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Those who believe that knowledge is power face an interesting challenge when confronted by a test that can alert an adolescent that odds of his suffering from Alzheimer’s disease are much greater than the average. That’s the type of question increasingly raised by advances in genetic testing.
What’s the appropriate response – transforming yourself into an obsessive expert on reducing all the non-genetic risks for the disease or having cupcakes for breakfast every day with your morning cigarette to increase the possibility that you will die prior to the normal onset of Alzheimer’s?
This new knowledge includes both promise and possible peril. The idea that you can find out whether you can benefit from the protection of a vaccine or targeted drugs is intensely attractive.
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Jessie
Gruman
President
Center for the
Advancement of Health |
But these new technologies also pose some challenges. As Melissa Healy of the Los Angeles Times notes, “This is largely a do it yourself marketplace, and patients intent on detecting cracks and flaws in their personal genetic foundation and acting to patch them up are finding they’re pretty much on their own.”
Learning more about how behavior can offset specific genetic risks should certainly be added to the research agenda if this new knowledge is going to deliver its optimal benefit.
But there’s a more basic potential threat to those of us who believe that an informed population is critical to the health of the public. The deterioration of mass media markets may be a portent.
Public health is based on the premise that we face some common problems that can be minimized by improvements in our shared environment and common behaviors – like maintaining clean water and keeping food safe, quitting smoking, and being physically active.
The growing focus on genetic testing could undermine that strategy. Just as there are some people who face an increased risk of colon cancer and Parkinson’s Disease, there are some people who can smoke and drink with impunity. Health messages and policies directed toward the health of the larger community may lose their appeal as individuals become distracted by figuring out how to compensate for their own unique risk profiles.
For example, at the moment, there’s wide agreement that cleaning up the air is a good idea. Will that consensus shatter as some lucky winners realize they’re impervious to certain pollutants and others acknowledge that their extreme sensitivity will leave them vulnerable irrespective of how successful clean-up efforts are?
The community does best when it can meet the individual needs of its members. Often the “one size fits all approach” may remain appropriate, but that isn’t as obvious as it once was. Holding the attention of an audience increasingly accustomed to personalized messages received via personalized media channels about their personal risks will require some new and creative approaches.
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