Managing health in inequitable contexts: The Youth Health Capacity Development model

• In Event: Families and contexts that shape developmental trajectories

Abstract

Racial/ethnic and socioeconomic disparities are well documented in nearly every health outcome. Researchers have begun to consider the role of the social determinants of health (i.e., inequitable distribution of resources and systems that result in inequitable health outcomes via unhealthy behaviors or a response to a stressful life) in persistent health disparities. The Lifecourse Health Development (LCHD) framework conceptualizes health as a process that unfolds throughout the lifespan and describes health capacities as resources that allow individuals to constantly manage the structurally-determined risk, protective, and promotive factors in their environment to sustain their health and wellbeing. Health capacities develop through person—environment interactions and are embedded in culturally-dictated social, historical, and political contexts. Within these contexts, resources for developing health capacities are inequitably distributed, resulting in the differential development of health capacities, or variation in the extent to which the health capacity will promote adaptive health development. However, even when differentially developed, health capacities may be drawn on for displays of resilient functioning. The Youth Health Capacity Development model expands on the LCHD and Relational Developmental Systems frameworks by considering the development of three interrelated health capacities (i.e., foundations of health, cultural health capital, and health identity) and how these health capacities are leveraged to promote resilient functioning in inequitable contexts. The foundations of health represent the personal characteristics and environmental conditions that set the stage for health development by facilitating the normative development of biological and physiological systems. Cultural health capital consists of health-related attitudes, beliefs, and behaviors needed to engage in a healthy lifestyle. These health-related attributes are socialized to children by parents/caregivers and social systems, and are reinforced by the social and physical environment. Health identity includes health-related schema that guide health-related meaning-making and decision-making. Although these health capacities inform one another to support health development, the health capacity that is central to health development shifts from early childhood to adolescence in accord with social environmental changes that result in increased autonomy for youth. Qualitative data collected to support the theoretical propositions of the Youth Health Capacity Development model will be presented in addition to the model. Specifically, themes related to how health identity is formed, including how parents teach their children about health and how adolescents learn about health, will be described. The Youth Health Capacity Development model is a strengths-based, social justice-oriented developmental model that can be used to frame the context in which heath identity is developed to promote positive health outcomes among adolescents.

Author

• Patrece Joseph, Tufts University
  Presenting Author