# Presentation: 097205

## Public Health Functions & Services: The Integration of Genetics

- Office of Genetics and Disease Prevention
- Centers for Disease Control & Prevention

## Goal of this Project

- Develop a taxonomy that:
- demonstrates the intrinsic role for genetics in achieving public health goals
- can be readily understood and widely accepted for use by the public health community
- provides a lasting framework for planning, carrying out, and evaluating the integration of genetics into CDC activities

## “Public Health in America”

- Assessment

- Policy Development

- Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

*Public Health Functions Project, Office of Disease Prevention & Health Promotion, Office of Public Health & Science, US Department of Health & Human Services (1994)*

- “Public Health in America”

## The Integration of Genetics??

- Assessment

- Policy Development

- Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

## The Integration of Genetics

- Assessment

- Policy Development

- Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Assessment**: The regular systematic collection, assembly, analysis, and dissemination of information, including human genome epidemiologic information, on the health of the community.
*	**Human Genome Epidemiology: The study of the role of genetic factors and their interaction with environmental factors in the occurrence of disease in human populations.*

## The Integration of Genetics

- Assessment

- Policy Development

- Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Policy Development**: The formulation of policies, in collaboration with stakeholders, that promote the appropriate use of genetic information and the effectiveness, accessibility, and quality of genetic tests and services.
*	*
*Stakeholders:**General public, patients, health professionals, scientists, policy makers, pharma/biotech industry, insurance industry*

## The Integration of Genetics

- Assessment

- Policy Development

- Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Assurance**: The assurance to constituents that genetic information is used appropriately and that genetic tests and services meet agreed upon goals for effectiveness, accessibility, and quality.

## The Integration of Genetics

- Assessment

- Policy Development

- Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Research**

**System Management**: Assessing and building the capacity of the public health infrastructure to integrate information from genetic research into public health practice.
*	**Public Health Infrastructure:**“The systems, competencies, relationships, and resources that enable performance of the essential public health services in every community.”**(HP 2010)*

## Essential Services: Research

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Research**: A systematic investigation designed to develop or contribute to generalizable knowledge of the impact of human genetic variation on health and disease.

## Essential Services: Research

**Epidemiologic & Laboratory Research**: Quantify the impact of gene variants on human health, and identify and quantify the impact of environmental risk factors that interact with gene variants.
- 	*Gene Variants:**Heritable mutations or polymorphisms*
*	**Environmental Risk Factors:**Any exogenous factors -- chemical, physical, infectious, nutritional*

## Essential Services: Research

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Epidemiologic & Laboratory Research**: Quantify the impact of gene variants on human health, and identify and quantify the impact of environmental risk factors that interact with gene variants.
**Policy & Communications Research**: Identify and analyze the economic, social, ethical, and political implications of advances in human genetics, including the information and communications needs of stakeholders.

## Essential Services: Research

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Epidemiologic & Laboratory Research**: Quantify the impact of gene variants on human health, and identify and quantify the impact of environmental risk factors that interact with gene variants.
**Policy & Communications Research**: Identify and analyze the economic, social, ethical, and political implications of advances in human genetics, including the information and communications needs of stakeholders.
**Health Services Research**: Identify and analyze the factors that influence the impact of genetic information, and the delivery, utilization, and quality of genetic tests and services.

## Essential Services: Assessment

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Monitor Health**: Monitor health status, including genetic factors, to identify health problems within the community.

## Essential Services: Assessment

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Monitor Health**: Monitor health status, including genetic factors, to identify health problems within the community.
**Diagnose & Investigate**: Investigate the distribution of genetic and modifiable risk factors within the community to determine their contribution to identified health problems and to improve health outcomes.

## Essential Services: Policy

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Inform, Educate, Empower**: Facilitate communication and education about the integration of genetic information into health promotion and disease prevention programs.

## Essential Services: Policy

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Inform, Educate, Empower**: Facilitate communication and education about the integration of genetic information into health promotion and disease prevention programs.
**Mobilize Partnerships**: Foster collaboration among public and private agencies and constituent groups to promote effective and efficient policy making about genetics.

## Essential Services: Policy

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Inform, Educate, Empower**: Facilitate communication and education about the integration of genetic information into health promotion and disease prevention programs.
**Mobilize Partnerships**: Foster collaboration among public and private agencies and constituent groups to promote effective and efficient policy making about genetics.
**Develop Policies**: Establish policies and guidelines for when and how genetic information should be applied to promote health and prevent disease.

## Essential Services: Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Enforce Laws**: Promote the enforcement of policies and standards enacted to ensure the appropriate use of genetic information, and the effectiveness, accessibility, and quality of genetic tests and services.

## Essential Services: Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Enforce Laws**: Promote the enforcement of policies and standards enacted to ensure the appropriate use of genetic information, and the effectiveness, accessibility, and quality of genetic tests and services.
**Link to / Provide Care**: Ensure the availability and accessibility of intervention strategies that incorporate genetic information to improve health and prevent disease.

## Essential Services: Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Assure Competent Workforce**: Ensure that present and future health professionals have training and skills in the appropriate use of genetic information to promote health and prevent disease.

## Essential Services: Assurance

**Diagnose & Investigate**

**Monitor Health**

**Inform, Educate, Empower**

**Mobilize Partner-ships**

**Develop Policies**

**Enforce Laws**

**Link to / Provide Care**

**Assure Competent Workforce**

**Evaluate**

**Research**

**S**

**y**

**s**

**t**

**e**

**m**

**M**

**a**

**n**

**a**

**g**

**e**

**m**

**e**

**n**

**t**

**Assure Competent Workforce**: Ensure that present and future health professionals have training and skills in the appropriate use of genetic information to promote health and prevent disease.
**Evaluate**: Evaluate the impact of genetic information, and the effectiveness, accessibility, and quality of genetic tests and services.