Precision Medicine for the Population—The Hope and Hype of Public Health Genomics

Abstract

Public health is the most recent of the biomedical sciences to embrace “precision.” Advocates for “precision public health” (PPH) call for a data-driven, computa¬tional approach to public health, leveraging genomic and other data to inform public health decision-making. Yet, like precision medicine, PPH risks overselling the value of genomic data to deter¬mine health outcomes, but on a population level. History has shown that over-emphasizing heredity tends to disproportion¬ately harm underserved minorities and disadvantaged communities. Comparing and contrasting cur¬rent PPH with an earlier attempt at using genetics to inform pub¬lic health during the Progressive era (1890–1920) highlights some potential risks of genotype-driven preventive public health.