THE INTERRELATION OF GENES, DISEASES, AND PUBLIC HEALTH

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THE INTERRELATION OF GENES, DISEASES, ANDPUBLIC
HEALTH

• Positive Health Outcomes Workshop
• 2006 Genetic Alliance Conference
• 20 years of Excellence in Advocacy
• by
• Apryl R. Brown, MD, MPH

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GENES

• A gene is defined as the biologic unit of
  hereditary where a particular quality or trait is
  transmitted from parent to offspring.
• Over 15,000 genetically inherited human traits
  have been identified. More than 5,000 of them
  pertain to diseases or disorders.

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PROMINENT DISEASES WITH FAMILIAL HEREDITARY
PATTERNS

• Obesity
• Cardiovascular Diseases
• Diabetes Mellitus
• Prominent Occurring Types of Cancer , such as
• Lung
• Breast
• Prostate
• Colorectal

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PUBLIC HEALTH

• Defined as the field of medicine and hygiene
  dealing with the prevention of disease and the
  promotion of community health overseen by
  governmental agencies.
• Threats to the community health of various
  population sizes involving cities, states, and
  countries are analyzed.

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MAIN FUNCTIONS OF PUBLIC HEALTH

• Monitor the health of communities especially
  populations at risk
• Formulate public policies designed to address
  regional and national health related issues and
  priorities
• Assure access to appropriate and cost-effective
  care to all populations, including that of
  preventive healthcare services

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HEALTH

• The World Health Organization, which is the
  United Nations specialized agency working to
  provide accessible healthcare for all
  populations, defines health as "A state of
  complete physical, mental and social well-being
  and not merely the absence of disease or
  infirmity."

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SOCIAL DETERMINANTS OF HEALTH

• According to the World Health Organization, our
  level of health is influenced by many factors
  including the environment in which we work and
  live, genetics, socioeconomic level, educational
  status, type of social relationships and access
  to health systems. These factors are referred to
  as the "social determinants of health."
  Individuals of the middle classes will generally
  have worse health outcomes in comparison to their
  counterparts of a higher social stratum. The
  poor generally suffer the worst health of all
  socioeconomic classes.

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EFFECTS OF POVERTY

• Many patients do not undergo annual medical
  checkups for reasons such as
• Lack of health care coverage and/or financial
  resources
• Lack of transportation to medical facilities
• Lack of time
• Lack of priority until materialization of severe
  signs and symptoms

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PUBLIC HEALTH

• Pertinent public health issues reflect the
  interrelation of
• Genes
• Manifestation of Diseases
• Multifactorial Determinants

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BEHAVIOR MODIFICATIONS

• The previously mentioned ailments clearly
  demonstrate familial hereditary patterns, but it
  appears that their prevalence may be altered by
  patients making healthy behavior modifications
  such as embracing nutritious dietary lifestyles,
  adhering to regular exercise regimens and
  receiving preventive healthcare attention.

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PUBLIC HEALTH

• In order to help educate the community about
  public health issues of high-priority in Metro
  Detroit, I became active with the following
  community organizations
• Detroit Medical Reserve Corps (MRC)
• Excellence in Cardiac Care Healthy Heart
  Advisory Board Member

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DETROIT MRC

• During October 2004, the Detroit Medical Reserve
  Corps was formalized as a faith-based
  organization and registered in the Office of the
  Surgeon General, in cooperation with the White
  Houses USA Freedom Corps and the Department of
  Homeland Securitys Citizen Corps in order to
  address serious public health issues manifesting
  in this city.

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DETROIT MRC MISSION

• This MRC unit is involved in promoting public
  health initiatives to residents of Metro Detroit
  by forming partnerships with other healthcare
  organizations.
• Preventive healthcare education has been provided
  in the formation of public health lectures,
  medical literature, and health fairs in order to
  inform the community about signs, symptoms, and
  treatments of major diseases flourishing in
  epidemic proportions.

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OBESITY

• Detroit rates among the top 10 cities nationwide
  with the highest percentage of obese residents
  which according to the Michigan Surgeon General
  takes an enormous toll on the health of those
  afflicted.
• According to Michigan experts, the high rate of
  obesity is attributed to numerous factors such
  as
• Easy access to unhealthy food
• Lack of recreational activities
• Inclement weather
• Heritage
• Level of income

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OBESITY LECTURE

• Responding to address this public health issue of
  obesity, a registered dietitian from the Detroit
  Medical Center (DMC) lectured to our audience on
  how to live a nutritious and healthy dietary
  lifestyle.
• The audience interacted favorably with the
  lecturer and asked numerous questions pertaining
  to their various issues of health.

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SUPPLEMENTAL MEDICAL LITERATURE

• In addition, the Detroit Medical Center provided
  literature pertaining to nutrition to inform the
  general public to
• Consume a daily adequate amount of fluids
• Eat a healthy combination of various food types
• Eat a very limited amount of fatty foods
• Adhere to a moderate exercise regimen
• Live a healthy and wholesome lifestyle

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COLORECTAL CANCER

• March is national colorectal cancer awareness
  month. Therefore, during March 2005, the Detroit
  MRC decided to educate the community about
  characteristics of this disease.
• According to the Karmanos Cancer Institute of the
  Detroit Medical Center
• During 2003, more than 5,100 new cases of colon
  cancer were reported in Michigan.
• Colorectal cancer is the second leading cause of
  cancer deaths among men and women in the United
  States.

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COLORECTAL CANCER

• A medical professional from the Karmonos
  Institute lectured about the signs, symptoms, and
  risk factors of colorectal cancer.
• Slides were shown that compared pictures of
  individuals with healthy colons to those showing
  polyps (noncancerous growths) and full blown
  colorectal cancer.
• In addition to the lecture, literature pertaining
  to this disease was distributed to the audience.

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DISCUSSION AT COLORECTAL LECTURE

• A large discussion erupted among everyone during
  the topic of being examined for polyps and/or
  colorectal cancer. Some people expressed
  concerns about undergoing an invasive procedure
  such as a colonoscopy in order to receive
  adequate medical attention. It was interesting
  to watch the interactions and listen to the
  passionate concerns of the audience.
• Other individuals explained that utilization of
  the colonoscopy helped to diagnose and remove
  polyps from their bodies when they did not
  realize that they had harbored this disease.

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CARDIOVASCULAR DISEASES

• Since heart disease is the number one killer of
  men as well as women residing throughout this
  nation, a cardiologist from the DMC lectured
  about the various types of prominent occurring
  cardiovascular diseases to our audience, such as
• Myocardial Infarction (Heart Attack)
• Coronary Heart Disease
• Angina Pectoralis
• Congestive Heart Failure
• Cerebrovascular Accidents (Strokes)
• Hypertension

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CARDIOVASCULAR DISEASES

• Although risk factors pertaining to age, gender,
  and familial inheritance can not be changed, the
  following behavioral modifications were taught to
  lessen the onset of cardiovascular diseases
• Healthy and nutritious dietary lifestyle to avoid
• Hypertension (high blood pressure)
• Hypercholesterolemia (high cholesterol)
• Diabetes
• Moderate exercise to avoid obesity
• Avoid cigarette smoke and substance abuse
• Avoid excessive alcohol

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EXPECTING SUCCESS EXCELLENCE IN CARDIAC CARE

• The Robert Wood Johnson Foundation selected
  Sinai-Grace Hospital, a healthcare facility of
  the Detroit Medical Center along with nine other
  medical institutions located throughout the
  nation to participate in this program designed to
  improve cardiac care for African Americans and
  Latinos consisting of both inpatient and
  community outreach components.

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EXPECTING SUCCESS EXCELLENCE IN CARDIAC CARE

• The inpatient component tracks Sinai Grace
  Hospital successful standards of cardiac care.
• The outreach component entitled the Healthy Heart
  Program provides Detroit residents with support
  and cardiac care education from the Healthy Heart
  Outreach Team consisting of a pharmacist, a
  registered nurse, and a social worker. This
  group regularly visits patients at one of 4 area
  sites ranging from a church to nursing homes to a
  community activity center. These free visits
  eliminate barriers such as limited transportation
  to health services and lack of health insurance.

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THE HEALTHY HEART TEAM

• The Healthy Heart Team provides education related
  to
• Medications
• Diet/Nutrition
• Weight Management
• Disease Management
• Smoking Cessation

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HEALTHY HEART ADVISORY BOARD

• The Healthy Heart Advisory Board meets quarterly
  in order to discuss innovative methods to reach
  and educate the Detroit community about the
  Expecting Success Excellence in Cardiac Care
  Program.
• Informed patients are equipped to make healthier
  choices about their lives.

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POSITIVE OUTCOMES

• Often, patients do not realize that incorporating
  daily health care regimens would lessen the
  likelihood of them succumbing to chronic and/or
  widespread diseases such as
• Daily body cleansing and brushing teeth can
  prevent extensive systemic illnesses.
• Healthy dietary lifestyles could enable patients
  to
• Possess healthier bodies
• Prevent certain types of cancer
• Maintain proper body weight

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POSITIVE OUTCOMES

• Public health education through lectures, health
  fairs, medical intervention and awareness
  programs enables the general public to make
  healthy life decisions including the importance
  of obtaining preventive healthcare.
• Although hereditary factors may be present and
  can not be changed, eliminating hazardous
  behavior patterns may change the outcome of the
  quality of life for many individuals.