Precision Health: Predict and Prevent Disease

What to know

Your genes, behaviors (such as exercise and eating habits), and environment are all factors that affect your health. The goal of precision health is to protect your health by measuring these factors and acting on them. Interventions can be tailored to you, rather than using the same approach for everyone. Precision health approaches can improve prediction and prevention of diseases.

A diverse group of people

What it is

You might have heard the terms "precision medicine" and "precision health" and wondered how they relate to you. Precision medicine, also called personalized medicine, helps your healthcare provider find your unique disease risks and treatments that will work best for you. Precision health is broader—it includes precision medicine but also includes approaches that occur outside the setting of a healthcare provider's office or hospital, such as disease prevention and health promotion activities. Precision health involves steps that everyone can take on their own to protect their health, as well as steps that public health professionals can take (sometimes called precision public health).

How it works

Let's explore how precision health approaches can improve prediction and prevention of diseases.

Family health history can help you know which diseases you are more likely to get: Having family members with certain chronic diseases, such as diabetes, heart disease, high blood pressure, or cancer, can sometimes mean you are more likely to get that disease. Collecting your family health history and sharing it with your healthcare provider can help you take steps to prevent disease or find it early. In some cases, your healthcare provider might recommend genetic counseling and testing for a disease that runs in your family.

EXAMPLE: When talking about your family health history, your healthcare provider asks if anyone in your family has had breast cancer. You mention that your mother was diagnosed at age 51. Your healthcare provider tells you that having a parent or sibling with breast cancer makes you more likely to get breast cancer. Therefore, they stress to you the importance of following current guidelines and getting a yearly mammogram, starting at age 40.

Personal devices can keep track of your health information: Mobile health applications on your smart device are an easy way to track information, such as nutrition, physical activity, and blood pressure. Measurements are taken in real time and can inform you of progress and even alert you to changes that could mean you need to seek medical care, although these devices are not a replacement for regular checkups.

EXAMPLE: Joe, an active 49-year-old man with no history of heart problems, got an alert on his smartphone that he had atrial fibrillation (also called AFib). He went to a nearby urgent care center, where healthcare providers confirmed that he had the condition. Left untreated, atrial fibrillation can lead to stroke. By finding out about his atrial fibrillation early, Joe could take steps to treat it before he had any serious health problems.

Social media can help public health workers track disease and communicate health information: Public health researchers are exploring how social media could be used to help track disease outbreaks, for example by looking for posts that self-report symptoms of a disease. Health departments can use social media to communicate important health information to a large audience.

EXAMPLE: Your state health department posts a message on social media in response to seeing an increase in the number of flu cases. The post details how to prevent the flu, what to do if you think you have it, and who is most at risk for complications. You've been busy and haven't had time to get a flu shot, but seeing this post encourages you to get one the next day.

Genome sequencing can help find, track and control infectious disease outbreaks: The type of germ that's making people sick can be identified using genome sequencing, which shows the DNA fingerprint of the germ. Healthcare providers and public health officials then can more easily find out which people's illnesses are caused by the germ. Knowing exactly which germ is making their patients sick can help healthcare providers determine the treatment that will work best. Public health workers can more accurately track the germ and find its source.

EXAMPLE: After eating at a restaurant, you and your friend have symptoms of food poisoning. You are seen by your healthcare provider, who orders tests of your stool. When Salmonella bacteria are identified in your stool, your healthcare provider alerts the health department. The health department then performs genetic testing on the Salmonella bacteria from your stool sample and determines that they are from a strain that matches that of several other confirmed cases in your area, all of whom reported eating papayas. Using this information, public health workers then find the source is a certain brand of papayas and remove them from grocery stores and restaurants, thereby preventing additional cases.

Newborn screening can find medical conditions early to prevent complications: Babies born in the United States are checked for certain medical conditions soon after birth. This is called newborn screening, which includes a blood test and screenings for hearing loss and heart defects. Newborn screening can prevent disability or death by identifying conditions and treating them sooner.

EXAMPLE: Through newborn screening, a baby is diagnosed with a type of primary immunodeficiency called severe combined immunodeficiency (SCID) soon after she is born. Babies with SCID can die without treatment because their bodies cannot fight infections.

Medical options can prevent disease in people with inherited conditions: Some people have inherited conditions that make them more likely to get a disease. Women with a BRCA1 or BRCA2 genetic change are more likely to get breast or ovarian cancer, and men with a BRCA1 or BRCA2 genetic change have an increased risk for some cancers as well. People with Lynch syndrome are more likely to get colorectal (colon) and other cancers. People with familial hypercholesterolemia are more likely to develop heart disease at a younger age and to die from the disease. However, if you have one of these inherited conditions, knowing about it can allow you to take steps to prevent the cancer or heart disease or find it early. Medical options can include screening earlier or more often, taking medicine, or having surgery.

EXAMPLE: Roger has a family health history of Lynch syndrome. He decides to have genetic testing for the Lynch syndrome genetic change that his family members have. If testing shows that he has the genetic change, he can take steps to prevent cancer and find it early if it develops, including starting yearly colonoscopy screening tests early.

What you can do

To fulfill the promise of precision health, much more research is needed. The All of Us Research Program, led by the National Institutes of Health, has begun enrolling participants and plans to enroll one million or more U.S. participants. All of Us participants will be followed for several years. They answer surveys on different topics and share their electronic health records. Participants may provide blood, urine, or saliva (spit) samples for lab and DNA tests. All health information is stored in a secure database.

All of Us researchers are using this information to look at how genetic, behavioral, and environmental factors can affect health, including likelihood of getting certain diseases and effectiveness of interventions. Having a wide variety of participants for this study is important to make sure it benefits everyone—learn more.