A Call for Course Correction: Applying an Antiracism Lens to Precision Public Health

Precision public health (PPH) has captivated the public health field in recent years on the premise that by tailoring preventive interventions for individuals who are considered high risk, the overall health of the population will ultimately improve. In this issue of AJPH, Allen et al. (p. 1210) apply an antiracism lens to this work, highlighting evidence-based, equity-minded approaches to the development, implementation, and evaluation of PPH interventions. As such, the authors illuminate potential opportunities for researchers and practitioners to apply a critical framework to PPH mental health interventions and, in doing so, strengthen PPH's promise of achieving greater health equity for all.The concept of PPH emerged nearly a decade ago as an extension of precision medicine, presenting the possibility of personalized clinical approaches to population health via big data and new genomics tools to predict, detect, and treat people exhibiting the greatest risk of disease.1,2 Elevated by President Obama in his 2016 State of the Union address, the initiative quickly captured the public's attention, inspiring global conferences and attracting major federal funding dollars.3 However, despite the excitement surrounding it, many in the field have questioned its potential impact on population health. Bayer and Galea have argued that PPH's individualized clinical focus distracts from the more pressing need for comprehensive social policy to address the social determinants of health that negatively affect millions of Americans across the lifespan.4In recent years, focus has shifted to include greater emphasis on the structural determinants of health, with proponents arguing for more social and economic policies aimed at uprooting the social inequities that drive health disparities.5,6 In the wake of COVID-19, the field of public health has acknowledged that greater attention is needed to comprehensively address the mental health crisis that has affected millions of Americans, especially those lacking adequate social and financial support.