The greatest impacts on the health of mankind have often been gained through public health efforts, particularly since 1854 when the connection between human waste removal and typhoid fever was discovered and dealt with in London. Clean air, water, sanitation, free immunizations, environmental safety and similar public efforts aimed at communities have created dramatic improvements in our health, though “private” diseases are still rampant.

Emory University in Atlanta has announced what may be one of the most valuable developments in private health today. It is constructing a “Center for Health Discovery and Well Being” on the 18th floor of Emory Crawford Long Hospital’s medical office tower, planned to be open in mid-June. This center will be part of the Emory-Georgia Predictive Health Initiative, and will be only the first step in a major investment in “predictive” health, elsewhere also known as “preventive”, “proactive”, pre-emptive”, with all denoting its focus on actions aimed at reducing the incidence and prevalence of disease and its complications.

It is part of the only recently widely recognized fact that it is often far more cost-efficient, to say nothing of more valuable to consumers, employers, insurers and practically everyone with the exception of sickness care providers to keep people from getting sick rather than treat them after the fact. The Emory center will combine medicine with anthropology, ethics and psychology in efforts to understand why people inherit disease and why they choose unhealthy behaviors over healthier alternatives.

As an employer, Emory will start its predictive health efforts with 700 of its own employees, with disease and risk factor screening and interventions. Based on what it learns from this pilot effort, it will be able to expand services to the general public in future. This appears to be the first center devoted to the study of private health, rather than sickness, in this country, though many other major academic medical centers are engaged in proactive health management to some degree. [D. Sams “Emory Close to Opening Predictive Health Center” Atlanta Business Chronicle, April 13, 2007.

Up to now, most proactive health efforts have focused on someone’s ideas about how to change people’s health behaviors, rather than learning why unhealthy behaviors develop in the first place, and how they might best be changed. Many favor “health education” as the solution, though if education were that effective we would already be living in a healthier state. Others favor incentives to promote healthier behavior, though extrinsic rewards are known to have limited effects over time, and add significantly to the costs of changing health behaviors.

The new Emory center will, ideally, add significantly to our understanding of the best ways to prevent and “cure” unhealthy behaviors. It will probably discover, as is only recently being realized with respect to sickness medicine, that a wide range of solutions are likely to be needed to deal with the enormous variability of human behavior factors that can promote the wrong behaviors or preferred alternatives. But at least, it will be looking at diagnosing the fundamental problem, rather than prescribing a popular solution first.