Precision Medicine and Population Health: Dealing With the Elephant in the RoomPosted on by
- Precision medicine might not improve population health because of the complexity of disease pathogenesis, especially for common chronic diseases. As a result, the promise of precision medicine to identify predictors of disease that can help guide personalized interventions may not be easily fulfilled. Changing behavior on the basis of genetic risk information to mitigate risks is difficult to achieve. The United States lags behind other high-income nations in population health status, and there are growing gaps between haves and have-nots in health. Solving these problems lies in addressing social, economic and structural drivers of population health, not in focusing more on individual health. Additionally, the precision medicine agenda could shift resources from other areas, and its appeal may lead to hype and premature expectations that may cause long-term disillusionment and erosion of public confidence in health sciences.
- Precision medicine might improve population health because we need both individual and public health approaches to improve health. Population health planning requires directing efficient use of resources toward those most at risk. Past successes of genomics and precision medicine indicate that they can yield population health benefit. For example, newborn screening is the largest “precision medicine” public health program in the world. Even with no new insights, near-term population health impact of precision medicine could accrue by implementing CDC’s evidence-based “tier 1” genomic applications that have evidence-based recommendations for their use and can benefits millions of people. Finally, new precision technologies and data science, over time, will improve our ability to track and prevent infectious disease outbreaks, measure environmental exposures, enhance disease tracking in populations and help develop policies and targeted interventions that can improve health and address health disparities.