Public Health Action in Genomics is Now Needed Beyond Newborn Screening

For decades, newborn screening was the only public health program in the United States that used human genetic information to reduce morbidity, mortality and disability in affected individuals. The landscape has changed, however, as evidence-based recommendations are now available for several other genomic applications that can save lives now with many more expected to emerge in the next decade. While most emerging genomic applications will be implemented in a clinical healthcare setting, there remains a crucial role for state-based public health programs. An action plan, based on evidence, provides the impetus for a new paradigm for public health practice in genomics across the lifespan using established multilevel processes as a guide. These include policy interventions, education, clinical interventions and surveillance. Evidence-based recommendations for improving health are already available for an increasing number of genetic conditions which are at present poorly ascertained by health care providers and systems. Applying what we know today in hereditary breast/ovarian cancer, Lynch syndrome, and familial hypercholesterolemia has the potential to reduce morbidity and mortality in thousands of individuals in the U.S. population every year. Enhanced partnerships between genetic and non genetic providers of clinical medicine and public health are needed to overcome the challenges for implementing genomic medicine applications beyond newborn screening, both now and in the future. Learning objectives: 1. Identify evidence-based genomics applications beyond newborn screening that are ready now for active public health interventions. 2. Define multilevel processes that comprise public health practice in genomics to realize health impact beyond newborn screening.