups defined by the World Bank. The final sample comprises 63638 respondents aged 50 and older (28568 males and 35070 females). Item Response Theory was applied to derive a measure of disability which ensured cross country comparability. Individuals with scores at or above a threshold score were those who experienced significant difficulty in their everyday lives, irrespective of the underlying etiology. The population was then divided into “disabled” vs. “not disabled”. We firstly computed disability prevalence for males and females by socio-demographic factors, secondly used multiple logistic regression to estimate the adjusted effects of each social determinant on disability for males and females, and thirdly used a variant of the Blinder-Oaxaca decomposition technique to partition the measured inequality in disability between males and females into the “explained” part that arises because of differences between males and females in terms of age and social and economic characteristics, and an “unexplained” part attributed to the differential effects of these characteristics. Results Prevalence of disability among women compared with men aged 50+ years was 40.1% vs. 23.8%. Lower levels of education and economic status are associated with disability in women and men. Approximately 45% of the sex inequality in disability can be attributed to differences in the distribution of socio-demographic factors. Approximately 55% of the inequality results from differences in the effects of the determinants. Conclusions There is an urgent need for data and methodologies that can identify how social, biological and other factors separately contribute to the health decrements facing men and women as they age. This study highlights the need for action to address social structures and institutional practices that impact unfairly on the health of older men and women.

Of the many current global challenges, one trend is certain: populations are rapidly ageing and this demographic transition will affect almost all aspects of society. Yet, while we are living [...]

Today, for the first time in history, most people can expect to live into their sixties and beyond. By 2050, the world's population aged 60 years and older is expected [...]

Several recent surveys have highlighted the significant risks of disability experienced by injured children. (1) While the distinction is inadequately captured in most databases, disability results from the interaction between [...]

Introduction: Women represent a growing proportion of older people and experience increasing disability in their longer lives. Using a universally agreed definition of disability based on the International Classification of Functioning, Disability and Health, this paper examines how, apart from age, social and economic factors contribute to disability differences between older men and women. Methods: World Health Survey data were analyzed from 57 countries drawn from all income groups defined by the World Bank. The final sample comprises 63638 respondents aged 50 and older (28568 males and 35070 females). Item Response Theory was applied to derive a measure of disability which ensured cross country comparability. Individuals with scores at or above a threshold score were those who experienced significant difficulty in their everyday lives, irrespective of the underlying etiology. The population was then divided into "disabled" vs. "not disabled". We firstly computed disability prevalence for males and females by socio-demographic factors, secondly used multiple logistic regression to estimate the adjusted effects of each social determinant on disability for males and females, and thirdly used a variant of the Blinder-Oaxaca decomposition technique to partition the measured inequality in disability between males and females into the "explained" part that arises because of differences between males and females in terms of age and social and economic characteristics, and an "unexplained" part attributed to the differential effects of these characteristics. Results: Prevalence of disability among women compared with men aged 50+ years was 40.1% vs. 23.8%. Lower levels of education and economic status are associated with disability in women and men. Approximately 45% of the sex inequality in disability can be attributed to differences in the distribution of socio-demographic factors. Approximately 55% of the inequality results from differences in the effects of the determinants. Conclusions: There is an urgent need for data and methodologies that can identify how social, biological and other factors separately contribute to the health decrements facing men and women as they age. This study highlights the need for action to address social structures and institutional practices that impact unfairly on the health of older men and women. [ABSTRACT FROM AUTHOR]