Recognising how early experiences frame and impact later health is a key concern for DOHaD. However, rarely in DOHaD studies are the synergistic characteristics of diseases throughout the lifecourse a central focus. Syndemic theory posits that disease concentrations (where diseases cluster together) and disease interactions (what adverse effects result from the clustering) cause more health adversity due to their synergistic dynamics. In this chapter, we consider how syndemic theory can contribute meaningfully to DOHaD studies because it considers how and why diseases occur, cluster, and interact across the lifecourse and integrates a synergistic understanding of early stressors and long-term adverse health. We describe the history of the syndemic concept and discuss the synergies of syndemic and DOHaD theory. We draw on our work with the ‘Birth to Thirty’ birth cohort based at the Developmental Pathways for Health Research Unit (DPHRU) at the University of the Witwatersrand to provide some examples of how social, psychological, and biological factors cluster and drive health and disease over a lifetime.

Despite the promise of a post-racial science, debates over the meaning and implications of race and population differences have persisted, albeit in transformed terms. Given that they eschew fixed genetic differences, ‘biosocial’ perspectives on race have brought with them a renewed focus on the social, historical, and political bases of contemporary health disparities. However, the move away from reference to fixed genes in describing how racial health disparities emerge or are maintained is not without problems. In this chapter, we first challenge the notion that the embrace of environmentally driven effects is inherently progressive, through an examination of the longue durée of pre-modern racial typologies. Second, we review recent research within DOHaD and environmental epigenetics that addresses racial health disparities. Our review reflects our concern that postgenomics has the potential to catalyse new forms of essentialism and typological thinking. Studies in our review hew closely to essentialist forms of racial thought, albeit now marked by methylation differences and adverse early life conditions. To avoid the return of racialised typological thinking, we suggest methodological interventions and various research orientations, such as interdisciplinarity, that can prevent a return to notions of fixed racial difference

This chapter, written by a founder of the field and a historian with a long-term interest in DOHaD, examines the key (long) decade in the history of DOHaD, bookended by two conferences: one in 1989 and the other in 2003. At the 1989 workshop, David Barker presented his retrospective epidemiological research to an audience of fetal physiologists and clinicians. Discussions about the plausibility and underlying mechanisms of Barker’s findings fostered new research collaborations, methodologies, and projects, which over the next decade produced a new field. By 2003, DOHaD had grown sufficiently in both numbers and ambitions to host a major global conference. This chapter argues that to understand the objectives, methods, research questions, and intellectual networks making the field of DOHaD, the reactions that it provoked, and how it responded to them, we must understand the historical and geographical context in which it was created, first in Europe, especially the United Kingdom, and then globally. Here we identify and explain three key drivers that shaped the field: interdisciplinarity, the history of social class and attempts to address health inequalities in the United Kingdom, and the globalisation of the 1990s informing the intellectual underpinnings of the global health agenda.

Four approaches to concept formation are particularly fruitful for the endeavor of this book. These are Adrian Cussins’ theory of cognitive trails, Serge Moscovici’s and Ivana Marková’s closely interconnected theories of social representations and dialogicality, Ed Hutchins’ theory of conceptual blending by material anchors, and Nancy Nersessian’s theory of model-based reasoning. An examination of these approaches yields the following initial lessons: (1) longitudinal character of concept formation, (2) materiality of concept formation, (3) societal and dialogical embeddedness of concept formation, (4) centrality of tensions and contradictions in concept formation, and (5) importance of change and future-orientation in concept formation in the wild. These first lessons are still embryonic. They draw on cognitive and social-psychological approaches that are not systematically built on materialist dialectics.

The chapter presents five types of functional concepts, with an example of each type. These are (1) prototypes, (2) classifications and categories, (3) process concepts, (4) systems concepts, and (5) germ cell concepts. Each type of functional concepts has its own specific strengths and affordances. In other words, one type is not “better” or “more advanced” than the other. However, many complex activities would benefit from making use of the complementarity of different types of functional concepts. Tools become powerful when they become an interconnected instrumentality. Recognizing the different conceptual resources – and conceptual gaps – in an activity system opens up the possibility of building a conceptual instrumentality, that is, a repertoire of different but complementary and interconnected types of concepts available for the practitioners for conducting and developing their collective activity. In particular, the germ cell concepts have potential that has so far remained largely unrecognized in organizations. This is demonstrated with the help of the example of the concept of knotworking.

The environment represents a central research object in the Developmental Origins of Health and Disease (DOHaD) and related fields such as epigenetics. This chapter discusses how DOHaD researchers operationalise and measure environments in and through their research practices to produce knowledge on how environmental experiences relate to health outcomes over the lifecourse. While DOHaD researchers discursively acknowledge the complexity of lived environments, we identify some of the current challenges to put this complexity into research practice, often resulting in reductionist accounts of the dynamic nature of human experiences. By proposing the term ’doing environments,’ we emphasise how practices to enact environments for scientific inquiry are products of decisions and negotiation processes that need careful consideration on what social and political consequences these ’doings’ might have and for whom. To that end, we aim to lay the ground for interdisciplinary conversations to engage in critical reflections about the social and political dimensions of doing environments in DOHaD research.

Although maternal, newborn, child, and adolescent health is a well-established determinant of health across the lifecourse and across generations, the underpinning concept of DOHaD has not had significant impact on policymaking. This chapter identifies some of the barriers involved and how DOHaD researchers may overcome them. Policymaking is a complex process that is influenced by many factors other than science. Translating evidence to policy requires brokerage that explains the implications of science in a clear, frank way, accompanied by impactful solutions. Yet, the largely preventive approach advocated by DOHaD science does not inherently offer simple, high-impact interventions but rather a broad shift in thinking within the policy community. DOHaD advocacy will need to demonstrate short- and medium-term, as well as long-term, benefits. A complementary approach is to engage with communities to adjust scientific ideas to local knowledge and expertise.

The three initial sources of this book are a Marxist dialectical theory of concepts, an emphasis on the collective and historically evolving nature of concepts, and the turn toward everyday practical activities as legitimate arenas of thinking and conceptualizing. The resources for integrating these sources into a coherent framework come from cultural-historical activity theory and the theory of expansive learning, applied and developed in interventionist studies of various types of work and organizations, from cleaning services to hospitals and courts of law to factories and banks. In recent years, this empirical basis has been broadened to include social movements and societal change efforts championed by broad-based coalitions. The primary focus of this book is on collective creation of culturally new concepts in the wild. The starting point is the realization that culturally novel concepts are not only created by scientists but also by people struggling with persistent problems and challenges in all walks of life. We are all involved in the creation of new concepts. This has been largely omitted by scholars of concept formation. Taking this seriously means that we need to reexamine and perhaps revamp aspects of our basic understanding of concepts.

This chapter describes the principles of the lifecourse perspective and its potential for examining the origins of health and disease (DOHaD). DOHaD research, framed by a lifecourse perspective, accounts for how experiences ’get under the skin’ by influencing biological functions during developmental windows of opportunity, transforming lifecourse trajectories, and affecting intergenerational health patterns. We go on to investigate how exposures and experiences influence different individuals in different ways, with some more vulnerable or susceptible to risk than others, resulting in significant variability in developmental outcomes. Yet, even when taking differential susceptibility into account, there are cross-cutting themes in research focusing on a wide range of disease outcomes in adulthood. These include socio-economic disadvantage and early adverse experiences, which result in a generalised susceptibility to risk. We conclude with a discussion on the limitations of current work in this field, and future directions and priorities for research, including more integrated, multidisciplinary approaches and longitudinal research designs, as well as more sophisticated statistical methods of analysis that move beyond correlational methods and simple causal models.

The question motivating this chapter is: What are the key characteristics of double stimulation and what is its role in concept formation in an everyday work activity facing transformations? The analysis shows how volitional change actions emerge and take shape in processes of double stimulation in critical encounters, and how they lead to attempts at concept formation. Critical encounters are fruitful breeding grounds for double stimulation and concept formation efforts in work activities. They may be described with the help of two dimensions, namely the dimension of restrictive vs. expansive use of artifacts and the dimension of incidental vs. planned use of artifacts. Conceptualization efforts often accompany the volitional actions resulting from the expansive use of artifacts. These conceptualization efforts are seldom conscious attempts to fully define or explain a concept. The conceptualization efforts are predominantly fragmentary and focused on specific aspects of the emerging concept. In this light, conceptualization efforts in critical encounters resemble the construction of a mosaic pattern distributed in time and social space across many actors and encounters. Although seemingly modest and piecemeal, such efforts may lead to a radical sea change over time.