Implications of Genomics for Public Health: Workshop Summary by Institute of Medicine of the National Academies

Author:Institute of Medicine of the National Academies
Language: eng
Format: epub
Tags: Biology and Life Sciences: Genetics. Health and Medicine: Public Health and Prevention
Publisher: NATIONAL ACADEMY PRESS
Published: 2005-04-06T00:00:00+00:00

CAPACITY

Kristine Gebbie, R.N., Dr.P.H.

Public health capacity depends upon the infrastructure, which includes data and information about the population; laws, organizational structures, and interorganizational relationships; and a workforce that is prepared in both general public health practice and specialty areas. Adequate infrastructure in the area of genomics includes genetic data about a population as well as genetic/genomic resources in a state or locale; updated laws (e.g., consent and confidentiality) and agreements among service or research agencies; and genomic competencies for the workforce.

This section focuses on the workforce and, more specifically, public health professionals. A recent IOM report, Who Will Keep the Public Healthy?, examined challenges to public health and developed a framework for how education, training, and research can be strengthened to meet the needs of future public health professionals. The report defined public health professionals as persons educated in public health or a related discipline who are employed to improve health through a population focus. A major challenge addressed in the report is globalization, including the movements of populations, of diseases, and of information. Another challenge relates to advances in scientific and medical technologies, including increasing surveillance and use of genetic information and communication technology. Demographic transformations were also examined.

The report proposed using an ecological model of health to address these challenges. An ecological model of health is aware of and takes into account the linkages and relationships among multiple determinants of health, including how genetic heritage fits into the model. Education about this model and about eight new content areas was deemed important for public health professionals in the 21st century, and the report recommended that competencies be developed for each area. One of these new content areas is genomics. However, an examination of the other seven content areas (informatics, communication, community-based participatory research, cultural competency, global health, ethics, and policy and law) shows that genomics-related information could very well be a part of the content in each area.

Genomics is a new challenge for public health professionals. Public health education programs and schools must provide their students with a framework for understanding the importance of genomics to public health and with the ability to apply genomics to basic public health sciences. Access to lifelong learning must be assured. Compared to medical schools, nursing schools, and some other health profession schools, public health has been relatively weak in continuing education. Without strong continuing education programs, however, it will be impossible to close the workforce knowledge gap in genomics. Finally, it is necessary to have supervised practice opportunities, not just classroom learning.

Genomic education for public health should be based on competencies. Competencies are things people can do, not what one thinks, knows, feels, or believes. Competency statements can be used not only for education and training, but also for updating or revising job descriptions and as self-assessment tools. The CDC specified competencies in genomics for public health workers, separating them into three levels: competencies for all public health workers; competencies for all public health professional workers; and competencies for those in

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