Precision public health - hopes and threats.

Abstract

The article formulates the following theses and conclusion: (1) the development processes of precision medicine and precision public health (PPH) are correlated; (2) the development of public health genomics depends not only on an increasingly complete exploration of the principles of the human genome, but also on a fundamentally better investigation of how broad environmental factors can alter gene expression or structure; (3) a necessary condition for the development of both precision medicine and precision public health is the collection of increasingly broader and more complete information about pro- and anti-health factors; (4) the above necessary condition is only possible in a situation of strong authoritarianism with regard to taking health-promoting measures. It is likely that in the near future public health will be shaped by health-promoting authoritarianism. There are two main problems in the development of precise public health (PPH). The first, is maintaining the right proportions between actions based on the genomic data, and actions determined by better understanding of the effect of environmental factors. The second, is the necessity to subject individuals and populations to increasingly closer pro-health surveillance, which must be increasingly more effective, forcing specific health-promoting behaviours on individual and social scales. PPH in full can only exist in conditions of complete information concerning health determinants of an individual, and each distinguished group of individuals, as well as fully pro-health organization of individual and social life, i.e. in conditions of full individual and social medicalization. However, such a full medicalization cannot be achieved in any way other than authoritarian.