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schizophrenia, stroke, traumatic brain injury
and many other neurological disorders.
Basic science also plays an important role in
prevention. Currently, most recommendations
about how to prevent disease are based on the
expected response of the average person. Pre-
cision medicine is an innovative approach to
the diagnosis, management and prevention of
disease that takes into account individual dif-
ferences in genes, environments and lifestyles.
To realize the full potential of precision med-
icine, the NIH launched the All of Us Research
Program in May 2018 to build a diverse research
cohort of 1 million or more volunteers from
across the U.S. Among other things, All of Us
will aim to do for all diseases what the Framing-
ham Heart Study has done for the prevention
of cardiovascular disease. Begun in 1948, the
Framingham study initially enrolled more than
5,000 residents of this small Massachusetts
town and, over time, their children and grand-
children, eventually reaching 15,000 volun-
teers. Because of them, we now know much
more about high blood pressure, high choles-
terol, smoking and other modifiable risk factors
for cardiovascular disease— knowledge that has
helped to save millions of lives.
Until recently, most studies and clinical
trials have been conducted with participants
largely of ancestral European origin. As a result,
there are many new drugs being developed to
treat cancers and other serious diseases—but
often their effectiveness has not been estab-
lished in African Americans or other racial and
ethnic groups because they were not included
in research studies. That needs to change.
To make sure that people of all backgrounds
benefit from advances in precision medicine,
All of Us has made it a priority to enroll volun-
teers from groups that are traditionally under-
represented in medical research, including
African- American, Hispanic and Latino, Amer-
ican Indian, lower- income and rural communi-
ties. So far the results have been encouraging.
More than half of the nearly 210,000 people
fully enrolled to date are racial or ethnic minor-
ities, and nearly 80% are from groups under-
represented in medical research.
We will apply the latest methods and ap-
proaches in data science to merge, integrate
and analyze information from a wide variety
of sources— biological, environmental, socio-
economic and geospatial. By combining data
into one large resource, with proper security
and privacy safeguards, the process of con-
ducting research will become easier, faster and
ultimately less expensive.
All of Us is just one of many innovative steps
that biomedical research is taking to build the
next generation of resources that will help to
tackle many of the complex and difficult is-
sues facing health care today. What we learn
using these transformative tools and technol-
ogies may help reduce costs by shortening the
translational timeline from scientific discov-
ery to real-world therapies, as well as provide
valuable new insights into how to set about ad-
dressing socioeconomic disparities in health
status both here and abroad.
Such insights can then be used to ensure
that people from all walks of life, all around
the world, will be healthier than ever. And is
that not the aim of all biomedical research, be
it basic, translational or clinical? We look for-
ward to the time when the long arc of scientific
discovery finally makes it possible to vanquish
many of the chronic diseases that devastate far
too many lives today. □
70%
Decrease in the
death rate due to
cardiovascular disease
in the U.S. in the past
50 years
ILLUSTRATION BY JUSTIN METZ FOR TIME
