The environment, public health and personalized medicine: Where do we go from here?

Philip M. Iannaccone, Lon J. Van Winkle

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The current challenge in environmental health is to merge public health, a population science, with individual-focused precision medicine. Environmental based health outcome disparities are well recognized. Social forces based on environmental dystopia will affect public health in a heterogeneous manner and requires reflective practice by interdisciplinary teams of healthcare professional students and practitioners. Fast, cheap sequencing will allow whole genome association studies (GWAS) that can identify genetic risk factors for adverse reactions to specific toxic exposures. Deep analysis of big data can identify gene/environment interactions including epigenetic alterations. Personal exposure information can be gained from citizen science approaches to capturing exposures. Robust reporting mechanisms of suspected exposure can leverage existing data in superfund and other resources. Putting these together will help us to understand disparities and inform environmental justice efforts. To further such efforts, interprofessional teams of healthcare professional students can begin by reflecting on pertinent community service projects they perform together. Specific examples will be discussed as well as experiences of persons met during service-learning. Consideration is given to the microbiome and to marine biology of wetlands, critical sources of food and vulnerable to pesticide and fertilizer run off. Mitigation of outcomes of toxic exposure involves personalized exposure prevention, political action informed by science and chemical interventions like lead chelation. In the future, we may find altering specific polymorphisms in individuals with gene editing methods may gain a place as we move toward personalized medicine in public health. Effective communication between patient and practitioner, learned through development of listening skills and bias mitigation, is essential. We must navigate individual micro environments and personal genomics as together they define exposure related health outcomes.

Original languageEnglish (US)
Title of host publicationComprehensive Precision Medicine, First Edition, Volume 1-2
PublisherElsevier
PagesV1-343-V1-354
Volume1-2
ISBN (Electronic)9780128240106
DOIs
StatePublished - Jan 1 2023

Keywords

  • Arsenic
  • Citizen science
  • Critical reflection
  • Endocrine disruptors
  • Environmental health
  • Environmental justice
  • GWAS
  • Medical workforce
  • Meta analysis
  • Microbiome
  • Precision medicine
  • Public data
  • Public health
  • Risk profile
  • Wetlands

ASJC Scopus subject areas

  • General Agricultural and Biological Sciences
  • General Biochemistry, Genetics and Molecular Biology

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