Genetics is the scientific study of heredity. Clinical genetics is applied medical genetics. The Human Genome Project has brought genetics to the forefront of medicine, promising cures for disease through gene therapy and more effective drugs that are tailored to a person's genetic make-up. In recent years genetics has expanded beyond issues related to newborn screening, birth defects, and rare genetic disorders that primarily affect children. Genetics is becoming integrated into healthcare across the entire life cycle. We are learning that most diseases are caused by an underlying genetic susceptibility that is modified by a host of environmental factors, such as we see in the adult disorders of asthma, diabetes mellitus, heart disease, and cancer. As this integration is occurring, the medical, ethical, legal and social challenges are arising. The need for clinical genetic services is also increasing. This expanded knowledge will have an impact on public health policy and service delivery as well as health care. To optimize the impact of this growing body of genetic knowledge, clinical genetic services will need to be further integrated into public health activities and address the emerging field of "genomics". Genomics is defined as "the study of functions and interactions of all the genes in the genome, including their interactions with environmental factors" (Genomic Medicine- A Primer). Breakthroughs in genomics will provide great promise for improving health outcomes. Public health programs will be able to integrate genetic information with disease prevention interventions and surveillance systems, so that their efforts are more effective. Consequently, this cross cutting nature of genomics provides an excellent opportunity for further aligning public health and clinical genetic services to assure that an infrastructure exists to plan, implement, monitor, and evaluate clinical genetic services in North Dakota.

Although North Dakota has had a number of programs and resources for individuals and families impacted by inherited conditions, a formal comprehensive and coordinated effort addressing the integration of clinical genetic services and public health has never been officially developed. To foster this type of integration many states have developed state genetics plans to ensure collaborative planning and implementation. In 2005, the Division of Medical Genetics applied for and received a grant from the Heartland Regional Genetics and Newborn Screening Collaborative to interface with major stakeholders of the state involved in genetics to develop a State Genetic Plan for North Dakota .

multidisciplinary workgroup began to meet in December, 2005, to create a State Genetics plan. The workgroup consisted of individuals who have a stake in the future of clinical genetic services in North Dakota. This group included, but was not limited to, genetic professionals, public health officials, primary care providers, other health care providers, governmental representatives, policy makers, legislators, educators, third party payers, consumers, and families. This group continued to meet during 2006 and 2007, collaboratively formulating a comprehensive plan addressing genetic issues throughout the life cycle. The process was coordinated by the Division of Medical Genetics and also overseen by the North Dakota State Genetics Advisory Committee.

Back to Outline          Next