s of public health. An overview of such efforts is given in Chapter 29.
There have been other national efforts to address education of professionals in various health disciplines other than public health in genetics. In 1996, the American Medical Association, the American Nurses Association, and the National Human Genome Research Institute formed the National Coalition for Health Professional Education in Genetics (NCHPEG) to promote health professional education and access to information about advances in human genetics (1). NCHPEG is a multidisciplinary group of leaders from more than 100 diverse health professional organizations, consumer and voluntary groups, government agencies, private industry, managed care organizations, and genetics professional societies.
To accelerate training in genetics for public health professionals, the content of existing courses will have to be supplemented by revised curricula or course work For example, training for laboratory personnel will need to cover new genetic tests and reagents and may result in recertification of these professionals. Training modules that address each component of the proposed framework (public health assessment, genetic testing evaluation, intervention, and communication) will need to be incorporated into the training of professionals in various public health disciplines (e.g., epidemiology, biostatistics, behavioral and social sciences, health services research, economics, health policy and management, and environmental health). A minimum level of competence needs to be achieved not only in genetics and disease prevention but in the ethical, legal, and social issues related to it.
Members of the general public will need to be similarly educated to become informed consumers of medical and genetic services and to be aware of potential misuse of genetic information. In addition, incorporating information on genetics into the life science curricula of elementary and secondary schools will help prepare the next generation to be responsive to the challenges and opportunities of genetic technology.
With acceleration of the discovery of human genetic variation and associated diseases in the next few years, public health professionals will not only be confronted with but will help develop, analyze and disseminate a large body of scientific information that will guide public health action. The potential for inappropriate or premature use of genetic information without adequate protections for privacy and confidentiality will demand public health leadership in evaluating and resolving the many ethical, legal and social issues associated with genetic information. In the not too distant future, however, disease prevention and health promotion programs will routinely consider whether or not to use genetic information to help target intervention activities in order to maximize benefit and minimize costs and harm to individuals. For this to occur, however, genetics needs to be incorporated into training programs for numerous fields (e.g., epidemiology, laboratory sciences, legislation and policy, medicine, nursing, behavioral and social sciences and communication sciences). This will require changes in professional training programs and targeted retraining of many public health professionals. Only then can we achieve a true integration of human genetics into public health practice in the 21st century.
Number of Genes*
*Includes identified or mapped genes.
Source: Online Mendelian Inheritance in Man [database] (1999) (3).
Genetics in Medicine
|Public Health Genetics and Community Genetics
Genetics in Public Health
Public Health Functions
|Public health assessment|
|Evaluation of genetic testing|
|Development, implementation, and evaluation of population interventions|
|Communication and information dissemination|
|Partnerships and coordination|
|Ethical, legal, and social issues|
|Education and training|
Source: Adapted from CDC (1997) (11).
|Assess the prevalence of gene variants in different populations.||Using the National Health and Nutrition Examination Survey III, a n