The concept of ’causal crypticity’ was introduced by Richardson (2021) to describe the DOHaD field’s high tolerance for both causes and effects that are challenging to observe in nature, show small effect sizes, and are unstable across study populations and contexts. Causal crypticity can be understood in three ways: as an epistemic norm; as a boundary-delimiting signature of field culture or epistemic style; and as a promissory mode. Increasingly, causal crypticity characterises many fields of the big data-rich, postgenomic life sciences, making DOHaD science a useful index case for scholars of the history, philosophy, and social studies of science interested in the epistemic terrain and social implications of postgenomic sciences. The chapter concludes with a discussion of ethical and accountable claimsmaking in DOHaD science under conditions of causal crypticity.

In this introduction to the Handbook of DOHaD and Society, we provide an overview of the biosocial research field of the Developmental Origins of Health and Disease (DOHaD). We first trace the evolution of this interdisciplinary field over the past two decades, charting the historical conditions that have brought DOHaD to a critical moment when the field is at a threshold of interdisciplinary innovation across both life and social sciences. We then discuss the biosocial perspective that DOHaD offers as its central premise and promise, allowing for questions of socio-environmental justice, discrimination, and equity to be centred in science and biomedicine. We explore the challenges that complicate this biosocial agenda in practice and attend to questions of research translation, interdisciplinary collaboration, and the socio-cultural dimensions of DOHaD-based health interventions. We end by highlighting the transformational potential of the DOHaD research paradigm and how this handbook offers a toolkit for robust interdisciplinary research in this field.

Embodiment is a key concept in the social sciences and has been particularly useful in discussions of the body, health, and disease. Embodiment allows us to connect the subjective experiences of the body, as well as its lived materiality, to broader social contexts. The concept also helps researchers make sense of the ways in which the body is inscribed with history, politics, and culture. This chapter explores the concept of embodiment in the social sciences and its potential use in DOHaD. We argue that it is important to integrate concepts/tools from the social sciences, in this case embodiment, as biosocial collaborations compel cross-disciplinary legibility and a shared vocabulary. Moreover, this integration of concepts and tools would allow DOHaD as a field to deepen awareness and understanding of the kind of influence environmental experiences can have on the development of health and disease over the lifecourse. We suggest that this deeper awareness and understanding achieved through employing the embodiment concept can make DOHaD research and interventions more socially just and socially sensitive.

Many contemporary scholars have described the gendered dimensions of DOHaD research and their consequences, particularly for women and mothers. In this chapter, we further these discussions by highlighting the need for a critical gendered analysis of DOHaD. This approach requires attending to both gender and racism as relations of power that are mutually constituted and shape the practices and unequal impacts of DOHaD. Examining DOHaD through a feminist and critical race lens, we provide an overview of feminist science studies of gender and DOHaD, introduce the intersections of biopolitics, medicalisation, and the politics of reproduction, and discuss the impacts of DOHaD studies that provide little attention to racism. Our analysis draws attention to how gender and racism unequally survey and manage the living conditions and behaviours of certain bodies, highlights the disparate impacts of DOHaD research, and reflects the need for what we call critical gender analyses of DOHaD and other postgenomic sciences. We conclude by considering the effects of DOHaD research on Black, Brown, and Indigenous people and the need for ongoing attention to the impacts of gender and racism in DOHaD science today.

The 2021 State of the World’s Children Report (UNICEF 2021) makes it clear that mental health is a human right and a global good. Research in a variety of fields, including DOHaD, suggests that infancy is a critical period in both brain formation and the formation of positive relational networks that are the grounds for development and adult well-being. Strong evidence that mental health is adversely affected by poor socio-economic conditions suggests the need for carefully directing resources towards structural conditions. At the same time, positive attachment relations within caregiver–child dyads can offset some environmental insults and futures of ill health. The field of infant mental health (IMH) pays attention to the formation of these relationships in the earliest periods of life. This chapter describes efforts to localise universalist models of infant well-being in South Africa, a low-resource setting. These include a new masters’ level training programme and diagnostic tools that can help to sensitise health practitioners to infant well-being. The discussion offers one route to reframing Euro-American models for local contexts while retaining the insights that strong relational capacities can generate resilience in difficult contexts. Its emphasis on historical context, local meaning, and social environment is instructive for DOHaD scholarship.

Communicating research findings is a storytelling practice. The stories we tell as researchers are important to how the publics understand research findings and how research circulates in society. This is especially true for fields that have important social, political, or policy implications, such as the Developmental Origins of Health and Disease (DOHaD). In this chapter, we introduce the term ‘narrative choreographies’ to describe how researchers, clinicians, science journalists, and other actors embed DOHaD knowledge claims as part of larger scientific, social, and political narratives. Using examples from our own research, we show how DOHaD narratives can inadvertently pathologise and stigmatise marginalised people, such as low-income mothers and obese mothers. In order to combat this potentiality, we advocate for deliberately choreographing DOHaD narratives to address structural inequality and advocate for social justice and health equity. At the end of the chapter, we offer concrete recommendations for DOHaD researchers who are interested in reflecting on and workshopping their own narrative choreographies to better support the healthy development of parents, children, and communities.

Knowledge of the molecular and physiological mechanisms of the Developmental Origins of Health and Disease (DOHaD) is no longer confined to the lab. Rather, DOHaD is part of a scattered landscape of policy initiatives, including political discourses, programmatic statements, and public health measures. This chapter examines what could be called the ‘moral paradox’ of DOHaD in policymaking; that is, the idea that while the scope, foundations, and practical implications of DOHaD research call for structural interventions addressing social determinants of health over the lifecourse, messages can boil down to simplistic claims of individual responsibility addressed to parents and gestating bodies. The chapter draws from a systematic literature review to document claims towards individual responsibilities in DOHaD publications. It shows that scientists rarely make any straightforward argument in favour of individual responsibilities for health. The ‘moral paradox’ of DOHaD arises from an ambiguous stance on the pragmatic possibilities of health promotion strategies inspired by DOHaD knowledge, which mixes up the current practical possibilities of the field with its policy framing, opportunities, and political ambitions. The chapter concludes that a greater awareness of these moral idiosyncrasies in DOHaD research may help the field embrace a social justice framing.

The DOHaD field provides critical evidence for investment in early life, linking environmental exposures during preconception, pregnancy, and infancy with later non-communicable disease risk. Despite the potential of this evidence to positively impact some of our most vulnerable communities, instances where communities are engaged in participatory DOHaD research and knowledge translation processes are limited. This chapter explores the benefits of community-based participatory research approaches and outlines current examples within the DOHaD field. In particular, it focuses on ongoing work within the Cook Islands where DOHaD has informed community-partnered research, scientific and health literacy programmes in schools, and the development of early-life nutrition resources for mothers and families.

A focus on the nutrition of women before and during pregnancy was important in establishing the field of the Developmental Origins of Health and Disease (DOHaD). Maternal nutrition provided a means by which poor living conditions could be embodied and affect the development of the unborn baby. Historical evidence linking women’s nutrition to the size of the baby at birth was limited, but a plethora of research with laboratory animals ensued, with maternal diets manipulated to determine consequences for the offspring. This was necessary for the scientific acceptance of the theory. However, a narrow view of nutrition and its role in the first 1,000 days has held prominence, with pregnant women provided nutritional advice, behavioural interventions, and marketed products. This obscures the broad scope and implications of the DOHaD theory for health inequalities. We take a feminist science and technology studies (STS) approach to show how hegemonic nutrition and biopolitics pervade DOHaD research and pregnancy care in ways that render invisible the gendered dimensions of precarity, mothering, and food. We argue that both the scientific method and socio-political influences have constrained responses to DOHaD as an issue of social and reproductive justice.

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.

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.

In the last decade, scholars in the Developmental Origins of Health and Disease (DOHaD) have increasingly engaged in translating the field’s insights into policy and society. Several multidisciplinary advocacy groups have been formed to promote women’s reproductive health as well as maternal and child health. They have framed DOHaD in different ways in order to attract policy attention. Framing is the practice of contextualising and interpreting the meaning of research results in various communication activities. Overall, DOHaD has often been shown to exhibit a narrow focus on individual responsibility and translation at the clinician–patient interface instead of focusing on wider socio-economic, cultural, and political factors influencing health in its framing activities. In this chapter, we examine two case studies of multidisciplinary networks (the Venice Forum and UK Preconception Partnership) and explore how they have framed DOHaD findings when communicating with and for policymakers. We analyse the social valences of these framings and make recommendations for framing DOHaD in ways that better align with social justice and health equity goals.

DOHaD and epigenetic research that investigates causal mechanisms and predictive biomarkers has often occurred in the absence of discussion of ethical, legal, and social implications or engagement with disability communities. These implications include maternal blaming, labelling, stigmatisation, and ableism. Considering the debate on different models of disability by disability activists and social scientists, this is a timely opportunity to optimise the design of epigenetic research into conditions labelled as disabilities. Research aims should address the needs of disability communities, acknowledge diversity, and move away from medical to social models of disability. Here we focus on the autistic community as an example. We argue that there is a need to work with autistic people and their supporters to co-design studies that facilitate a better understanding of autism’s challenges and assets and to use this knowledge to assist these individuals and communities. We also stress the importance of autonomy and information provision in relation to autistic individuals’ engagement with epigenetics tests. We conclude by urging researchers planning DOHaD and epigenetics research to listen to and engage with disability communities when they say, ‘nothing about us without us’.

DOHaD research in economics finds inequitable health and labour market outcomes but lacks insight into structural factors that contribute to disparities. In practice, social relations like racism, sexism, and ableism can translate into inequitable ‘returns to investment’ in ‘human capital’. DOHaD literature in economics could contribute more to understanding the determinants of health. It is limited by a narrow focus on molecular factors and the decontextualised use of demographic variables, which should be interpreted as proxies for hierarchical power relations. Excluding systems of oppression from analyses renders inequity-generating social structures less visible instead of clarifying their unjust consequences. Egalitarian economic approaches can address the failure to adequately integrate social structures with historically grounded, socially informed analyses. This chapter demonstrates how by tracing the devaluation of reproductive labour in economic thought to the reduction of women and girls to their reproductive roles in the DOHaD literature. The marginalisation of women’s labour and of women’s economic research contributes to the dehumanising instrumentalisation of women in orthodox economic research in DOHaD. The analysis reveals risks for women and girls, linking DOHaD literature to debates about ’foetal personhood’, women’s autonomy, and gender inequity.