Genomics, individuals and public health: a view from clinical genetics * Comment on Dr R.L. Zimmern's Genomics and individuals in public health practice: are we luddites or can we meet the challenge?

As a clinical geneticist, I am not too surprised that many public health practitioners appear to have ignored the wellpublicized advances in genome science. Their response is understandable since Mendelian and chromosomal disorders are generally rare, while for common, complex diseases, the progressive elucidation of genetic variation has yet to impact significantly upon prevention, diagnosis or treatment. But, like Zimmern, 1 I am concerned that the public health community needs to act now if it is to contribute to the ‘responsible and effective translation of genome-based knowledge and technologies for the benefit of population health’. Opportunities for the judicious application of genomics are emerging across a wide range of health settings, but the potential costs of irresponsible, ineffective or inappropriate application are high. Public health will simply not be able to contribute optimally to improving health in the twenty-first century unless it factors genomic science into its practice.