Trajectories: The social science of developmental pathways to health from preconception to childhood in South Africa

In the 21st century, scientific advances have fundamentally challenged the view that an individual’s health and well-being is written into their genes. Human development and health are now understood as profoundly shaped by early life environmental conditions. There have been significant public health investments in developing interventions during pregnancy and early childhood, particularly for decreasing obesity and non-communicable disease in the next generation. Recent evidence shows that interventions in pregnancy for decreasing obesity risk is of limited efficacy, and scientists are turning to the period before conception as a window of opportunity to shape intergenerational health. Testing this theory requires clinical trials that start before pregnancy and measure outcomes in the next generation.
These new scientific approaches raise important questions that require urgent consideration given their possible societal impacts. The 'preconception' focus could productively emphasise the wide range of social determinants of health, but also has the potential for a loss of gains in reproductive rights and gender equality, and diminished attention to the social drivers of health inequities.
This timely program of research meets the urgent need for
(1) Social science attention to the social and ethical implications of research and intervention in the 'preconception period', including how preconception trials are conducted, the assumptions underpinning this research, and what this means for global public health policy;
(2) Innovative qualitative methodologies for studying the social factors that shape life trajectories.
To do this, Trajectories hosted at King's College London is partnered with the Developmental Pathways for Health Research Unit at the University of the Witwatersrand in South Africa, the Geneva Graduate Institute and the Healthy Life Trajectories Initiative (HeLTI) study. HeLTI is hosted by the World Health Organisation and has cohorts in Canada,...