The Role of Government in Precision Medicine, Precision Public Health and the Intersection With Healthy Living☆
Section snippets
The All of Us Research Program
The All of Us Research Program (AoURP) is a longitudinal cohort study that aims to recruit at least 1,000,000 people living in the United States (US) and will evaluate behavioral, environmental, and biological exposures over at least 10 years. The study launched in May 2018, and as of October 2018 has recruited more than 100,000 participants, with more than 60,000 of those having completed biospecimen gathering, physical examinations, and electronic health record donation. The AoURP prioritizes
Non-profit sector commitment to precision medicine and public health
Non-profit organizations like the American Heart Association (AHA) catalyze a commitment to health and well-being through precision medicine at the local, state, national, and international levels. Specifically, the AHA has established an Institute for Precision Cardiovascular Medicine (Institute). Fig 1 depicts the five impact strategies of the Institute: to be a convener, provide transformational grants, enable date discoverability and access, act as the critical translational agent, and
Appropriations
Appropriations at all levels of government are needed to fund primary research for precision medicine and precision public health and their translation to clinical practice, quality initiatives, policy, systems and environmental change, and public health infrastructure. Governments can also amplify private sector investment in precision medicine and precision public health research and workforce development.24 Federal investment in research includes the NIH, the Centers for Disease Control and
A vision for the future
Moving at the speed of trust through local communities and meeting people where they are will be as important to precision medicine and precision public health as any large change that affects people's and population's health and well-being. Continual digital innovation will be needed for sharing data equitably and securely, and innovative research combined with data science to drive new policies, prevention strategies, diagnostics and treatments for the right person at the right time for
Conclusions
Governments have a central role to play in precision medicine and precision public health, helping to transform what is learned into evidence-based, equitable policy, system and environmental changes. Richer, more granular longitudinal data will be used for better decision making in medicine and public health to transform healthy living. A visionary future creates transparent, secure, and fair systems to equitably promote health, well-being, and better health care.
Statement of conflict of interest
Mark Huffman: MDH receives grant support from the World Heart Federation to serve as its senior program advisor for the Emerging Leaders program, which is supported by unrestricted educational grants from Boehringer Ingelheim and Novartis with previous support from AstraZeneca and Bupa. MDH also receives support from the American Heart Association, Verily, and AstraZeneca for work unrelated to this project. MDH also serves as associate editor for JAMA Cardiology for which he receives
References (26)
- et al.
The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis
Lancet Public Health
(2017) Government's role in promoting healthy living
Prog Cardiovasc Dis
(2017)- et al.
Million Veteran Program: a mega-biobank to study genetic influences on health and disease
J Clin Epidemiol
(2016) - et al.
Current status and what it means for epidemiology
Health Policy Technol
(2012) - et al.
Genetic architecture: the shape of the genetic contribution to human traits and disease
Nat Rev Genet
(2018) - et al.
Epigenetics: definition, mechanisms and clinical perspective
Semin Reprod Med
(2009) Environmentally induced gene expression
(2001)- et al.
Health hazards in the home: an assessment of a southern Nevada community
J Community Health
(2017) - et al.
Environmental effects on gene expression phenotype have regional biases in the human genome
Genetics
(2007) - et al.
Public health and precision medicine share a goal
J Evid Based Med
(2017)
A new initiative on precision medicine
N Engl J Med
Four steps to precision public health
Nature
Precision medicine initiative: privacy and trust principles
Cited by (12)
Enterprise imaging and big data: A review from a medical physics perspective
2021, Physica MedicaCitation Excerpt :In the EU, the implementation of GDPR and it’s strict requirement for patient consent, personal data safeguards and provenance – all generally positive aspects – has put up a number of impediments to the sharing and collecting of medical data that could lead to true ‘big data’ [93]. Because of the limitations of organized data collection approaches, there are ongoing efforts to crowd-source clinical data directly from patients, and collect not only medical histories, but actual images and even genomic analyses [94,95]. However, in light of the increased need for training and validation data with which to develop robust deep learning models, health care facilities could be incentivized to share data to support these efforts.
An Assessment of the Knowledge and Perceptions of Precision Medicine (PM) in the Rwandan Healthcare Setting
2023, Journal of Personalized MedicineRecommendation of precision medicine application in Indonesia from multiple perspective: a review
2023, International Journal of Public Health ScienceAn innovative framework to determine the implementation level of personalized medicine: A systematic review
2023, Frontiers in Public HealthAir quality and cancer risk in the All of Us Research Program
2023, Research Square
- ☆
Statement of Conflict of Interest: see page 54.