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The Role and Uses of Genomics in Public Health Discussed at EPH Alumni Day

Genomics has produced a wealth of information that will ultimately play an important role in preventing, diagnosing and managing a variety of chronic diseases, including cancer, diabetes, and cardiovascular disease. While it presents exciting opportunities, genomics also presents complex challenges, such as avoiding the misuse of genetic information or the creation of a genetic underclass that has difficulty getting health insurance.

A number of experts convened to discuss the issues raised by genomics at EPH's June 3 Alumni Day. Keynote speaker Kenneth Kidd, PhD, Professor of Genetics, Psychiatry, and Biology at Yale, explored race and geography from a global perspective, including how distribution of genetic variation among individuals and populations yields a better understanding of differential susceptibility to disease.

A panel of faculty and alumni experts gave numerous examples of the role that genomics can play in public health, but also cautioned against over-emphasizing genetic causes – as opposed to environmental and behavorial causes – of disease. Marta Gwinn, MD, MPH, Director for Science, Centers for Disease Control and Prevention (CDC) Office of Genomics and Disease Prevention, Coordinating Center for Health Promotion, argued that, despite the preference of some public health professionals to assign genomics to the realm of medicine because of its individualized nature, genomics has an important place in public health. She noted that genomics holds potential for stratifying disease risk and differentiating intervention, identifying or confirming environmental risk factors, and gaining a better understanding of disease and population. Kathleen Merikangas, PhD, Chief, Section on Developmental Genetic Epidemiology, National Institutes of Health, noted that “we need to put together the knowledge gleaned from clinicians, epidemiologists who study the environment, and geneticists, before we can really embark on expeditions to identify genes or environmental factors, and likely both.” Referring to the dichotomy between public health and medicine, Gwinn argued that genomics can be used “to bridge medicine and public health, put them back together like they should have been by saying that 'we're going to bridge individuals and populations by identifying families and groups at increased risk – diagnosis and risk assessment through susceptibility testing and early detection, therapy and prevention by effective evidence-based intervention.'”

James S. Marks, MD, MPH '80

Several people were honored at the annual Alumni Day Award Luncheon. James S. Marks, MD, MPH '80, Senior Vice President, The Robert Wood Johnson Foundation, received the 2005 Distinguished Alumni Award. Jerald Fagliano, PhD, MPH '85, was inducted into the Public Service Honor Roll. Peter Singer, MD, MPH '90, received the Award for Excellence in Bioethics, and gave a special address exploring the bioethical implications of the genomics revolution, including the incremental harnessing of genomics and biotechnology to improve health in developing countries.

–Story by Christy Gordon