Ronald Bayer, Ph.D., and Sandro Galea, M.D., both of the Columbia University Mailman School of Public Health, argue in The New England Journal of Medicine that the federal government and the healthcare industry’s focus on personalized medicine could hurt efforts to improve population health.
They argue that precision medicine advocates’ focus on treatment at the individual level means that they tend to ignore such pressing concerns as the United States’ low ranking among developed nations in care quality or socio-economic factors’ (aka the “social determinants of health”) big effect on mortality.
The authors say that the Feds have invested about five times more in National Institutes of Health research, increasingly focused on individualized-care models, than in the Centers for Disease Control and Prevention. And, they write, the proportion of NIH-funded initiatives with “population” or “public” in their names fell 90 percent in the last decade.
“Without minimizing the possible gains to clinical care from greater realization of precision medicine’s promise, we worry that an unstinting focus on precision medicine by trusted spokespeople for health is a mistake — and a distraction from the goal of producing a healthier population.”