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A factoid I just came across: If not for the Beatles, we wouldn't have CT scans, aka CAT scans, the advanced medical scanning technology that lets your doctor see how badly your bones are broken or whether your aunt really has emphysema.

Out of the bounty of new apps for the iPhone, I was pleased to see a couple dozen focused on health & fitness. To me, the potential here is this: Combine a device that's easy to use and portable with the growing trend of life-logging. The result, I hope, would be several apps that let us track our health, quantatively, and log progress and data (basically, the idea would be not unlike the Virgin HealthMiles product I blogged about recently).

Put together, a couple stories in the NYTimes today show that while preventive medicine is theoretically the way of the future, it's going to be a cultural challenge getting the public to synch up with the program. First, there's Tara Parker Pope's column about the American Academy of Pediatrics recommendation to prescribe statins to children as a longterm preventive measure against heart disease. The idea is to identify those children at a higher lifetime risk for heart disease as early as possible - as early as eight years old - and take preventive measures to ward off the disease.

Nearly 30 years after smallpox was eradicated from the face of the earth, it still stands alone as the only pathogen to have been deliberately eliminated (Though efforts on guinea worm and polio are getting close). Catching up on back issues of Science, I was surprised to learn that, at long last, there is now another virus very close to eradication. Rinderpest. The only catch: it doesn't affect humans. But that doesn't make the prospect of rinderpest eradication any less stunning. Quick background: Rinderpest is a viral disease that afflicts livestock, mainly cattle. It is brutal, often killing a third of a herd. A century ago, it spread throughout Asia, Africa, and Europe, but various efforts, culminating in a sustained international campaign, begun in 1994, has driven it to isolated patches in Africa. Lately, it's been confined to Kenya, and now may be even gone from there.

OK - A couple more thoughts on this move by health departments in California and New York to regulate personal genomics. I've made my quasi-libertarian case that this is my information and shouldn't be mediated by an under-informed (and possibly antagonistic) physician gatekeeper. And I'll leave the companies to make their own case on the issue of lab oversight. But now let me make an argument on public health grounds - the home turf, after all, of these state agencies. To my mind, their actions will directly contravene their own mandate, and will have the result of reducing the public's health.

...but this op-ed in the New York Times, by Gary Hart, really strikes me as a profound framing of what the future bodes. Regardless of your politics, you have to consider his list of challenges that the next president - whoever he may be - will face:

They include globalized markets; the expansion of the information revolution into places like China; the emergence of new world powers including India and China; climate deterioration; failing states; the changing nature of war; mass migrations; the proliferation of weapons of mass destruction; viral pandemics; and many more.

Though much attention has been paid - here at Epidemix and elsewhere - on the power of genomics as a predictive tool for disease, there are other approaches to forecasting risk that are potentially more helpful, equally bold, if somewhat less sexy. I had the chance a couple weeks ago to learn about one: a new predictive test for diabetes risk developed by Tethys Bioscience. It is a cool tool, and I think it represents a new breed of diagnostics and predictive testing.

Behavior change is hard. That's well established in public health research. Despite millions of dollars and thousands of studies trying to get people to change their habits and improve their health, and despite plenty of evidence that shows that when people in fact *do* change their behavior their health improves, well, most people keep acting pretty much the same way. I've written about this before, but it's one of the big cunundrum's behind personalized medicine or, more specifically, personal genomics. It's one thing to know that we have an elevated risk, and it's a second thing to know that by changing our diet or exercise habits we can ameliorate that risk. But it's quite a different thing to actually go out and do that. And this fact puts tremendous strain on our healthcare system, and means that, despite the promise of predictive medicine, we will always be dealing with late-stage conditions that could've been avoided.

About the news that California health regulators have sent cease-and-desist letters to a baker's dozen genetic testing firms, forbidding them from selling tests without a doctor's order: I have two observations. First, I know that the direct-to-consumer personal genomics twosome, 23andMe and Navigenics, have been diligent in working with the FDA to make sure that their tests line up with current testing regulations and efficacy rules. So on some level, this may be a turf battle between state health departments (NY state has sent a previous notice) and the Feds.

The new May issue of Wired (the "Get Smarter" issue) has an essay I wrote about why medical science should spend more time studying the baseline - i.e., what's "normal" - and less on the aberration.