dustry, and state and local health departments to develop and evaluate communication strategies for genetics and public health. Communication effectiveness will hinge on many factors, including coordinating communication strategies among various groups; targeting appropriate audiences with messages that result in health promotion and disease prevention; and providing messages that are accurate and appropriate on technical and cultural levels. Particular attention must be given to primary care physicians, nurses, and other health professionals who will often serve as a conduit for information and who can help shape widespread attitudes and behaviors. Finally, an appropriate mix of mechanisms should be used for disseminating information, including distance-based interactive meetings, information centers and means of electronic communication (e.g., the Internet). Chapter 28 discusses overall principles of communication science related to genetics and public health and focuses on the Internet as an emerging medium for information dissemination (chapter 31).
In order to integrate genetics into the four public health functions discussed (public health assessment, genetic testing evaluation, public health intervention, and communication), three critical issues must be addressed for each: partnerships and coordination; ethical, legal and social implications (or issues); and education and training. Details on these critical issues are provided in the CDC strategic plan on genetics and public health (11). Section V (chapters 25 through 27) addresses some of the emerging ethical and legal issues related to the integrating genetics into public health practice. Section VI other critical issues such as training public health professionals in genetics (chapter 29), and consumer and public perspectives on genetic testing (chapter 30).
The following are highlights of these topics.
I. Partnerships and coordination
For all of the public health functions in genetics discussed earlier to be carried out, strong partnerships and coordination of efforts among various groups need to occur (11), including partnerships and coordinated efforts among various agencies of the federal government; federal, state and local agencies; the public and private sectors; and the public health, medicine and academic sectors, with various community and consumer involvement.
One example of such partnership is annual national meetings on genetics and public health. CDC, the Health Resources and Services Administration (HRSA), the National Human Genome Research Institute, and the Association of State and Territorial Health Officials (ASTHO) and affiliates held the First Annual Conference on Genetics and Public Health in Atlanta, Georgia, in May of 1998 (47). This first meeting addressed the public health opportunities and challenges presented by advances in human genetics research. The conference sought to establish awareness about the scope of and process for integrating advances in human genetics into public health programs and strengthening partnerships for disease prevention and health promotion efforts. The conference was attended by nearly 400 people from federal, state, academic, consumer, community, and industry organizations, representing 41 states and several European countries. The second annual meeting in December, 1999, is cosponsored by ASTHO in collaboration with the Maryland Department of Health and Johns Hopkins University School of Hygiene and Public Health. These meetings will provide crucial gatherings for exchanging information and building partnerships among various groups.
II. Ethical, Legal and Social Issues
As the Human Genome Project was being planned, there was widespread recognition that the information gained from sequencing the human genome would have profound implications for individuals, families and society. A number of complex ethical, legal and social issues can arise around the integration of genetic technologies in practice, and the use and interpretation of genetic information. To address these issues, the Ethical, Legal and Soc