10 No. 3
December 2007/January 2008
Prediction as the Cure
Gazing into the human body's crystal ball
The "engineers" in bioengineering
“I find it interesting that it’s incredibly difficult to define health without talking about a default position—you know you have health because you’re not sick.”
“There’s significant new ethical ground to be broken here. . . . We’re collecting a large amount of personal information. How do you protect it, who stores it, how do you store it, who has access to it?”
Defending basic science
Looking South Exploring Southern Spaces
The new terrain of Emory's multi-media scholarly journal
The Near Past
Tone and tension in writing about the modern South
Stories from the Frontlines
Or, How to survive co-authoring a book (with your spouse
Academic Exchange: How did you become interested in predictive health?
Michelle Lampl: I’m an anthropologist and also an MD. My research interests have been in human growth and development, and human biological variability in general. My specific research involving development is much about predictability. Health is an outcome of your genetic background, together with environmental influences and human variability, and that’s a hallmark of anthropology. My passion for predictive health is that it combines human biological variability and my research interests of development across the lifespan and various interactions between genes and environment. In my traditional medical training, it’s mostly about aberrations—it’s about disease, not health or normality. A lot of what we know about health development is actually a default of what’s unhealthy, so I find this intellectual perspective invigorating and on the cutting edge of what we need to be doing in science, which is to understand more about health itself. I find it interesting that it’s incredibly difficult to define ‘health’ without talking about a default position—you know you have health because you’re not sick. It’s an incredible challenge for science to begin to discuss a concept of normality without it being the mean or the average.
AE: It seems that moving society toward predictive health will be very difficult.
ML: It is a huge challenge to move toward caring for health as opposed to curing disease. A lot has to do with education. This is a paradigm shift, and it’s not going to be easy. You can’t just say, “OK, you’re going to change the way you think about health.” But I do think people want to care for themselves. They’re
looking for information about how to do that. It’s part of our culture. We have a strong value system of health and personal care, and I think we expect health. While we might talk in a grandiose way about how we must change medical care in this country, we’re starting simply at home, trying to begin to answer questions by going and doing through community outreach programs. It has to become integrated in education from the earliest levels, and to develop a new curriculum: health. Not disease, because most health courses are a list of dis-
eases. It’s different to say, Here’s the human body, and this is what can go wrong, than to say, Here’s the human body, and this is how to keep it functioning. We have to develop programs that reach into the community on all levels, and there’s going to have to be some novelty in the way that we do that, whether it’s lectures at our center or opportunities for people to come together in seminars here. It really has to become a university outreach.
AE: Do you think there will be resistance to predictive health from some quarters?
ML: We’re never going to put insurance companies or health care providers out of business. People will still get sick and still need traditional medical services that the medical establishment provides. In the short run, there’s no threat here. If an insurance company had insight and can get behind this and partner with predictive health, that would be smart. Put another way, it would be a smart idea for businesses to partner with insurance companies and back this kind of idea. One of the biggest expenditures for corporations is health care for employees, and we really offer a model that could—speaking very hopefully—end up reducing health care costs by maintaining the health of people who work for you. It only makes sense that that will be the wave of future in this country, considering the amount of money spent on health care. A lot of that is because people don’t take care of themselves. We live in a culture of excess, and it’s sort of reached the limit, given the numbers rolling in about rising obesity rates or rates of this or that condition. Health is not on peoples’ minds as much as it might be until they get sick, and a lot of this is preventable. We need to establish new behavior patterns, and that’s really hard to do. Any time we try to change anything—stop smoking, eat better, exercise more—these are difficult things for people to do. I should exercise more, and I know that. It’s embracing something that’s difficult for people to do, and that’s changing their behavior patterns. It’s in everyone’s best interest financially to help people be healthier. Hospitals are overcrowded; they’re treating people with sore throats
in the emergency room because so many people have no health insurance. It’s out of control.