The Impact on Healthcare Dr. Ashley J. Duits Director Red Cross Blood Bank Foundation Technological advances have had an enormous impact on healthcare. Spectacular developments in the fields of immunology and genetics have resulted in better diagnostic and treatment options for patients with a variety of diseases ranging from allergies to cancer. With the elucidation of the genetic code progress has also been made in the better understanding of an individual’s susceptibility for disease development. Although at first this genetic knowledge seemed only fit to use in predicting disease development, disease classification and its eventual treatment, recent investigations have also shown its potential use for disease prevention. Quality of life and the couch potato On an individual basis the term “quality of life” is often associated with being healthy. Through ages mankind has changed his way of life from a predatory mode (hunting for food) to a sedentary mode (the couch potato). Human metabolism has not adapted itself so efficiently to this way of life with all its (health) consequences. Partially as a result of this development we have seen a surge in cardiovascular diseases, diabetes and related risk factors like obesity and hypertension. Locally the impact is also seen as reflected by the high prevalence of diabetes reported in Curaçao (5.6% in Curaçao as compared to 2.5% in the Netherlands). Diabetes development is related to risk factors like obesity, genetic factors and environmental factors. With this knowledge in mind we can also define susceptibility for disease development according to environment, behaviour and genetics. Nowadays prevention of disease development not only addresses environmental and behavioural aspects but also the field of genetics. Genetic information and DNA chips It has been extensively documented that childhood obesity can lead to all kinds of diseases during adulthood including diabetes. Furthermore obesity as a youth increases the chance of being overweight as an adult. The competitive scientific race for elucidating the human genome (which was accomplished in 2001) resulted in the introduction of innovative new technologies in genetics that are now being put to effective use in modern day health care. Making use of DNA chips, it has been possible to develop an individual person’s unique genomic imprint (which is in a certain way comparable to an individual’s fingerprint). This information is of course not only suitable for identification purposes but is nowadays a very promising tool in disease management. It provides us with important information concerning the genetic make up of an individual related to all types of disease (development). For instance information can be obtained on a person’s susceptibility to become obese. When correctly used, the use of genetic information can promote a better medical approach of delaying or preventing a potential development by increasing and optimizing its (medical) monitoring in an individual patient. Remarkably also, intervention guided by genetic information in a disease when it has already developed is becoming possible. Environment and genetic information The field of epigenetics has presented us with several interesting examples that genetic information (resulting in an individual person’s characteristics) can be influenced by environmental factors. Although obviously requiring more research in some cases, it has already been shown that a special diet can correct genetically determined characteristics by turning the gene in question off. On an individual basis the term “quality of life” is associated with being healthy. Technological development in the field of genetics has provided modern day healthcare with important tools to combat disease development by not only improving early detection and treatment but also through the determination of an individual’s susceptibility for disease development and its potential prevention.