During pregnancy, you may wonder about genes, how inheritance works, how gender is determined, and genetic disorders. Learn about the role of family genetics in your baby's traits and characteristics. The full genetic instructions for each person, known as the human genome, is. States include genetics services among their public health programs, but budget shortfalls raise the question, is genetics an essential part of public health?. With its heterogeneous aetiopathogenesis the exact role of genetics in causing stroke remains controversial; family history studies, twin studies and studies.
Genetics of The Role
Genetic influence tends to increase with age for many characteristics — for example, body weight and intelligence. It is thought that with increasing maturity comes the ability to make independent choices in line with our genetic predispositions. For example, a child who is genetically predisposed to be good at reading might join a library to gain access to more books and meet like-minded people once he or she is a teenager. Twins can therefore identify the windows of opportunity when environmental influences might be strongest, and when behaviours may be easier to change.
Twin studies also inform researchers where best to target environmental interventions. Interventions targeting characteristics influenced by shared environments might best be directed at the family environment.
But policymakers may have greater success if interventions are oriented towards the wider environment for characteristics shaped by factors unique to each person. On a broader level, twin studies are also the first step towards molecular genetic research identifying specific genes involved. One classic example is body weight. We have known from twin studies that weight has a strong genetic basis , which led researchers to identify approximately genetic variants involved.
The most important of these is FTO the fat mass and obesity gene ; and adults carrying two copies of the risk variant are heavier and at increased risk for obesity.
The discovery of FTO and other variants paved the way for researchers to study the mechanisms through which genes influence weight in order to develop new drugs, and to help people with obesity to understand their vulnerability better. However, studies exploring individual feedback on DNA-based disease risk suggest that knowing your genetic predisposition does not necessarily undermine attempts to improve health, but may increase engagement and motivation to change behaviour.
Twin research has undoubtedly advanced our understanding of human nature and has revolutionised the way we discuss the complicated relationship between nature genes and nurture environment. Twin research has also led to breakthroughs in molecular genetic research that has the potential to change the course of disease treatment. The paper by Niiranen et al. These individuals, at the very least, should be offered aggressive lifestyle modification and closer monitoring for development of high blood pressure.
Perhaps a useful intermediate step while we await the promise of precision medicine. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.
Sign In or Create an Account. Close mobile search navigation Article navigation. Understanding the role of genetics in hypertension Riyaz S.
View large Download slide. Risk for hypertension crosses generations in the community: Genomics and precision medicine for clinicians and scientists in hypertension. Genome-wide association study of 14, cases of seven common diseases and 3, shared controls. The genetics of blood pressure regulation and its target organs from association studies in , individuals. Genome-wide association analysis identifies novel blood pressure loci and offers biological insights into cardiovascular risk.
Genome-wide association analyses using electronic health records identify new loci influencing blood pressure variation.
Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk. Identification of seven loci affecting mean telomere length and their association with disease. Published on behalf of the European Society of Cardiology.
For permissions, please email: Add comment Close comment form modal. The public communications campaigns of public health genetics programs can bolster efforts in the research for new insights and innovative solutions to health problems. Through the work of public health genetics programs and community organizations, researchers and practitioners can learn more about strategies for communicating risk to relevant parties.
Although public health institutions have a history of communicating behavioral or infectious disease risk, new methods for conveying inherited risk across diverse populations may require more study. Research could inform the development of Web-based resources that teach the public about genetic risk. This area may be of particular interest to chronic disease programs that are increasingly incorporating family history and inheritance into activities. For example, state programs focusing on diabetes, asthma, heart disease, and heritable cancers may consider familial obligation, family involvement in decisionmaking, variation in communications between relatives of different genders, cultural factors affecting familial communication, and perceived salience of family history.
Intergovernmental collaborations by public health genetics programs are an important way for states to enforce laws and to develop policies that support health efforts. As Thomas et al. One question resulting from cross-agency collaboration is whether data integration inadvertently reveals the potential carrier status of parents and siblings for conditions such as cystic fibrosis, which many states are considering for NBS.
Strategies for maintaining confidentiality while still enabling service delivery will need to incorporate—and protect—the information that program staffs require. Finally, issues of informed consent arise because families concerned about stigma or genetic discrimination may not welcome automatic referral.
With the establishment and growth of public health genetics programs, public health practitioners can improve service delivery by providing 2 related essential services. First, monitoring health status to identify and solve community health problems involves the collection and analysis of information on access, utilization, costs, and outcomes of personal health services.
Although some NBS and clinical genetics programs track utilization of services via patient counts, these programs could improve essential services by conducting more extensive and rigorous evaluations.
States could conduct long-term evaluations with families to assess whether inclusion of new NBS tests in NBS programs affects clinical and quality-of-life outcomes. Evaluations of clinical genetic services could identify population subgroups that do not access genetics services to determine why not.
Researchers could also assess whether care at state-sponsored clinics affects utilization of other health care services, such as hospitalizations. Evaluation plans and data gathering could be developed in conjunction with patient groups to incorporate social values and patient satisfaction with program services. Second, ongoing evaluation of program effectiveness, accessibility, and quality provides information necessary for allocating resources and reshaping programs.
A standard conceptual framework to assess public health performance allows practitioners to compare and prioritize important traditional and emerging health issues.
Information from well-devised evaluations and cross-program comparisons in combination with data on populations at risk for disease will assist states as they determine how to invest scarce resources for rare disorders, chronic conditions, genetic disease, and nongenetic disease.
Information from 19 state genetics plans demonstrates that public health genetics programs fulfill public health obligations and conduct essential services, including mobilizing community partnerships, educating the public, linking people to needed services, and ensuring a competent workforce.
As public health genetics programs grow, they can attend to 5 additional essential services. Future research could provide insight into risk and family communication.
Laws and policies could account for confidentiality issues brought about by data integration. Rigorous evaluations could enable the public sector to prioritize nongenetic and genetic issues appropriately when deciding resource allocation.
Certainty among states that their activities in genetics are fundamental to public health becomes increasingly important as legislators and the federal government turn their attention to genomics. Wang conceptualized the research question, synthesized analyses, and led the writing. Watts originated the study, supervised its implementation, and reviewed article drafts.
National Center for Biotechnology Information , U. Am J Public Health. Find articles by Grace Wang. Find articles by Carolyn Watts. Author information Copyright and License information Disclaimer. Requests for reprints should be sent to Dr. This article has been cited by other articles in PMC. Abstract States include genetics services among their public health programs, but budget shortfalls raise the question, is genetics an essential part of public health?
Prevent epidemics and the spread of disease. Protect Against Environmental Hazards Birth defects surveillance and prevention programs protect against environmental hazards by diagnosing and investigating health problems and health hazards in the community. Prevent Injury State genetics plans indicate that all 19 states conduct NBS, a service intended to prevent injury. Ensure Health Service Quality and Accessibility Clinical genetic service programs ensure the quality and accessibility of health services with diagnostic evaluations and confirmatory testing, counseling, case management, consultation, referral, and treatment programs for both children and adults with genetic and inherited disorders.
Open in a separate window. Education About Community Partnerships and Health Public health genetics programs mobilize community partnerships to educate and empower people about health issues. Link People to Needed Health Services The 3 most common public health genetics programs link people to needed health services by ensuring access into the health system for socially disadvantaged people. Ensure a Competent Health Care Workforce Public health genetics programs train health care personnel to increase their knowledge and awareness of genetics, genetic services, and available resources.
Research for New Insights The public communications campaigns of public health genetics programs can bolster efforts in the research for new insights and innovative solutions to health problems. Develop Policies and Enforce Laws Intergovernmental collaborations by public health genetics programs are an important way for states to enforce laws and to develop policies that support health efforts.
Monitor Health Status and Evaluate Effectiveness With the establishment and growth of public health genetics programs, public health practitioners can improve service delivery by providing 2 related essential services. Notes Peer Reviewed Contributors G. President Clinton announces the completion of the first survey of the entire human genome: Accessed August 22, Accessed August 29, Cracking the code of life. A vision for the future of genomics research.
US newborn screening policy dilemmas for the twenty-first century. The role of state public health agencies in genetics and disease prevention: Survey of nationwide public health genetics activities. Accessed January 11, Integrating genetic services in public health—guidance for state and territorial programs from the National NBS and Genetics Resource Center.
Association of State and Territorial Health Officials. Accessed January 27,
The Role of Genetics in the Provision of Essential Public Health Services
Scientists have studied twins for many years to understand how genes and environments influence differences among individuals, spanning. Whereas genetic factors are important for stability in SWB, environmental factors play an important role for change. People tend to return to their. This editorial refers to 'Risk for hypertension crosses generations in the community: a multi-generational cohort study'†, by T.J. Niiranen et al.