Genetics Meets Preventive Health Care

Posted on | April 22, 2008 | Comments Off on Genetics Meets Preventive Health Care

Can our system transform fast enough to catch up to our science?The people, and the people caring for the people, in the United States and around the world, are just beginning to absorb what the term “preventive health care” really means. Until recently, it was enough to simply think of it as something different from our usual approach to health care – that is, reacting to and controlling the effects of chronic disease, or rescuing someone in the case of a medical emergency.

Now, as we awaken to a brand new scientific era filled with an array of brand new medical tools and the promise of the Human Genome, the public and their caregivers are beginning to understand that true preventive health care is complex – and will require a massive change in the structure of our health care system if it is to take hold.

Prevention is, in one word, planning. To stay ahead of disease, and possibly eliminate its emergence completely, requires anticipation and a new application of genetic science. Elias Zerhouni, head of the National Institutes of Health, has laid out his own "Vision for Transforming Medicine in the 21st Century,” in which he describes a future approach with 4 P’s: “predictive, preemptive, participatory and personalized.”

Zerhouni’s view is that our genetic makeup profoundly determines the likelihood of our suffering in the future from chronic diseases. If we have early knowledge of personal vulnerability, it is possible we can not only keep diseases at bay, but prevent them from ever occurring at all.

In this construct, health and preventing disease involve not only science and genetics, but also a range of social and behavioral factors, environmental conditions, and timely access to quality care. Early diagnostic testing, even at times before birth itself, may help direct planning efforts on behalf of those about to be born.

That’s where scientific inquiry has taken us: a new, exciting vision for the future. But our current health care system’s power axis – the hospital-to-doctor’s-office-to-hospital loop – will not support this vision. In fact, our health system is lagging well behind our knowledge. There’s no way we can achieve the promise before us with an antiquated system and antiquated beliefs. To get to true preventive health care, we’re going to need extensive scientific and organizational re-tooling – along with a much more rigorous national discussion of topics such as genetic testing. Are we up to the task? We’ll need to act soon if our system is going to catch up.

To learn more – watch this week’s video, embedded with this blog post, or read the full transcript. Then send me your thoughts about genetic testing. Is relying on genetic information for health planning a good idea?