Why do we need personalised health?
Most countries now face a growing and costly chronic disease burden. Chronic diseases are the leading causes of death and disability worldwide. Disease rates from these conditions are accelerating globally, advancing across every region and pervading all socioeconomic classes. The World Health Report “2002: Reducing risks, promoting healthy life” showed that the mortality, morbidity and disability attributed to the major chronic diseases currently account for almost 60% of all deaths and 43% of the global burden of disease. By 2020 their contribution is expected to rise to 73% of all deaths and 60% of the global burden of disease. Moreover, 79% of the deaths attributed to these diseases occur in the developing countries (1).
Health care costs are not only direct costs of treatments, drugs or services which are currently counted but can be borne by a range of stakeholders across the community, including community support groups, local businesses, families, carers and individuals within region. The costs are tangible to people in such things as out-of-pocket costs and gap payments, travel and accommodation costs, loss of income to individuals and families etc. But costs are also intangible, both to our community and individual families including areas such as family unit stress and social disadvantage. The resulting social impacts including mental health, domestic violence, addictions, chronic disease, and the resulting increased dependency and reliance on welfare payments and associated community support.
It is becoming increasingly clear that a development in our modern health care is required to match the growing disease burden and health needs of a rapidly changing and complex world. Evidence based environmental and lifestyle modification is proving to be the most clinically and economically effective therapeutic tool for prevention and treatment of many chronic diseases. For example; hypertension, coronary artery disease (CAD), atherosclerosis, type 2 diabetes, obesity, metabolic syndrome, nonalcoholic steatohepatitis (NASH), chronic pain disorders and even early prostate cancer have evidence to show that they can be completely or partially reversed with lifestyle and environmental modifications. The current body of evidence for disease prevention is more substantial with estimates that 80% of CAD and type 2 diabetes are preventable and conservatively at least 33% of cancers (2). These are outcomes that no pharmaceutical agent can achieve at a fraction of the cost of current therapy regimes. Evidence is growing rapidly for the treatment and prevention of further chronic diseases like a range of cancers, autoimmune disorders, alzheimer’s disease and gastrointestinal disease using cost effective and evidence based environmental and lifestyle modification.
Throughout history the practice of medicine has largely been through trial and error. We have not fully understood the genetic and environmental factors that cause major diseases and hence our efforts to prevent and treat these diseases are often imprecise, unpredictable and ineffective. The therapies we devise are tested on broad populations and are prescribed using statistical averages. Consequently, they work for some patients but not for many others, due to genetic differences among the population. On average, any given prescription drug now on the market only works for half of those who take it.
By collating the latest research and utilising the latest technologies personalised health care has the capacity to identify the genetic tendencies to identify the onset of disease at its earliest stages and identify therapeutic high-yield areas. By correlating these tendencies with epigenetic and environmental modifications of individuals we can increase the efficiency and cost effectiveness of the health care system by reversing chronic disease pathology and improving quality, accessibility, affordability and avoiding the adverse effects of modern drug and procedural interventions.