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Health professionals have an increasing tendency to work in silos despite the explosion of knowledge indicating that most diseases span the life course. Furthermore, it is increasingly difficult to interest busy adult physicians about the importance of early causation of diseases with which they regularly interact. Why should healthcare teams dealing with COPD and other disorders presenting in adult life, or paediatricians specialising in respiratory care, be interested in the outcomes of babies born premature?
The answer is there is mounting evidence that virtually all chest diseases have their origins in childhood, and for many the die is cast well before birth—through a combination of external influences such as nicotine use and air pollution, and the secondary effects of reduced fetal growth, infection and poor nutrition. Among individuals precise causative pathways may differ, but many more patients are now presenting in childhood or early adult life with evidence of increased risk of future respiratory morbidity. Understanding how this risk …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.