Several thought leaders, including Francis Collins, have heralded the age of “precision medicine.” A recent commentary provides compelling arguments why “enthusiasm is premature.”

The greatest problems we face in improving health care do not require precision medicine.

“In 2013, the National Research Council (NRC) and the Institute of Medicine (IOM) issued a bleak report on life expectancy and well-being in the United States.  Shorter Lives, Poorer Health documented the extent to which Americans were at a disadvantage at every stage of life compared with their counterparts in peer countries.”  Americans fared worse in all of the following:

• Birth outcomes
• Heart disease
• Motor vehicle accidents
• Violence
• Sexually transmitted disease
• Chronic lung disease

The NRC notes that “health is determined by far more than health care.”

Other points:

• While the U.S. may have the most advanced healthcare in the world, the “whiz-bang technology just cannot fix what ails us.” (NY T-inequality-is-costing-the-us-on-social issues.html)
• “Precision medicine itself may ultimately make critical contributions to a narrow set of conditions, but the challenge we face…entails…willingness to address certain persistent social realities”
• “Our public investments in broad, cross-sectional efforts to minimize…foundational drivers of poor health as poverty…are pitifully few in comparison with those of other countries.”
• Take-home message from authors: “We worry that an unstinting focus on precision medicine by trusted spokespeople for health is a mistake — and a distraction from the goal of producing a healthier population.”

My view: The challenges posed by the authors do seem monumentally greater than those facing the development of precision medicine.

Related blog posts:

• Zip Code or Genetic Code -which is more important for …
• “Issue-attention cycle” problem.  “This pattern occurs when initial public alarm over the discovery of a problem and optimism about its quick resolution are replaced by the realization that solving the problem will require some public sacrifice and will displace powerful societal interests.”from Weight of the Nation | gutsandgrowth

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