Predictive Health and Society Health is the essential infrastructure for all that humans are capable of being doing or becoming individually or together

American health compared to that of other developed countries Cost US spends more (15+% of GDP) US has steeper rate of cost increase “Benefit” Shorter life expectancy in US Slower rate of increase in life expectancy “America's health care system is second only to Japan... Canada, Sweden, Great Britain... well, all of Europe. But you can thank your lucky stars we don't live in Paraguay!” - Homer Simpson We are at serious risk of losing our health while paying dearly for it

The Health/Disease Continuum Normal Low risk Normal High risk Pre disease Early disease Late disease Predictive Health Contemporary Medicine HEALTHHEALTH DISEASEDISEASE

Predictive Health A personal matter

The Emory Model: A limited number of generic processes can define individual health and predict premorbidity GENETICS ENVIRONMENT BEHAVIOR INFLAMMATION OXIDATIVE STRESS REGENERATIVE POTENTIAL IMMUNE HEALTH Determinants of Health Generic Processes IMPAIRED GLUCOSE TOLERANCE EARLY COGNITIVE DYSFUNCTION INCREASED CAROTID IMT DEPRESSION ASYMPTOMATIC PRE-CANCER Premorbid Conditions DIABETES NEURO- DEGENERATIVE DISEASE ATHERO- SCLEROSIS PSYCHIATRIC DISORDERS CANCER

Predictive Health A societal matter

Health matters because it is inextricable from individual happiness, productivity and quality of life, but also because human beings do not thrive in units of one.

Humans don’t thrive in units of one Individual health is defined in a social context Defining societal health Healthy societies healthy people Changing the health system means changing society

Predictive Medicine What others are doing

Johns Hopkins ad in Sunday NYT: April 25, 2005

Predictive Medicine Duke University Broad Institute Washington University Institute for Systems Biology Johns Hopkins

Predictive Health and Society It takes a universe It takes a University

Research Institute for Predictive Health Generic Pathways Specific Diseases Cardiovascular Diseases Chronic Lung Diseases Diabetes Cancer Other Diseases Neurological Diseases Determinants of Health Environment Genetics Behavior Oxidative Stress Development and Senescence Regeneration and Repair Other Generic Pathways Immunology and Inflammation Education Some Enabling Disciplines Finance and Economics Public Policy Ethics Systems Biology Population Biology Some Enabling Technologies Genomics/ Metabolomics/ Proteomics Molecular Imaging Bioinformatics Nanomedicine Quantitative Medicine Novel Therapeutics

Why Emory University? A focus on health Generic processes as definers of health A special environment Unique combination of technologies Integration of science, technology, ethics, humanities, law, business, health policy, economics Systems science---cells to societies Building bridges between population health and individual health

A Transforming Theme A destination university---Emory, a recognized destination for the new biomedicine Internationally recognized---New knowledge and practical experience with health care innovation will have global implications and will identify Emory as a leader in health care innovation with global implications Inquiry-driven---The entire effort will be driven by a passion for new knowledge and how it can be used to impact individual and societal health. Ethically engaged---Predictive health is fundamentally an ethical concept. A diverse community---Diverse scholars and new definitions of health related diversity that transcend traditionally defined ethnicities. Working collaboratively---The nature of the theme dictates dynamic interactions among a diverse group of scholars Positive transformation in the world---It is difficult to imagine an effort with as great a potential to impact every aspect of society Courageous leadership in teaching, research, scholarship, health care and social action---This is a bold theme with a grandly ambitious goal that integrates research, scholarship and education in an innovative effort aimed directly at revolutionizing care of people to preserve and prolong the health of individuals and of society.