'Children of 1997': from paediatric to lifecourse epidemiology, thence population health and policy

Abstract

Birth cohorts are a unique resource to understand the causal impact of clinical and other broader determinants of child public health. If followed into adulthood, even old age, they can provide invaluable aetiologic insights over the lifecourse, especially regarding the pathogenesis of chronic conditions, and specific to the socioeconomic contexts within which the children have grown up. I will review our experience to date studying 8,327 children born in April and May of 1997. In particular, we focused on the inter-relations between method of delivery, pre- and post-natal smoke exposure via nonsmoking mothers, breastfeeding and health care use. I will also outline future plans to continue following these currently 10-year-olds to examine the impact of epigenetics in the generation of adult diseases, mediated through anthropometric and endocrine changes in infancy, childhood and adolescence. This is particularly important in Hong Kong which has experienced a recent and rapid epidemiological transition from essentially pre-industrial conditions over the last two or three generations. Hong Kong’s empirical experience can provide a counterfactual check on hypotheses in evolutionary medicine generated from western Caucasian cohorts with very different developmental trajectories. Additionally, our findings may well presage forthcoming changes as much of rural China develops economically.