BSSR Lecture Series

Investment in understanding the genetic basis of disease has long promised a potentially revolutionary way to predict which individuals will get disease and to tailor treatments to individuals with particular genetic sequences. In some respects the genetic revolution has indeed brought important triumphs. On many fronts, however, the promise of personalized medicine remains quite far from realized and the science is encountering substantial stumbling blocks in bridging the gap between genetic sequencing and tailoring medical treatment. We suggest that despite the promise of personalized medicine approaches, we are not going to be in a position-any time soon—to rely on an individual-based approach for disease prediction or cure. We base this argument on a formal understanding of the mathematical limits of individual prediction. Using simulation models we show how the drivers of individual disease risk are as much (and in many cases more) features of an individual’s environment as they are individual genetic or other characteristics. This argues strongly for a greater re-engagement in the behavioral and social sciences that attempt to identify approaches to improving the fundamental drivers of individual and population health.

Dr. Galea is the Anna Cheskis Gelman and Murray Charles Gelman Professor and Chair of the Department of Epidemiology at the Columbia University Mailman School of Public Health. Dr. Galea is a physician and an epidemiologist. Dr. Galea’s research program seeks to uncover how determinants at multiple levels—including policies, features of the social environment, molecular, and genetic factors—jointly influence the health of urban populations. His work also explores innovative methodological approaches to population health questions. His primary focus is on the causes of mental disorders, particularly common mood-anxiety disorders and substance abuse. His work has documented the mental health consequences of mass trauma and conflict worldwide, including as a result of the September 11 attacks, Hurricane Katrina, conflicts in sub-Saharan Africa, and the American wars in Iraq and Afghanistan. The National Institutes of Health, Centers for Disease Control and Prevention, and several foundations have funded his research. He has published over 400 scientific journal articles, 50 chapters and commentaries, and 7 books and his research has been featured in The New York Times, NPR, the Wall Street Journal, and many other media outlets. During Dr. Galea’s tenure as Chair, the Department of Epidemiology has launched several new educational initiatives and substantially increased its focus on six core areas: chronic, infectious, injury, lifecourse, psychiatric/neurological, and social epidemiology. Dr. Galea chairs the New York City Department of Health and Mental Hygiene’s Community Services Board and sits on its Health Board. He is president of the Society for Epidemiologic Research and an elected member of the Institute of Medicine of the National Academies of Science.

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