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Thinking Developmentally

The Next Evolution in Models of Health

Garner, Andrew S. MD, PhD

Journal of Developmental & Behavioral Pediatrics: September 2016 - Volume 37 - Issue 7 - p 579–584
doi: 10.1097/DBP.0000000000000326
Special Article

ABSTRACT: As the basic sciences that inform conceptions of human health advance, so must the models that are used to frame additional research, to teach the next generation of providers, and to inform health policy. This article briefly reviews the evolution from a biomedical model to a biopsychosocial (BPS) model and to an ecobiodevelopmental (EBD) model. Like the BPS model, the EBD model reaffirms the biological significance of psychosocial features within the patient's ecology, but it does so at the molecular and cellular levels. More importantly, the EBD model adds the dimension of time, forcing providers to “think developmentally” and to acknowledge the considerable biological and psychological consequences of previous experiences. For the health care system to move from a reactive “sick care” system to a proactive “well care” system, all providers must begin thinking developmentally by acknowledging the dynamic but cumulative dance between nature and nurture that drives development, behavior, and health, not only in childhood, but across the lifespan.

Department of Pediatrics, Case Western Reserve University, and University Hospitals Medical Practices, Westlake, OH.

Address for reprints: Andrew S. Garner, MD, PhD, 960 Clague Rd, Suite 1850, Westlake, OH 44145; e-mail:

Disclosure: The author declares no conflict of interest.

Received January 25, 2016

Accepted May 09, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.