Breaking the Intergenerational Cycle of Disadvantage: The Three Generation Approach

Abstract

Health disparities in the United States related to socioeconomic status are persistent and pervasive. This review highlights how social disadvantage, particularly low socioeconomic status and the health burden it brings, is passed from 1 generation to the next. First, we review current frameworks for understanding the intergenerational transmission of health disparities and provide 4 illustrative examples relevant to child health, development, and well-being. Second, the leading strategy to break the cycle of poverty in young families in the United States, the 2-generation approach, is reviewed. Finally, we propose a new 3-generation approach that must combine with the 2-generation approach to interrupt the intergenerational cycle of disadvantage and eliminate health disparities.

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Copyright © 2016 by the American Academy of Pediatrics.

Figures

FIGURE 1

Two-generation approach. G1, generation 1, parents; G2, generation 2, child. (Adapted with permission from Schmit S, Matthews H, Golden O. Thriving children, successful parents: a two-generation approach to policy. CLASP Policy Solutions; July 9, 2014. Available at: http://www.clasp.org/resources-and-publications/publication-1/Two-Gen-Brief-FINAL.pdf. Accessed June 14, 2015.)

FIGURE 2

Dynamic relationship of SES and health across generations. G1: generation 1, parents; G2: generation 2, child; G3 generation 3, future offspring.

FIGURE 3

Three-generation approach. Adol, adolescent; G1, generation 1, parents; G2, generation 2, child; G3, generation 3, future offspring. (Adapted with permission from Schmit S, Matthews H, Golden O. Thriving children, sucessful parents: a two generation approach to policy. CLASP Policy Solutions; July 9, 2014. Available at: http://www.clasp.org/resources-and-publiations/publication-1/Two-Gen-Brief-FINAL.pdf. Accessed June 14, 2015.)

FIGURE 4

The 2- and 3-generation continuums. (Adapted with permission from Ascend: The Aspen Institute. The two generation approach. What is the two generation approach? 2012. Available at: http://ascend.aspeninstitute.org/pages/the-two-generation-approach. Accessed May 31, 2015.)