Precision public health emerging as a discipline

A new buzzword has crept into the health sciences lexicon: precision public health.

By mixing the technical advancements of precision medicine with the goals of public health, practitioners of precision public health believe they can improve health at the population level. At least, that’s the vision driving the Centers for Disease Control and Prevention’s office of genomics and precision public health, according to Director Dr. Muin Khoury.

Khoury oversaw the office’s founding in 1997, though it just added the term “precision” in September. Previously, it was known as the office of public health genomics.
 
A quick search on the medical journal database PubMed for “precision public health” suggests the term is catching on, returning 75 articles from journals and books with the phrase in the title or abstract since 2016. The first publication to include the phrase was a paper Khoury co-authored that year arguing that big data, genomics and enhanced surveillance systems could help promote health equity.

“Could the same technologies that propel precision medicine usher in a parallel era of ‘precision public health’ beyond treatment of sick individuals?” he wrote.

That could mean leveraging analytics to forecast and prevent health threats, or pinpointing areas with increased rates of certain diseases to target a response.

But not everyone has taken to this new approach.

“The notion is to use big data approaches to inform decision-making for population health,” Dr. Sandro Galea, dean of the Boston University School of Public Health, said of precision public health. “I feel like that’s great. I’m just not sure that’s particularly different than what modern public health is.”

Ronald Bayer, a professor of socio-medical sciences at Columbia University’s Mailman School of Public Health, agreed, calling it “an utterly confusing phrase.”

“But it seems to me that the battle against that term—to say that it’s an oxymoron, or that it doesn’t really help us understand what we need to do—I have to admit I think we’ve lost that battle,” he said.

Khoury acknowledged that precision public health isn’t too different from the standard way of thinking about public health, which can involve data-driven thinking to reach its goals. But he said that’s the same when discussing precision medicine and typical medicine—precision medicine just highlights the idea that it’s a bit more personalized, or a bit more precise, than the traditional field.

“Really what drives precision in public health is more data,” he said. “Whether it’s big data, whether it’s genomics—just like what drives precision medicine.”