ww.sciencedirect.com

p u b l i c h e a l t h 1 2 7 ( 2 0 1 3 ) 9 8 4e9 8 6

Available online at w

Public Health

journal homepage: www.elsevier .com/puhe

Public Health Genomics Essay Competition – Runner Up

Our DNA family reunion

Kee Chan, PhD*

Boston University, Sargent College of Health and Rehabilitation Sciences, 635 Commonwealth Ave,

Office Room 401A, 4th Floor, Boston, MA 02215, USA

a r t i c l e i n f o

Article history:

Received 29 April 2013

Received in revised form

17 September 2013

Accepted 18 September 2013

Available online 20 November 2013

* Tel.: þ1 617 358 6025.E-mail address: keechan@bu.edu.

0033-3506/$ e see front matter ª 2013 The Rhttp://dx.doi.org/10.1016/j.puhe.2013.09.010

realize how much we still do not know or understand about

are connected to each other at the 99.9% DNA level. In light of

As we begin to personalize our life to the string of four-letter

code (GATC) that holds the secrets to our phenotypic differ-

ences based on our genetic variation, I believe the success of

public health genomics will stem from our ability to be

mindful of how connected we are to each other. 99.9% of our

genomes are identical, and it is that which defines our hu-

manity. I do not doubt that genomics will help us to live

longer, healthier, and perhaps better than we did during the

preHuman Genome Project era. The speed of sequencing

technology will continue to improve as we expedite genomic

information processing,1 the cost of the sequencing will be as

low as a few hundred dollars,2 and the wealth of genomic data

will increase to fuse new genome-wide association studies

(GWAS) with possible implications for better medicine and

health.3 Using GWAS we could personalize our diet based on

our genes and epigenetic factors that influence the ‘on and off

switch’ of our genes along with our behaviour.4 The potential

use of genomics in health and medicine to prevent disease,

reduce disease severity, delay diseasemanifestation and even

avoid death may all be within our reach.

When I teach my undergraduate course ‘Genomics in

Public Health’, I ponder the take-home messages I want my

students to remember after completing my course. Will they

learn the history of the Human Genome Project? Will they

understand the complexity of genomic information?Will they

oyal Society for Public H

our DNA? Will they have the skills to make their own de-

cisions when they consider genetic testing?Will they focus on

seeking the implications of the 0.1% that make up our

phenotypic differences, or the 99.9% that defines our

connectedness and our humanity? For me, success is for my

students and the general public to appreciate how much we

our common DNA, the ideology of the racial and cultural dif-

ferences and barriers can be broken down. Thus, I believe

success in public health genomics will rely on our ability as

researchers to help emphasize to the public our unique

genomic common ground.

However, I worry whether the plethora of genomic infor-

mation now available may have unintended consequences.

The definition of ‘better health’ is subjective and personal. If

one learns that they may have the genes for early onset Alz-

heimer’s Disease,5 will that person find the information

comforting in preparation for the manifestation, or will that

person be worried indefinitely, thus changing the course of

his/her life? The boundaries separating the ‘good, bad, and the

ugly’ from the implications of genomic information are blur-

red by our desire to seek knowledge and the fear of knowing.

Thus, we must learn to be conscious and critical of new

studies and the benefits they offer. In recent years, studies are

increasing that suggest the existence of genes for athletic

ability6 and the genes for leadership.7 If one was to learn that

they do not possess an ‘affinity gene’ for sports, will that

person decide to do something different, or will they fight

against the odds of their geneticmake-up and train harder? Or

if their DNA predicts their lack of leadership, will the person

decide to be a follower for the rest of their life? Will additional

information about our genomes change how we view our-

selves, or alter our relationships with ourselves, our families,

or our society? Soon, medicine and health may become so

ealth. Published by Elsevier Ltd. All rights reserved.

p u b l i c h e a l t h 1 2 7 ( 2 0 1 3 ) 9 8 4e9 8 6 985

individualized that we could lose sight of the 99.9% of the

genome that defines our common ground. We as a human

species are defined by the 99.9%.

In addition to our scientific contributions, as researchers,

we have the expertise to translate the underlying public

health impact from our scientific discoveries through writing

press releases, giving lectures at local adult learning centres,

or participating in science fairs. I believe it is important to

teach our students about the possibilities inherent with

increased genomic information while keeping in mind that

our mental, spiritual, and emotional being has not been

decoded.8 As instructors, we could create a curriculum that

examines the genetic similarities and help ourselves, our

students, and others to acknowledge the importance of these

similarities to our health and well-being.

To me, the success of public health genomics will lie in our

ability to improve our quality of life by appreciating the similar

genomic features between us. I fear that genetic testing that

focuses too much on our individual differences will cause us

to lose sight of the grand scale; that we are connected through

a central bloodline that originated from Africa and we are all

related in this way. The recent bombings at the Boston

Marathon9 were a devastating event that highlighted what

can happen when people forget how intimately they are

connected with the rest of the human race. My students were

frightened and were wavering on whether or not to attend

class. All I could thinkwas “how can this have happeneds?” At

the time, we knew very little about the cause, the perpetra-

tor(s), and the exact unfortunate number of victims. As the

days unfolded, we learned that the motives were based on a

dangerous view of political, cultural and religious differences.

Can the 0.1% of the differences in our DNA drive people to

such intolerance for each others’ differing views on politics,

race, faith, and cause such violence? How does one continue

to teach under these circumstances? At that moment, I

decided that I needed to teach the students about embracing

our similarity as a healing mechanism. In class, I had the

students view the ‘Human Family Tree’ film, which filmed the

Genographic Project created by the National Geographic So-

ciety (https://genographic.nationalgeographic.com/)10. Na-

tional Geographic Researcher Dr. Spencer Wells led a team of

researchers to sample people’s DNA in Queens, NY. With the

DNA sample, the researchers were able to trace the partici-

pants’ seemingly diverse lineages back to the first man and

woman, the Scientific Adam and Scientific Eve. The film

elegantly discussed how migration from Africa and climate

change influenced the movement of people and thus, new

generations of people coming to populate different parts of

the world. I had students share their reactions to the film, and

the students were unanimously surprised at how connected

we are on Earth. They started to question their own identity

and any racial or cultural barriers that they had witnessed

with other or within themselves. They realized that people

from Africa were more diverse than people in any other

continent. They started to feel that they were connected with

their classmates as well as the world outside the classroom.

They pondered the purpose of inter-ethnic war, which is

costing lives in our ‘DNA family’. They were aware that we are

similar to each other at 99.9% genetic level, but it wasn’t until

they could visualize this similarity froma cinematic viewpoint

that they can see the connection. In their discussion re-

sponses, while there was still a mixed reaction of fear and

anger about the tragedy in Boston, they learned the value of

forgiveness, understanding, and acceptance of our DNA

family.

To expand this understanding and appreciation in the

general public, we must ensure that in the future we will

disseminate public health genomics information effectively

using many avenues in the arts, film, and humanities, to

highlight our common genomic humanity. As genomic in-

formation becomes available, our decision-making power will

seemingly increase, yet there will still be many unknowns.

Thus,my definition of ‘success of public health genomics’ is in

our need to embrace our similarities, in spite of different

views experienced during our personal journey in life. As

teachers and scientists, using our desire to share knowledge,

we can alleviate these barriers that keep us apart based on

’perceived differences’. Through social engagements in our

community such as genomics activities during science festi-

vals, book club discussion on genomics and race, or even an

annual celebration on the April 25th DNA Day, we collectively

can increase each other’s appreciation of our genomic family.

We must not lose our focus on our similarities in our genetic

code and our similarities throughout our whole society, which

are the similarities that define our humanity.

Author statements

Acknowledgement

The author would like to thank the research assistant, Ms.

Emily Petro, for her editorial assistance.

Ethical approval

None sought.

Funding

None declared.

Competing interests

None declared.

r e f e r e n c e s

1. Goh G, Choi M. Application of whole exome sequencing toidentify disease-causing variants in inherited humandiseases. Genomics Inform 2012 Dec;10(4):214e9.

2. Wetterstrand KA. DNA sequencing costs: data from the NHGRIgenome sequencing program (GSP). Available at: www.genome.gov/sequencingcosts (accessed 28 April 2013).

3. Khoury MJ, Gwinn M, Clyne M, Yu W. Genetic epidemiologywith a capital E, ten years after. Genet Epidemiol 2011Dec;35(8):845e52.

4. Low FM, Gluckman PD, Hanson MA. Developmental plasticityand epigenetic mechanisms underpinning metabolic andcardiovascular diseases. Epigenomics 2011 Jun;3(3):279e94.

p u b l i c h e a l t h 1 2 7 ( 2 0 1 3 ) 9 8 4e9 8 6986

5. Bettens K, Sleegers K, Van Broeckhoven C. Genetic insights inAlzheimer’s disease. Lancet Neurol 2013 Jan;12(1):92e104.

6. Rankinen T, Bray MS, Hagberg JM, Perusse L, Roth SM,Wolfarth B, Bouchard C. The human gene map forperformance and health-related fitness phenotypes: the 2005update. Med Sci Sports Exerc 2006 Nov;38(11):1863e88.

7. De Neve JE, Mikhaylov S, Dawes CT, Christakis NA, Fowler JH.Born to lead? A twin design and genetic association study of

leadership role occupancy. Leadersh Q 2013 Feb;24(1):45e60[Epub 2012 Sep 10].

8. Chan K. Translating 7 effective habits for the classroom. In: TheChronicle of Higher Education online; November 3, 2011.

9. www.cnn.com. Dated April 16, 2013.10. https://genographic.nationalgeographic.com.