Negotiating the Evidentiary Turn in Public Health: Integrating Genomics into a State Health Agency’s Mission

• In Event: 372 - Section on Medical Sociology Paper Session. Technology, Health and Medicine

Abstract

Although social scientists have explored how evidence-based medicine has transformed medical education and clinical practice, we have paid far less attention to how evidence-based practice is transforming other healthcare professions. In public health, policymakers have embraced evidence-based approaches in hopes that they will lead to more efficient use of public and private resources and improve overall population health. This paper examines how one particular state health agency (the Michigan Department of Health and Human Services) marshaled specific kinds of organizational resources to navigate this evidentiary turn. We specifically examine their attempts to modernize their chronic disease prevention programs to include recommendations for the use of genetic tests to identify subsets of patients at particularly high risk of cancer and other chronic diseases. We show how staff mobilized four types of organizational resources in the transition to evidence-based public health practice: program-specific organizational resources; intradepartmental partnerships; external partnerships; and state-specific surveillance data. We also, however, argue that their success was driven in large part by the way they matched these organizational resources to institutional logics or narratives that linked novel and unfamiliar genomic advances to core elements of public health’s disease prevention and health promotion mission. Our findings show how the health agency’s use of organizational resources, state-specific surveillance data, and rhetorical strategies worked interdependently to institutionalize genomics as part of an evidence-based, chronic disease prevention program.

Authors

• Laura Senier, Northeastern University

• Rachael Lee, Northeastern University

• Lauren A. Nicoll, Northeastern University

• Michael Shields, Northeastern University

• Danielle Falzon, Brown University

• Boris Templeton, Northeastern University