apters 14 through 17), application of prevention effectiveness principles to genetics programs (chapter 18), and impact of genetic counseling on public health (chapter 19). Another series of chapters in this section illustrate the process of policy and program development and evaluation in relation to specific disease conditions, including PKU (chapter 20), cystic fibrosis (chapter 21), sickle cell disease (chapter 22), hemochromatosis (chapter 23), and coronary heart disease (chapter 24). Although much of the discussion of genetic services still focuses on traditional genetic programs related to reproductive genetics and child health, an increasing emphasis will be in the next few years on the utility of genetic testing for preventing adult-onset diseases.
IV. Communication and information dissemination
The fourth public health function in genetics is developing and applying communication principles and strategies related to advances in human genetics, the use of genetic tests and services, interventions, and the ethical, legal, and social issues related to these topics. The relevance of advances in human genetics to disease prevention and health promotion needs to be communicated to a large number of audiences, including policy makers, healthcare providers, researchers and the general public (11). Public health agencies can play a crucial role in translating the ever-growing, amount of complex information related to genetics and disease prevention to healthcare providers and communities alike. Early on, the public health community needs to develop a baseline understanding of both professional and consumer perceptions of and attitudes toward the recent developments in and future expectations for human genetics. Because the subject of human genetics can be sensitive, effective communication will be key to the success of public health programs involving genetic research results. Effective communication could be achieved by coalition building among federal agencies, professional organizations, consumers, private industry, 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 coordi