COPYRIGHT ESA/NASA As medicine has evolved, we have developed epidemiological and pharmacological approaches using surrogates and population averages, often addressing look-alike symptoms with uniform treatment protocols. But no patient is “average”—we all have unique genes and lifestyles, which we experience in varying environments.
The next leap in the health sector, therefore, will come from the disentanglement of these uniquely individual traits. For example, the expression of many genes depends on environmental factors, including one’s diet, microflora, or exposure to pollutants, and such factors do not have the same effects on everyone. Similarly, lifestyle changes can influence one’s health, but this alone cannot overcome all genetically defined traits or environmentally induced medical conditions. Unveiling such interdependence will shed a completely new light on the complexity of our dynamic health status.
By trying to understand these interactions, a new paradigm emerges—namely to address health from an individual, participatory, and probabilistic approach. Cheaper and rapid high-throughput genomics and other omics, together with big data handling via supercomputing, have already greatly increased our ability to predict predisposition to certain cancers and helped define the risks of urban pollution exposure. Going forward, it will be an immense public health challenge to tailor individual prevention, diagnoses, and treatments, especially for the people who need it most: the growing elderly population. Indeed, half of today’s teenagers will still be alive in 2100.
Mixing various disciplines is key to such advancements. In this sense, doctors and clinical researchers would do well to take a lesson from space sciences, a field for which co-disciplinary research has become the norm. Furthermore, collecting environmental data or handling comprehensive individual health data are concepts that space programs are familiar with, as they combine satellite communication, remote sensing, and precise positioning for advanced monitoring of the planet’s atmospheric and surface conditions.
On the prevention side, personal health data and real-time environmental data can already be collected remotely, geo-referenced, and made available globally. Giving a boost to such synergies will open the door for a new era of preventive medicine, in the form of “health meteorology” services. An example is advanced risk maps that predict, for example, the probability of certain infectious disease vectors to spread and reproduce in well-defined local environments at a certain time. Once again, compiling such maps requires the collaboration of very diverse specialists, including epidemiologists, disease ecologists, behavioral scientists, climatologists, sociologists, economists, policy experts, and others.
On the health-care side, human spaceflight has contributed so much to the advancement of “remote” health monitoring, in which medical procedures can be performed by distant specialists. Indeed, despite astronauts being amongst the healthiest men and women on Earth (or rather, in space), they need to be scrutinized more than anyone in an environment that is remote, confined, and isolated—a situation that has driven specific technological developments. However, rocket science is not in the lead anymore here; space programs are in desperate need of advances in individual-centric health prediction, prevention, and care to select and monitor their space travellers for future long-distance journeys.
In this way, health and space science are now at a crossroads. In order to boost multidisciplinary work, the space sector needs to open up more to the health sector, and the health professionals need to become familiar with the potential that space applications can bring. The question is not to see which field is looking up, but to look ahead together. The 21st century’s public health challenges will be best addressed using satellites and, at the same time, astronaut health will benefit from advances in personalized healthcare. We still need to improve our current approach to health to fly a crew in good shape to Mars and back!
Didier Schmitt is the scientific adviser and foresight coordinator in the bureau of European policy advisers to the president of the European Commission. The opinions expressed in this article are those of the author and do not represent the position of the European Commission.