The U.S. federal government’s “All of Us” program marks a key departure point in how health care will be delivered in the United States in the future and represents two important shifts in our understanding of human health and health care. First, it recognizes that the search for individual “blockbuster” genes that are single-handedly responsible for a substantial portion of major chronic diseases such as cancer, heart disease, and diabetes has not borne fruit. Instead, many different genes are relevant for any health condition, each of which may make only a relatively minor contribution to the population risk for that condition. This necessitates the massive DNA sequencing of all 3.1 billion base pairs of DNA from one million individuals to achieve the statistical power and coverage to discern the more complex and nuanced genetic influences on our health. This shift in focus from genetics (study of individual genes) to genomics (study of all genetic information in an individual) is one of the driving factors behind the All of Us program.
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