Public Health Is Getting Precise – Let's Make Sure It's Fair
It may sound like a contradiction, but public health—the field built on serving entire populations—is becoming more precise. At its core, precision public health seeks to marry the tools of big data, genomics, and individualized insights with population-level interventions. The surprising twist? By focusing on smaller population units, specific communities, neighborhoods, or even individuals, interventions can be more effectively tailored, improving outcomes while reducing inefficiencies and unintended consequences.
Public health has long embraced the principle of serving the many, with sweeping interventions aimed at benefiting entire populations. Public health accomplishments, include community sanitation policies, vaccination campaigns, and smoking cessation programs. These efforts, built on the understanding of generalized patterns in populations, have saved countless lives.
Recent advancements in technology, such as the ability to analyze large amounts of data and detection of disease risk using AI frameworks, are drastically changing how public health practitioners develop interventions. Precision public health is assuredly the next great leap in improving health and well-being for the masses. However, we are faced with the question, is precision public health equitable or at risk of exacerbating health disparities?
For some, it feels like a contradiction. Public health is rooted in equity, aiming to level the playing field for all — not just those with access to individual, personalized treatment and therapeutics. Critics worry that even the term "precision" conjures the idea of individual health. This descriptor shifts attention away from determining factors of health, such as poverty, housing, education, and systemic racism and discrimination, which contribute to a community's quality of life and their health span. Cultural biases, accessibility, and systemic inequities in healthcare could turn a promising innovation into yet another mechanism that widens gaps rather than bridging them.
When applied thoughtfully, precision public health can enhance — not replace — the principles of equity and prevention. For example, advanced mapping technologies can identify urban heat spots, helping to target cooling interventions for neighborhoods that are at higher risk for unhealthy temperatures, or being able to accurately predict everyone's risk profile for diabetes using their weight change patterns. Similarly, machine learning algorithms can better detect, diagnose, and treat diseases by reducing unwanted variations in blood data removing a potential challenge to using metabolite profiles of blood samples for research or improve standard of care when triaging patients during the Covid-19 pandemic using an algorithm on electronic health data.
The challenge, then, lies in implementation. To realize the potential of precision public health, equity must remain the foundation, which can be applied in several ways:
While precision technologies can provide incredible insights, they should not distract from addressing the root causes of health disparities. Precision public health should empower systemic change rather than reinforce the status quo.
Ultimately, precision public health is is a tool — a powerful one — that must be wielded with care. By anchoring it in the principles of equity and prevention, we can harness its potential to address both individual needs and the collective wellness of entire populations.
As we stand at this crossroads, the path we choose will define the future of health and wellness. With deliberate action and conscientious oversight, precision public health could complement traditional approaches, creating a more inclusive and effective model for improving health outcomes. Whether it becomes the future of wellness or an empty buzzword, it depends on our commitment to using it fairly.
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