Genomics and YouGenomics and You

““What is it and why now?”What is it and why now?”

OverviewOverview

• Genetics vs. GenomicsGenetics vs. Genomics• MisperceptionsMisperceptions• Applicability to public healthApplicability to public health• ChallengesChallenges

Genetics vs. GenomicsGenetics vs. Genomics

• Genetics: Genetics: study of study of single genessingle genes and and their effects (cystic their effects (cystic fibrosis)fibrosis)

• Genome:Genome: all the all the genetic material genetic material (DNA) of an (DNA) of an organismorganism

Genetics vs. GenomicsGenetics vs. Genomics

• Genomics:Genomics: study study of of allall the genes in the genes in the genome, the genome, including their including their interactionsinteractions with with environmental environmental factors (heart factors (heart disease, asthma)disease, asthma)

MisperceptionsMisperceptions

• ““Genomics isn’t relevant to me or Genomics isn’t relevant to me or the area of public health in which I the area of public health in which I work”work”

• Did you know that …Did you know that …

99 of the top of the top 1010 causes of causes of death in the death in the U.S. have a genetic component?U.S. have a genetic component?

Top 10 Causes of Death in Top 10 Causes of Death in the U.S. (2000)the U.S. (2000)

Heart DiseaseHeart Disease CancerCancer Cerebrovascular DiseaseCerebrovascular Disease Chronic Lower Respiratory DiseaseChronic Lower Respiratory Disease? Accidents/Unintentional InjuriesAccidents/Unintentional Injuries DiabetesDiabetes Pneumonia/InfluenzaPneumonia/Influenza Alzheimer’s DiseaseAlzheimer’s Disease Kidney DiseaseKidney Disease SepticemiaSepticemia

MisperceptionsMisperceptions

• ““Genetic susceptibility equals Genetic susceptibility equals health destiny”health destiny”

• Diseases can be caused solely by Diseases can be caused solely by genetics. However, most diseases genetics. However, most diseases are caused by are caused by gene-environmentgene-environment interactionsinteractions

Genetic Susceptibility is Genetic Susceptibility is NOTNOT Health Health DestinyDestiny

Genetics Genetics is just one is just one piece of piece of

the the “puzzle”“puzzle”

MisperceptionsMisperceptions

• ““There are no interventions based There are no interventions based on genomics”on genomics”

It’s true, we can’t change our genes. It’s true, we can’t change our genes. BUT we can use this knowledge to …BUT we can use this knowledge to …

Potential InterventionsPotential Interventions

• Modify Modify screeningscreening and and medicalmedical recommendationsrecommendations– More Frequent More Frequent

ScreeningsScreenings

– Genetic Genetic Testing/EvaluationTesting/Evaluation

– Interventions or Interventions or PreventionPrevention

Potential InterventionsPotential Interventions

• Modify Modify exposureexposure to environmental to environmental factors that may factors that may interact with interact with known genetic known genetic susceptibilitiessusceptibilities– Pesticide ExposurePesticide Exposure– Genetic Screening Genetic Screening

for agricultural for agricultural workers at high-riskworkers at high-risk

Potential InterventionsPotential Interventions

• Target Target messagesmessages and and interventionsinterventions aimed at changing aimed at changing behaviorsbehaviors of high- of high-risk groupsrisk groups– Diet Diet – Physical ActivityPhysical Activity– Smoking CessationSmoking Cessation– Alcohol AvoidanceAlcohol Avoidance– Others?Others?

Genomics and YouGenomics and You

• What are some examples of What are some examples of public health genomics?public health genomics?

•Did any of Did any of these activities these activities apply to you?apply to you?

Family HistoryFamily History

Powerful tool that can identify Powerful tool that can identify geneticgenetic, , behavioralbehavioral, , socialsocial, , environmentalenvironmental, and , and culturalcultural factors factors

Should We Wait?Should We Wait?

• Direct-to-consumer Direct-to-consumer marketing of BRCA marketing of BRCA genetic testgenetic test

• Genetic profiles for Genetic profiles for nutrition, drug response, nutrition, drug response, osteoporosis, and heart osteoporosis, and heart diseasedisease

• Genetic tests available for Genetic tests available for over over 900900 conditions conditions

Overcoming ChallengesOvercoming Challenges

• Potential Potential discrimination in discrimination in health health insuranceinsurance or or employmentemployment

• Access to genetic Access to genetic services for services for all all populationspopulationsEthical, Legal, Ethical, Legal,

and Social Issues and Social Issues (ELSI)(ELSI)

Overcoming ChallengesOvercoming Challenges

Genomics won’t change the goals of public Genomics won’t change the goals of public health. But it can be used as a tool to help health. But it can be used as a tool to help target at-risk populations, through tailored target at-risk populations, through tailored

messages and interventions.messages and interventions.

Genomics and YouGenomics and You

““Genomics will be to the 21Genomics will be to the 21stst century what century what infectious disease was to the 20infectious disease was to the 20thth century … Genomics should be century … Genomics should be

considered in every facet of public considered in every facet of public health: infectious disease, chronic health: infectious disease, chronic

disease, occupational health, disease, occupational health, environmental health, in addition to environmental health, in addition to

maternal and child health”maternal and child health”- “Gerard et al. Journal Law, Medicine, Ethics 2002; vol 30 (suppl): 173-176”- “Gerard et al. Journal Law, Medicine, Ethics 2002; vol 30 (suppl): 173-176”

Thank You!Thank You!

• Questions or comments?Questions or comments?• Contact UsContact Us

– Chronic Disease Genomics ProgramChronic Disease Genomics Program

• Rebecca Giles Rebecca Giles rgiles@utah.govrgiles@utah.gov• Jenny Johnson Jenny Johnson jennyjohnson@utah.govjennyjohnson@utah.gov• Jess Agraz Jess Agraz jagraz@utah.govjagraz@utah.gov