Written by Anne Trolard, manager for the Public Health Data and Training Center at the Institute for Public Health
An article in my inbox on precision medicine caught my eye recently, reminding me I had wanted to learn more about this buzz-word in healthcare.
The article, in WUSTL’s The Source, describes precision medicine (PM) as the next frontier in healthcare, and features the precision research of a number of Washington University physician-scientists. When I finished I had a good grasp on it, but also had some new questions: how did we get to this new paradigm in healthcare? And will the massive resources needed for PM also end up shifting the conversation about health?
President Obama officially launched the precision medicine initiative during his 2015 State of the Union Address, and stated this next frontier of healthcare will be “delivering the right treatments, at the right time, every time to the right person.” This kind of personalized approach is made possible by advances in genetic testing, but also by access to lifestyle information from electronic medical records and environmental data based on where a person lives. A major goal of the PM initiative is to build one of the world’s largest and most diverse datasets for research—the genomic and electronic health record data from 1 million US volunteers. The data must be representative of the US population and all of its diversity in order to make accurate personalized predictions of disease and treatment for everyone. One challenge that the initiative is already facing is people not wanting to share their electronic health record data.
To understand more of the history, I read the transcript of another speech Obama gave on PM, and was a little surprised by the contexts of economic growth and of innovation. Surprised because of the irony that while the United States is a leader in advancing healthcare and biotechnology, it maintains poor health outcomes compared to other wealthy countries. I was then reminded of a phrase in The Source article that had caught my attention: “We’re living longer because we’re surviving cancer, heart disease, and other disorders.” What struck me was the use of the word “we.” There is no one “we” in the United States when it comes to health. The richest men in America live 15 years longer than the poorest men, and the richest women 10 years longer than the poorest women. While it may seem like I’m missing the point of the statement, I wonder just how much precision medicine can address the overall patterns of morbidity and mortality, and also how much it could pull the focus of our nation’s health away from the root causes of these disparities.
There is no one “we” in the United States when it comes to health.
I am looking forward to learning more about these issues, and more about what is going on at Washington University and BJC regarding precision medicine and also precision prevention. It seems to me one important thing we as a community can do is to keep the conversation on PM diverse and ongoing. The Institute for Public Health will feature a number of other posts on PM this month, which will undoubtedly highlight more opportunities to learn and engage.