COVID-19 across the Life Course

Abstract

Abstract This chapter examines how a life course epidemiological perspective can improve understanding of the lifetime risks and long-term health consequences of the COVID-19 pandemic. It first introduces life course epidemiology and identifies the key life course questions to address in relation to the pandemic. The authors provide a brief historical overview of the role of infectious diseases in the development of chronic diseases, noting how the pandemic is helping to break down the traditional divide in epidemiology between these two types of diseases, and then discuss what can be learned from studying the long-term health and economic effects of previous pandemics. COVID-19 and the chronic health conditions of later life share many risk factors, such as poor lifetime living conditions, education and cognition, health behaviors, and prior physical and mental health. The authors identify the groups at highest risk in childhood and adulthood of chronic diseases and poor or accelerated functional aging and discuss how the COVID-19 pandemic may influence and exacerbate the impact of these risk factors on those outcomes. They discuss how the value of life course epidemiology may be enhanced by incorporating pandemics and other global challenges into traditional life course frameworks and models, benefiting from advances in exposure science in assessing lifelong exposures, and paying more attention to the lifetime determinants and consequences of infectious diseases. In particular, they emphasize the importance of focusing on how lifetime health inequalities are being exacerbated by the COVID-19 pandemic, and the interventions needed to address these inequalities across the life course.