Nature vs Nurture: How Social and Behavioral Data is Helping Reshape the Healthcare Landscape

The acclaimed 2018 documentary, Three Identical Strangers, recounts the true story of three identical triplets, Eddy Galland, David Kellman, and Robert Shafran, who were separated and put up for adoption at birth. Each grew up without ever knowing that they had a sibling, let alone two. Years later, they were reunited: spurring plenty of discussion about nature vs. nurture.

The debate surrounding nature vs. nurture -- meaning the extent to which human behavior is determined by our environment vs. our genetics -- has been ongoing for many, many years. But how does this apply not just to behavior, but also our health?

The answer is: Probably a whole lot more than we might think. Factors like genetic predisposition to certain diseases are well known. However, our societal factors have a big part to play as well, often far more than our genetics. 

The factors that go into health outcomes

According to a McKinsey report, social and behavioral determinants of health -- meaning the non-medical factors influencing health outcomes, such as where a person works or lives, social policies and more -- far outweigh any other factor when it comes to overall health outcomes. While nonmodifiable factors like genetics represent 25% of health outcome results, and clinical care represents 15%, social determinants account for an incredible 40% and health behaviors 20% of overall health outcomes. That’s 60% between them. Take a second to let that sink in. 

For years, however, these social and behavioral determinants have been severely downplayed in terms of importance. There’s a good reason for it, too. For the longest time, this data has been in short supply meaning that, even if patients and physicians were aware of it, they weren’t necessarily in a position to act on it.

But things are changing -- and fast. The same McKinsey report notes that, over a patient’s lifetime, just 0.4 terabytes of clinical data is typically gathered. However, during that same time period, health behaviors and the social determinants of health -- the two areas we can most proactively affect as individuals -- generate an enormous 1,000 terabytes of data. In other words, the typical individual will generate 2,750x more data that relates to social and environmental influences than they will from clinical factors. While this must’ve always been true to an extent, thanks to advances in technology, the amount of data we’re able to gather about our behaviors and surroundings is increasing all the time as well.

The holy grail of health outcomes

Tapping these rich veins of data can make truly individualized healthcare, the holy grail of health outcomes, a reality. Personalized healthcare that treats every patient as an individual isn’t just a buzzword referring to good customer service, but rather the revolutionary idea that patients should be treated as singular individuals rather than being lumped in with an anonymous group of others who just happen to share their diagnosis.

The push toward personalized healthcare can be seen throughout the cutting edge of medicine and healthcare research. For example, drug researchers are working to create personalized therapies, including use of patients’ unique cells or delivering specially targeted genetic materials that can treat diseases more effectively. In cancer management, nonspecific chemotherapy for cancer treatment exposes patients to significant adverse effects, but is suboptimal in its results. However, by utilizing large scale sequencing, more personalized therapies -- with better patient outcomes -- can be developed.

On the horizon there is even the possibility of 3D bioprinting technology being used to create custom-printed organs or “organoids” for testing treatment courses on or, eventually, implanting into patients. The societal benefit is improved precision medicine tailored to the individual.

Alike is focused on personalizing healthcare by bringing together the massive amounts of data now available about patients and using AI algorithms to connect patients to others who share a high measure of similarity, going way beyond the basics of a simple diagnosis. The goal is to create proactive models built around personalized healthcare instead of simply population-based reactive models.

The Alike revolution

Alike uses your de-identified electronic medical record and other socio-demographic data to “compare” you to every other person in the Alike system. You are then given an “Alikeness” score for each other patient: the higher the score, the more you have in common.

What makes Alike so powerful is that similarities run much deeper than simply sharing a medical diagnosis. Instead, the people you match closest to (your “Alikes”) might also be of a similar age to you, take the same medication, or have undergone the same surgical procedure, and more.

Connecting with your Alikes lets you develop meaningful relationships with other people who are sharing the same (and often life-changing) journey as yourself. Patients can share medical experiences, health tips, and gain personalized insights from each other that help to manage not only the burden of disease, but the disease progression itself.

Now is your chance to be part of the biggest paradigm shift seen in healthcare for decades. We no longer need to accept second-rate, generalized, healthcare that prioritizes insurance premiums over patient outcomes.

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