While the initiative has been hailed as a "turning point" and has the support of a majority of people, it may fail to move the needle on population health for a few key reasons, write Muin J. Khoury, M.D., Ph.D., of the Centers for Disease Control and Prevention, and Sandro Galea, M.D., of Boston University School of Public Health. Not only is pathogenesis considerably complex, particularly for non-communicable diseases, but identifying predictors of diseases to guide interventions is unlikely to be effective for most complex diseases. Furthermore, the success of the initiative requires high-risk patients to change their behavior in response to learning of health risks, but available data suggests patients can’t be relied on to do that.
However, they write, there are three primary reasons to believe precision medicine could successfully strengthen population health:
- Stratifying patient populations into categories based on risk for multiple chronic ailments can potentially reduce care costs.
- Targeting health at the genetic level has historically improved population health. For example, newborn screening, the nation’s biggest precision medicine public health program, could help identify conditions associated with preventable premature deaths, risks affecting an estimated 2 million people, many of whom aren’t aware of them.
- Precision medicine addresses more than genes, diseases and drugs; information technology, for example, will play a major role in developing targeted health interventions.
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