The role of state public health agencies in genetics and disease prevention: Results of a national survey

Objectives. The onset and severity of the clinical expression of most disea ses that are of public health importance are influenced by genetic predispo sition. The ability to assess human genetic predisposition for many disease s is increasing rapidly. Therefore, state public health agencies should be incorporating new developments in genetics and disease prevention into thei r core functions of assessment, policy development, and assurance. The auth ors assessed the status of this process. Methods. The Council of State and Territorial Epidemiologists (CSTE) survey ed states about projects and concerns related to genetics and public health activities. Respondents were the Health Officer, the Maternal and Child He alth/Genetics Program Director, the Chronic Disease Program Director, and t he Laboratory Director. Where applicable, responses were categorized into a ssessment, policy development, and assurance functions. Results. Thirty-eight (76%) state health departments responded. Ongoing gen etics activities were assurance (82%), assessment (17%), and policy develop ment (2%). In contrast, Health Officers responded that future genetics acti vities would be distributed differently: assurance, 41%; assessment, 36%; a nd policy development, 23%. Future assurance activities would be largely ed ucational. Topics of interest and recently initiated activities in genetics were primarily assessment functions. Funding was the greatest concern, fol lowed by lack of proven disease prevention measures and outcomes data. Conclusions. State health departments recognize a need to realign their act ivities to meet future developments in genetics. Lack of adequate resources , proven disease prevention measures, and outcomes data are potential barri ers. Public health agencies need to develop a strategic plan to meet the op portunities associated with the development and implementation of genetic t ests and procedures.