General Information

What the Research Program is all About

Improving health care

The Research Program on Genes, Environment, and Health (Research Program) came about in response to Kaiser Permanente’s commitment to improving health and in response to new knowledge of genetics that made it possible. It is a long-term research program to:

1. Identify genetic and environmental factors that affect human health.
2. Use that knowledge to improve health care for Kaiser Permanente members and the general public.

The findings could lead to entirely new ways of diagnosing, treating, and even preventing some diseases, especially common diseases like cancer, heart disease, asthma, diabetes, mental health problems, and many, many others.

Common diseases are complex

A person’s risk for getting most common diseases depends on a combination of factors including:

• Genetic traits, the ones you inherit from your parents. Unlike purely genetic diseases such as cystic fibrosis, the risk of common diseases is influenced by multiple genes that may interact with one another in complex ways.
• Environmental exposures, in this context meaning just about everything you are exposed to in your daily life – like what you eat and drink, chemicals in the air and water, where you live and work, and whether you smoke or exercise.  Specific environmental factors are likely to influence the risk of specific diseases, and may interact with genetic traits to affect health.

These same genetic and environmental factors can also affect the outcome and severity of a disease once it occurs, and may influence how a person responds to different medications.  In fact, virtually every aspect of human health is influenced by these factors.  Unfortunately, doctors and scientists still know very little about which factors, and how these factors, play a role in specific health conditions and response to medications. To improve health and health care, greater understanding of these factors and their relationship to many different diseases, is very important.  That is why this research program is important.

A cooperative effort

In the simplest terms, the Research Program will involve:

• Kaiser Permanente Northern California adult members who are willing to provide background, health, and environmental information, and in some cases, genetic samples for analysis. This data will be entered into large, coded databases.
• Researchers who will use the databases for studies on specific diseases, searching for common factors among people who have similar health conditions and those who don’t, and then doing more research into those factors.

Unraveling medical mysteries

With this knowledge, scientists hope to unravel some of the biggest medical mysteries.

• For example, why did  someone get breast or prostate cancer but another member of their family did not?  Are their children more likely to get their diseases? More importantly, is there anything that can be done to make it less likely that they will?
• Or, why don't all people with high blood cholesterol and blood pressure get heart disease?  We know that both of these factors are linked to heart disease, but what are the other factors that might make you or your neighbor more or less predisposed to heart disease?
• Similarly, why does a particular medication work well for you, when the same dosage results in more side effects or doesn’t work at all for someone else? Can research help doctors prescribe the right medicine for each person at the right dose for that person?

The answers to these questions may lie in understanding how the interactions between genes and environmental factors affect health. That is what this research program is all about. Once answers to these and similar questions about other diseases are known, it may be possible to change some factors or intervene early in order to make a difference in many people’s health.

KP members a unique resource

This kind of research is called population-based research because it requires large numbers of people, who are representative of the overall population, to yield meaningful results that can be applied to Kaiser Permanente members and the population beyond Kaiser Permanente.

Kaiser Permanente is one of few organizations in the United States with both the scientific expertise and a membership suitable for such an extensive effort. The membership is large, ethnically diverse, stable,  and this provides a unique resource for the study of a large number of medical conditions. That is why we have asked most Kaiser Permanente Northern California adult members to take part in the program.

KP members support research

Kaiser Permanente members have a long history of supporting research. They have volunteered in groundbreaking studies that led to advances in childhood immunization, cancer screening, and managing chronic conditions like high blood pressure and heart disease, to name a few.

KP members support research

Kaiser Permanente members have a long history of supporting research. They have volunteered in groundbreaking studies that led to advances in childhood immunization, cancer screening, and managing chronic conditions like high blood pressure and heart disease, to name a few.

Unequalled databases

As the largest and oldest nonprofit, medical care program in the United States, Kaiser Permanente’s databases are unequalled in their scope and depth. No other health plan or medical care organization in the U.S. has the high quality, comprehensive health information from large numbers of people.  Electronic health records are a key component of a research program such as this one.  That was a major consideration when scientists at our Division of Research (DOR) decided to pursue the Research Program on Genes, Environment, and Health in 2001.

KP’S scientific expertise

Similarly, the 400 person DOR staff is well-known for their innovation in medical information technology and for having a broad range of expertise in epidemiological and health services research.

Established in 1961, the DOR has more than 230 projects underway, looking into the environmental, behavioral, and genetic causes of a broad range of diseases; conducting clinical trials; and measuring heath care effectiveness. Most of the funding for these projects comes from governmental agencies and private foundations.

Participation is voluntary

Participation in this research program is entirely voluntary. Whether members decide to join us or not, their decision will not affect their health care or their membership in Kaiser Permanente. Those who agree to participate now can drop out at any time.

We can’t do it without you

Voluntary participation in medical research is vital in order for it to occur. Members who agree to participate will be helping advance medical knowledge that may lead to improvements in the way we detect, treat, and prevent disease.

The content of this Web site has been reviewed and approved by the KPNC IRB.

Common Diseases Heart disease and stroke are the most common cardiovascular diseases. They are the first and third leading causes of death for both men and women in the United States, accounting for nearly 40% of all annual deaths. In addition, more than 70 million Americans currently live with a cardiovascular disease. Coronary heart disease is a leading cause of premature, permanent disability in the U.S. workforce. Stroke alone accounts for disability among about 1 million Americans. more info Cancer is the second leading cause of death in America...Every year, cancer is diagnosed in more than a million people. The number of new cancer cases can be reduced substantially, and many cancer deaths can be prevented. Adopting healthier lifestyles—for example, avoiding tobacco use, increasing physical activity, achieving optimal weight, improving nutrition, and avoiding sun exposure—can significantly reduce a person’s risk for cancer. Making cancer screening, information, and referral services available and accessible to all Americans is also essential for reducing the high rates of cancer and cancer deaths. Cancers that can be prevented or detected earlier by screening account for about one-half of all cancer cases in the United States. more info Asthma is the most common long-term illness of children. We know that family history contributes to susceptibility, but in most cases we don’t know what causes asthma to develop, and we don’t know how to cure asthma. You can control your asthma by knowing the warning signs of an attack, avoiding things that trigger an attack, and following the advice of your doctor. more info Depression results from abnormal functioning of the brain. There is no single known cause of depression. Rather, it likely results from a combination of genetic, biochemical, environmental, and psychological factors. Some types of depression tend to run in families, suggesting a genetic link. However, depression can occur in people without family histories of depression as well. Research suggests that risk for depression results from the influence of multiple genes acting together with environmental or other factors. In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Subsequent depressive episodes may occur with or without an obvious trigger. more info Many other diseases are also considered common in that they affect millions of people in this country and around the world.   These other common health conditions will also be studied in the RPGEH. Common diseases are costly – 70 percent of the costs of health care in Kaiser Permanente are associated with the care of five common chronic conditions – diabetes, asthma, congestive heart failure, coronary artery disease and depression.

The Division of Research     KaiserPermanente.org