(This article has been translated into French.)

New evidence could help Canadian scientists and policy-makers transform how chronic diseases are treated. Last spring, Canadian researchers found unequivocal evidence that environmental exposure has a significantly stronger impact than ancestry on the regulation of genes and their impact on disease. The discovery came out of one of the largest studies yet to examine the relationship between genetics and environmental stimuli, and the data paves the way for precision medicine and targeted policies to be used together to support healthy living.

I was a researcher in the study, which examined more than 1.6 million data points from biological specimens, health questionnaires and environmental exposures of people living in Montreal, Quebec City and Saguenay, Quebec.

The study revealed how environmental factors influence gene expression by linking an individual’s personal health and genetic information with what some scientists call the exposome — the collective impact that external factors such as air pollution and neighbourhood walkability have on the body.

Study participants were enrolled in the Quebec cohort of the Canadian Partnership for Tomorrow Project, Canada’s largest population health research study, which allows researchers to explore how genetics, environment, lifestyle and behavior interact and contribute to the development of cancer and other chronic diseases.

Over the past decade, data from more than 330,000 Canadians have been collected, making the study a valuable living population laboratory, the largest health data collection of its kind in Canadian history.

This wealth of data opens up exciting opportunities for the use of precision medicine. For the first time in history, it is clear that health and well-being could be improved through personalized therapies and prevention tactics tailored to individual patients based on factors that are unique to them, including genetics and environment. Precision medicine could be used to identify people at risk of developing disease before they’re in the doctor’s office seeking treatment.

But researchers in the project are also thinking about precision policy. Entire populations could reap the benefits of strategic policies that draw on the kind of evidence that came out of the study.

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Heart disease, cancer and other chronic diseases are incredibly complex. Managing and preventing them requires a layered approach with levels of government from various ministries. When they work together, policy-makers and scientists are better equipped to tackle issues of transit, food availability, affordable housing, and encouraging physical activity.

Our study found that environmental factors are a stronger predictor than genetics for respiratory conditions. That’s why we need political and academic collaboration to help translate this research into the creation of healthy environments. For example, researchers can help municipal governments strategically plan for housing developments and schools to be a safe distance from major highways, near clean public transit and green space.

Now more than ever, policy-makers at all levels of government are collaborating with researchers to develop evidence-based policies, community programs and targeted investments to create healthy environments for people to thrive. More partnerships are key to deliver precision medicine to Canadians, as well as more population health research funding to generate the evidence needed to inform policy decisions.

Data is the key to policy change. The collection of information — and understanding it — is the first step toward rethinking perspectives and policies. The Canadian Partnership for Tomorrow Project is Canada’s precision medicine initiative that provides Canadian scientists with the data and tools for the job. Now we need Canadian (and global) scientists and policy-makers to take the leap.

Photo: Shutterstock, by crystal light

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Philip Awadalla
Philip Awadalla is national scientific director of the Canadian Partnership for Tomorrow Project, based at the University of Toronto’s Dalla Lana School of Public Health. He is also director of computational biology at the Ontario Institute for Cancer Research, executive scientific director of the Ontario Health Study, and professor of population and medical genomics at the University of Toronto’s Faculty of Medicine.

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