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 Table of Contents  
REVIEW ARTICLE
Year : 2021  |  Volume : 2  |  Issue : 1  |  Page : 1-3

Genetics in public health


1 Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
2 Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
3 Orthodontics and Dentofacial Orthopaedics, Private Practitioner, MDS Department of Orthodontics and Dentofacial Orthopaedics, Bihar, India

Date of Submission04-Jan-2021
Date of Decision21-Jan-2021
Date of Acceptance05-Feb-2021
Date of Web Publication9-Mar-2021

Correspondence Address:
Shilpa Rai
Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Campus - 5, Patia, Bhubaneswar - 751 024, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpcdoh.jpcdoh_8_21

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  Abstract 


Genetics is considered a branch of science dealing with the study of heredity and variation in genes and genotype. A hybrid subspecialty of genetics and public health has come up in recent years. Public health genetics involves the application of genetics and molecular biotechnology in the improvement of community health and disease prevention. The Centers for Disease Control developed a framework comprising four essential public health functions and three critical issues associated with individual function. This review aims to highlight the integration of discoveries in genetic into public health. Scientific approach is required to study the impact of genetic discoveries on community health. Judicious assessment of the utility of genetic tests and development of standards and guidelines for reassuring superior genetic testing are critical steps in the process. Strong public health leadership to develop, implement, and evaluate disease intervention strategies is required for utilizing the advances in genetics for disease prevention. The critical issues that affect each function are partnerships and coordination; ethical, legal, and social issues; and education and training. An integrated and comprehensive scheme is required for the control of genetic diseases. Public health professionals shall help evolve, study, and propagate the scientific knowledge that would serve as a guide for public health action.

Keywords: Community, education, genetics, public health


How to cite this article:
Rai S, Kumar G, Suresan V, Sethi AK, Bhushan V. Genetics in public health. J Prim Care Dent Oral Health 2021;2:1-3

How to cite this URL:
Rai S, Kumar G, Suresan V, Sethi AK, Bhushan V. Genetics in public health. J Prim Care Dent Oral Health [serial online] 2021 [cited 2021 Jun 23];2:1-3. Available from: http://www.jpcdoh.org/text.asp?2021/2/1/1/310946




  Introduction Top


Epidemiological studies are essential to find out the preponderance of genetic variations that make people vulnerable to disease. These studies are also crucial to estimate the burden of disease and mortality and risk factors in genetically susceptible individuals. Interaction of the environmental factors with genetic factors can also be studied from these researches though these are usually long-term studies.

A new hybrid specialty of genetics and public health has come forth in the recent years as public health genetics which involves the application of genetics advances and molecular biotechnology in the improvement of public health and disease prevention.[1] It shall be an commendable achievement for public health professionals if they integrate genetic research, policy, and program development into their routine work.[2] Genetic counseling and treatment involve nuclear or extended families. Prevention of genetic diseases requires identification and engagement of the target population, and thus, clinical genetics acts as a bridge between medicine and public health. This review aims to highlight the integration of discoveries in genetic into public health.

The framework

The Centers for Disease Control (CDC) developed a framework for utilizing essential public health functions in evaluating the relation of genetic discoveries to disease prevention and health promotion.[2] This framework includes four essential public health functions and critical issues associated with each function [Table 1].
Table 1: The framework for integrating genetic discoveries into public health functions

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Role of public health assessment in genetics

The first function depends upon scientific approaches for the assessment of the impact of newly disclosed genes on community health.[3] The approaches are the use of surveillance,[4] epidemiology,[5] and human genome epidemiology.[6],[7] They determine the genetic variations in the population responsible for common as well as rare diseases and the morbidity and mortality associated with them as well as the impact of environmental factors.[4]

Evaluation of genetic testing

It includes assessing the usage of these tests for health promotion, diagnosis, and disease prevention followed by formulation of standards and guidelines for quality assurance.[8]

Development, implementation, and evaluation of population interventions

A powerful public health leadership is required for incorporating the advances of human genetics into opportunities in disease prevention. Development of good policy requires the use of a systematic evidence-based approach to assess the decisions on the use of genetic information in testing population-based programs.

Communication and information dissemination

Communicating the importance of using genetic advances in disease prevention and health promotion is pivotal, especially among the policymakers, healthcare providers, researchers, and the general public. Information dissemination can be well undertaken by public health agencies. It is necessary to target primary care physicians, nurses, and other health professionals as they are the ones who act as a channel for widespread information flow, thereby helping in shaping attitudes and behaviors of a larger population.


  Critical Issues in Genetics and Public Health Top


To integrate genetics into the four public health functions, three critical issues must be addressed.[9] They are as follows:

Partnerships and coordination

Secured partnerships and coordinated efforts among different groups need to be established for fulfilling all the public health functions in genetics.

The annual national meeting on genetics and public health is an example of such coordination. In May 1998, the First Annual Conference on Genetics and Public Health was conducted in Atlanta, Georgia, with the combined efforts of CDC, the Health Resources and Services Administration, the National Human Genome Research Institute, and the Association of State and Territorial Health Officials and affiliates.[10] A year later, the second annual meeting was held with the partnership and coordination among Maryland Department of Health and Johns Hopkins University School of Hygiene and Public Health.

Ethical, legal, and social issues

During the planning of Human Genome Project, there was acknowledgment of the fact that the message obtained from human genome sequencing would have significant consequences for individuals, families, and the community.[11] Numerous ethical, legal, and social issues can emerge on integrating genetic technologies in practice. Thus, to address these issues, the Ethical, Legal, and Social Implications Program was constituted as a constitutional part of the Human Genome Project.

The probable social issues include confidentiality of genetic information;[12] its fair use; psychological interaction between individual, family, and group; disapproval accompanying this information; cultural conflict; and influence on disability concept.

Education and training

Researchers in public health, practitioners, policymakers, and consumers need to keep in touch with the latest developments along with its probable consequences, to frame policy, carry out research, and practice clinically. This can be achieved through joint efforts and is best illustrated by the current CDC training activities. Several genetics training programs in different U. S. schools of public health also cater to this issue.

Timely revising the curricula of these existing courses is mandatory to intensify genetic training for public health professionals.[4] General public also requires to be informed about the benefits and misuse of genetic information so that they become well-educated consumers of medical and genetic services. Incorporating the study of genetics into the elementary and secondary schools curricula shall be a great aid in preparing the upcoming generation for the challenges and opportunities in genetic sciences.


  Conclusion Top


Genetics and hereditary play a salient role in the transmission of several diseases. Primary healthcare delivery system can be modified by incorporating the principles of genetic medicine in the diagnosis and treatment of human diseases. An integrated comprehensive strategy utilizing community education, population screening, genetic counseling, and early diagnosis shall prove to be keys to success in the control of genetic diseases. With advances in the discovery of variations in human genetics and associated diseases, public health professionals shall help develop, analyze, and disseminate a large body of scientific information that would serve as a guide for public health action.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Genetics and Public Health: An Overview. Centre for Disease Control. Available from: https://www.cdc.gov/genomics/resources/books/21stcent/chap01.htm. [Last accessed on 2020 Jan 12].  Back to cited text no. 1
    
2.
Molster CM, Bowman FL, Bilkey GA, Cho AS, Burns BL, Nowak KJ, et al. The evolution of public health genomics: Exploring its past, present, and future. Front Public Health 2018;6:247.  Back to cited text no. 2
    
3.
Jackson FL. Human genetic variation and health: New assessment approaches based on ethnogenetic layering. Br Med Bull 2004;69:215-35.  Back to cited text no. 3
    
4.
Conceptual Framework for a Public Health Program in Genetics. Centre for Disease Control. Available from: https://www.cdc.gov/genomics/about/strategic_plan/1997strategic_conceptual.htm. [Last accessed on 2020 Jan 12].  Back to cited text no. 4
    
5.
Nadin-Davis S. Molecular Epidemiology. Rabies: Scientific Basis of the Disease and Its Management. 3rd ed. United States. Academic Pesss; 2013.  Back to cited text no. 5
    
6.
Khoury M. Genetics and public health in the 21st century: A scientific foundation for using genetic information to improve health and prevent disease? Genet Med 2000;2:59. [doi: 10.1097/00125817-200001000-00047].  Back to cited text no. 6
    
7.
Austin MA, Peyser PA, Khoury MJ. The interface of genetics and public health: Research and educational challenges. Annu Rev Public Health 2000;21:81-99.  Back to cited text no. 7
    
8.
Hogarth S. Regulation of genetic tests: An international comparison. Acad Press 2009;1:63-83. [doi: 10.1016/B978-0-12-374125-7.00004-7].  Back to cited text no. 8
    
9.
Centers for Disease Control and Prevention. Translating Advances in Human Genetics into Public Health Action: A Strategic Plan; 1997. Available from: https://www.cdc.gov/genetics/about/reports/1997.htm. [Last accessed on 2020 Jan 12].  Back to cited text no. 9
    
10.
Institute of Medicine (US) Committee on Assuring the Health of the Public in the 21st Century. The Future of the Public's Health in the 21st Century. Washington (DC): National Academies Press (US); 2002. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221231/. [Last accessed on 2020 Jan 12].  Back to cited text no. 10
    
11.
Carrasco-Ramiro F, Peiró-Pastor R, Aguado B. Human genomics projects and precision medicine. Gene Ther 2017;24:551-61.  Back to cited text no. 11
    
12.
Hartman AL, Hechtelt Jonker A, Parisi MA, Julkowska D, Lockhart N, Isasi R. Ethical, legal, and social issues (ELSI) in rare diseases: A landscape analysis from funders. Eur J Hum Genet 2020;28:174-81.  Back to cited text no. 12
    



 
 
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