Translating Epigenetics into Health Interventions: Which Road Should we Take?
1. Bioethics Program, Department of Social and Preventive Medicine, School of Public Health (ESPUM); University of Montreal, Montreal, QC, Canada
In the past decade, molecular epigenetics has garnered attention from both the biomedical and the social science communities. Two dominant translations of these findings have emerged. First, a ‘clinical translation’ provides additional avenues for investigating diseases – and their potential treatments – at the molecular level. It opens new horizons for the development of technologies that would detect and address newly identified health risks embedded within patients’ bodies through epigenetic processes. Thus, the study of the epigenome (e.g., methylome, histone code) could be instrumental in the development of novel strategies of high- tech personalized medicine. Second, a ‘political translation’ introduces new arguments in favour of addressing lifestyle and living conditions. They complement existing arguments from epidemiological studies, but are based on the molecular level, and justify public health strategies that aim to address both the unhealthy behaviours of individuals and social health inequalities. In a context where scarce resources are selectively allocated between significantly different opportunities to improve the health of Canadians (e.g. predictive, preventive or curative strategies), questions arise regarding the preferred avenue for implementing epigenetics knowledge. In this poster, we argue that the current biopolitical context is largely in favour of the clinical translation of knowledge from epigenetics. First, drawing on the sociological trend towards molecularization, we caution against an over-emphasized focus on internal and isolated rather than external and socio-environmental determinants of health. Second, drawing on the sociological trend towards biomedicalization, we caution against excessive commodification and technologicalization of health care interventions that can be inspired by epigenetics studies. We conclude that the contemporary ‘regime of truth’ (to use Foucault’s term), that finds fertile soil under neoliberal assumptions in Western societies, is an important barrier to the political translation of epigenetics in Canada. It is also a barrier to recognizing the urgent requirements for public policy interventions that promote and facilitate the adoption of healthy behaviours by informed citizens, and so reduce health inequalities by addressing socioeconomic and environmental disparities.