The Healthy Start EPIC Framework presents four guiding principles that can help Healthy Start grantees to maximize the effectiveness of their services to reduce infant mortality, improve birth outcomes and eliminate health disparities. Utilizing the EPIC principles enables grantees to strengthen community service systems to best meet participant needs across all phases of the perinatal period. The fourth principle is…

Consider the participant’s context

Integrate the social determinants of health and life course approaches in program planning and service delivery. Consider circles of influence and the multiple contributing factors that impact women’s and infants’ health.

To apply this principle, HS grantees should sustain or build their capacity to:

  • Promote comprehensive women’s health beyond the nine months of pregnancy to improve birth outcomes
  • Integrate a life course approach in program planning and implementation to address health disparities
  • Ensure assessment of participants’ life conditions and circumstances
  • Link participants to social services to address social determinants of health
  • Ensure that all services are provided in a culturally and linguistically appropriate manner


The Promise Neighborhoods Institute at PolicyLink (PNI) – The federal Promise Neighborhoods program works to break the cycle of generational poverty by wrapping children in a pipeline of health, social, and educational supports from birth through college. PNI provides technical support to all communities, whether or not they have been awarded a federal grant. PolicyLink, the Harlem Children’s Zone, and the Center for the Study of Social Policy.

Achieving Health Equity in Promise Neighborhoods: A Resource and Implementation Guide – Describes the results-based approach used by Promise Neighborhoods to improve community environments to support health, and provides communities with best practices and resources to achieve population-level results for children. Policy Link and California Endowment.

Applying Social Determinants of Health to Public Health Practice – The November/December 2013 Supplement to Public Health Reports, the journal of the U.S. Public Health Service, focused on how public health professionals can address Social Determinants of Health. Association of Schools and Program of Public Health.

Data Set Directory of Social Determinants of Health at the Local Level – Contains an extensive list of existing data sets organized according to 12 dimensions of the social environment.  Social Determinants of Health Workgroup, CDC.

Rethinking MCH: The Life Course Model as an Organizing Framework – Concept paper commissioned by MCHB as a resource to help the broad MCH community shape its public health approaches for the 21st century. MCHB, HRSA Nov 2010.

A Life Course Approach Resource Guide – A collection of resources exploring the implications of life course perspectives for efforts to improve the health and well-being of women, children, youth and families. MCH Training Program, MCHB, HRSA.

Closing the Black-White Gap in Birth Outcomes: A Life-Course Approach – This article by Michael C. Lu, Milton Kotelchuck, Vijaya Hogan, Loretta Jones, Kynna Wright, and Neal Halfon outlines a plan using a life course approach to close the Black-White gap in birth outcomesEthnicity & Disease, Volume 20, Winter 2010.

Healthy Start Project Checklist – Helps HS Projects to track progress in implementing key elements of Healthy Start. Checklist questions are aligned with the 4 EPIC principles. HS EPIC Center.