Understanding the potential of state-based public health genomics programs to mitigate disparities in access to clinical genetic services.
Genet Med
; 21(2): 373-381, 2019 02.
Article
en En
| MEDLINE
| ID: mdl-29895854
ABSTRACT
PURPOSE:
State health agencies (SHAs) have developed public health genomics (PHG) programs that play an instrumental role in advancing precision public health, but there is limited research on their approaches. This study examines how PHG programs attempt to mitigate or forestall health disparities and inequities in the utilization of genomic medicine.METHODS:
We compared PHG programs in three states Connecticut, Michigan, and Utah. We analyzed 85 in-depth interviews with SHA internal and external collaborators and program documents. We employed a qualitative coding process to capture themes relating to health disparities and inequities.RESULTS:
Each SHA implemented population-level approaches to identify individuals who carry genetic variants that increase risk of hereditary cancers. However, each SHA developed a unique strategy-which we label public health action repertoires-to reach specific subgroups who faced barriers in accessing genetic services. These strategies varied across states given demographics of the state population, state-level partnerships, and availability of healthcare services.CONCLUSION:
Our findings illustrate the imperative of tailoring PHG programs to local demographic characteristics and existing community resources. Furthermore, our study highlights how integrating genomics into precision public health will require multilevel, multisector collaboration to optimize efficacy and equity.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Salud Pública
/
Genómica
/
Servicios Genéticos
Tipo de estudio:
Prognostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Genet Med
Asunto de la revista:
GENETICA MEDICA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Estados Unidos