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Individualizing Prevention: A Response to Obama’s Precision Medicine Initiative

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A message from Wayne B. Jonas, MD

A message from Wayne B. Jonas, MD

Samueli Institute has long supported the exploration of how healing happens. But exploring the linked question—how preventable disease happens—is also a priority. Diseases don’t merely pick and choose individuals. They arise when our continuous healing processes breakdown.

Scientists are searching for an answer to the question of why some people are affected by diseases like addiction, diabetes and cancer, while others are not. What’s the interplay between genes, behavior, social determinants of health and perhaps as of yet unknown factors? Could we prevent chronic illnesses if we could track and enhance how the body operates to keep us free of them?

Current statistics suggest that white Americans are more susceptible to certain diseases like breast cancer and addiction, according to the Department of Health and Human Services. Individuals who are African American, Mexican American, American Natives, or Asian American and Pacific Islander are more likely to suffer from Diabetes (Type II), Hypertension, Heart Disease and Stroke. Race/ethnicity is only one of the many factors that contribute to one’s chances of contracting diseases. The issue is that no one knows what the definitive factors are and why they matter.

To finally find an answer, the White House has launched the Precision Medicine Initiative (PMI), a new research effort to improve the American healthcare system. The initiative will include studies, infrastructure building, and health policy efforts to streamline preventative healthcare measures and uncover the many determinants of health.

The PMI, which President Obama first announced in 2015, was launched in response to the upsurge of preventable disease in the country. Obama stated that the idea of there being an “average patient,” is unrealistic and that “one size does not fit all,” when it comes to both preventative care and treatment for disease. The PMI study will be one of the first studies to look at disease prevention in such a broad way.

One cohort that has emerged as a result of Obama’s PMI, is a series of studies conducted by the National Institutes of Health (NIH), who have contributed $55 million to the study of disease prevention that focuses on the genetic and biological differences in humans. Perhaps this part of PMI should be called Precision Prevention.

“This range of information at the scale of one million people from all walks of life will be an unprecedented resource for researchers working to understand all of the factors that influence health and disease. Over time, data provided by participants will help us answer important health questions, such as why some people with elevated genetic and environmental risk factors for disease still manage to maintain good health, and how people suffering from a chronic illness can maintain the highest possible quality of life. The more we understand about individual differences, the better able we will be to effectively prevent and treat illness.” –NIH Director, Francis S. Collins, M.D., Ph.D.   

Past Research

Previously, large studies like the Human Genome Project (HGP) discovered that it was possible to activate and deactivate genes by changing lifestyle. This means that the pre-existing genes for conditions like obesity can be redirected by nutrition and exercise. The question that the PMI cohort seeks to answer that the Genome project did not is, does this remain true when factors like ethnicity, location and culture are brought into the equation?

The widespread belief is that these differences do contribute to health. But so far, the only issue researchers have looked into is health disparities associated with ethnicity and income.

Creating Human Flourishing

At Samueli Institute we acknowledge health disparities as issues that can, for the most part, be solved with health policy change and through advocacy, and multi-sector involvement in the promotion of health and wellbeing. Also, through integrating more holistic and integrative practices into everyday care, more Americans can be resilient and remain healthy throughout their life. Most of our work in this area falls under one important initiative, Wellbeing in the Nation (WIN).

Wellbeing in the Nation (WIN)

The Institute has gathered leaders from all levels of the public and private sectors to write recommendations for improving the health and wellbeing of the nation. This includes fusing health with determinants like socioeconomics, providing recommendations for leadership and deciding which healthcare costs are essential and which can be eliminated with preventative health measures.

The Creating Wellbeing Leadership Group, which oversees WIN, not only identifies the key problems with the American healthcare system but also recommends ways to improve it. Part of that is through advocating for evidence-based research for individualized care.

What is Precision Medicine?

The White House has described precision medicine as “healthcare tailored for you.” This description is important, as it recognizes people’s unique characteristics, which often contribute to their health and wellbeing.

NIH hopes to draw participation from various agencies in the federal government to ensure its success. The PMI study will begin in late 2016 and is expected complete by 2020.

We at Samueli Institute are pleased that our continued priority of health prevention and healthcare improvement are priorities of the White House as well. When patients receive individualized, patient-centered care in a health system in which preventative health measures are just as important as the treatment of disease, we will all prosper.

Planting Seeds for National Wellbeing with Senator Tom Harkin

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Having a healthy community relies on so much more than the healthcare industry according to former Senator Tom Harkin. The ideal system is one in which entities that control commerce, education, transportation and defense all work together to promote wellness and prevent illness. Continue reading “Planting Seeds for National Wellbeing with Senator Tom Harkin” »

Shattering the Myth of Immutable Genes with Dr. Pamela Peeke

Dr. Pamela Peeke for On Human Flourishing

For a long time, scientists considered genetics to be the predisposition of a person’s health. In other words, whatever genes a person was born with, determined if that person would develop a hereditary disease, addiction or obesity. New scientific studies have shown that genes are not determinant of a person’s wellbeing. The lifestyle choices a person makes including exercise and eating habits can deactivate the genes that originally would have lead to disease. Continue reading “Shattering the Myth of Immutable Genes with Dr. Pamela Peeke” »

PODCAST: An Interview with Henry Samueli, PhD

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Simply understanding how the am/fm radio works; that was the assignment for Henry Samueli’s 7th-grade electric shop class, the point in his life that turned out to be the beginning of it all. Continue reading “PODCAST: An Interview with Henry Samueli, PhD” »

Podcast-An Interview With Dr. Robert Bonakdar

Dr. Robert Bonakdar Interview Image

Dr. Bonakdar recently visited Samueli Institute to discuss his journey in integrating the practices of integrative medicine. He currently holds the title, Director of the American Academy of Pain Management in addition to working as a Director of Pain Management at the Scripps Center for Pain Management in California. When asked how he got started, Dr. Bonakdar explained that what Americans call alternative medicine, is not as foreign to him.

Born in Iran, Dr. Bonakdar learned of integrative medical practices like mind-body therapy and Tai Chi at a young age. In his homeland, these practices are primal and others like prescription medication are secondary and sometimes forbidden. His vision for pain management practice is to help make so-called alternative medicine, more prominent in the United States.

“We need a huge transformation. We need more individualized pain care, not just specifically what the guidelines say; and a lot more self-care.”

His current approach involves offering alternative pain management treatment as a first choice or after patients have exhausted all other forms of treatment, including medication. In his practice, he often finds that many patients are not healing from conventional practices because the root of their problem is not what it appears. Sometimes chronic pain comes from injuries and strain, but other times, it comes from stress. Dr. Bonakdar strives to look at the whole picture to heal his patients.

“How can condition ‘X’ fit the entire picture and how can you then approach this complex picture in a way that’s patient’s centered.”

Acknowledging that there has been considerable evidence that integrative medicine heals patients, Dr. Bonakdar is looking for ways to make some integrative treatments standard in healing patients with chronic pain.

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