Precision Health for Disease Prevention

We live in an era where the rise in healthcare costs for insurers and employers parallels the rise in chronic disease.  Our reactive medical model sits still, patiently waiting for illness to strike before taking action. As individuals, we are identified as patients by our diseases, not by what makes us truly unique.

It is evident that our current system is flawed; however, knowing why we are failing sets us up for the excitement of how we can succeed.

Stanford Medicine recently noted that, “We are on the brink of an amazing transformation in how we approach health. Instead of a frantic race to cure disease after the fact, we can increasingly prevent disease before it strikes”.1 At a recent biomedicine conference, Stanford’s Dean of Medicine, Lloyd Minor, discussed this transformation using a relatively new idea termed “Precision Health”.

Precision health is an approach that aims to prevent disease, not just treat it. It does this using health data to provide targeted, predictive, and hyper-personalized care. Health data is collected through a variety of means, and this information is then analyzed and used to predict disease risk. It also provides hyper-personalized engagement strategies to eliminate risk before it escalates causing harm and spiralling costs upward.

Some of the data that is being explored lies in the field of genetics. Since the completion of the Human Genome Project in 2004, there has been growing interest in the use of genetic testing for diagnostics and therapeutics, but there has been little discussion about the power of genetic engagement to spark positive behavior change. We know that each and every person is unique, and we differ in everything from body chemistry, physical makeup, personality, motivation, and metabolism to our susceptibilities to illness. Why, then, do we group anyone with the same medical condition into one basket or curriculum and treat them all the same way? And when did we begin associating ‘patients’ with their disease states instead of individual characteristics and symptoms?

Exploring the information that our genes contain isn’t about determining our ultimate health destiny. Instead, genetic analysis is used for the valuable information it can provide on understanding the different disease risk that two people may have, even if they are similar in age, gender, and background. Genetic testing also provides information required to personalize or further refine treatment strategies. Again, two individuals may appear quite similar and have the same medical condition; however, what works for one, might not be what works for the other.  A third and very powerful use of genetic testing is to engage and spark positive behavior change towards a healthier lifestyle. When genetic testing is used in this manner, it helps an individual open up to the possibility of change which combined with the right personalized action plan and support can make all the difference in taking those positive steps towards living healthier everyday which is where the rubber hits the road for preventing conditions like obesity, heart disease, type 2 diabetes and stroke.

Genetics is already proving to be a game changer for engagement in disease prevention programs. In these programs, genetic testing is being used to better understand struggles with weight gain and obesity, type 2 diabetes, and other cardiometabolic conditions. These programs are able to identify individuals who are more likely to gain weight in the mid-section as a direct result of dietary struggles related to blood sugar and carbohydrate utilization. The results allow for more effective dietary advice that corresponds with lower carbohydrate intake, which offsets the difficulties in carb metabolism. Some programs also explore the link between behavior and genes, and how this effects why some people tend to use food and other addictions as a reward mechanism, or why some individuals tend to eat more in response to emotions and stress. Having this valuable information allows recommendations to be more suited to the individual and removes the guess work.

While still new and on the leading edge, genetic testing and precision health can be a way that we migrate away from our traditional one-size-fits all system. It allows us to shift our focus from disease management to disease prevention – a much needed change – and a more personalized treatment plan, where the right engagement approach can be designed for each participant. Using precision health has proven to be effective in disease prevention and, also honors the unique attributes of each of us. It’s time for ‘n of 1’ to become the standard for inspiring individuals to live healthier every day to prevent disease.

 

  1. http://med.stanford.edu/precisionhealth.html

 

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