About This Program: About the Research

The Research Program on Genes, Environment, and Health (RPGEH) came about as a result of Kaiser Permanente's commitment to improving the health of our members and the communities in which we live and work. It also evolved in response to new scientific knowledge gained from mapping the human genome.

Recent advances in understanding the human genome, along with advances in technology, have made this research possible and the RPGEH is responding by developing new studies and the infrastructure needed to support them.

A great deal of research is needed to discover which genes are linked to common diseases and how they interact with environmental conditions to affect health. The findings could lead to entirely new ways of diagnosing, treating and even preventing some diseases, especially such common diseases as cancer, heart disease, asthma and diabetes, as well as diseases like bipolar disorder and many others.

Common diseases are complex

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

  • Genetic traits, which are inherited from one's 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 and with environmental factors in complex ways.

  • Environmental exposures. In this context, this term means just about everything we are exposed to in daily life, including what we eat and drink, chemicals in the air and water, where we live and work, and whether we 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 are involved and how these factors play a role in specific health conditions and response to medications. Developing a greater understanding of these factors and their relationship to many different diseases will help us improve the health of our members and society at large, and also the way health care is delivered.

A cooperative effort

In order to carry out this research, we need to bring together information about genes, environmental and lifestyle factors and health conditions on a very large number of Kaiser Permanente members in California who represent the diversity of the general population.

Researchers are collecting medical, lifestyle, demographic, environmental and, in some cases, genetic information from up to 500,000 California Kaiser Permanente members.

DNA from participants' saliva and/or blood samples will be used to obtain information about genes and exposures to environmental contaminants. This information will be entered into the new, secure database that contains participants' survey responses and medical record information. Once we have all this information in one secure place, we'll have one of the largest databanks of its kind in the United States.

Scientists from Kaiser Permanente's Northern Calfornia Division of Research (DOR) and Southern California Department of Research and Evaluation (R&E), often in collaboration with scientists from other institutions, will use the databank to conduct many separate studies for a number of years.

Unraveling medical mysteries

With this knowledge, scientists hope to unravel some of our biggest medical mysteries. Here are some examples of questions we hope to answer.

  • Why do some health problems such as diabetes or cancer seem to run in families? Are they inherited through the genes? Or is it the environment that family members share? Are the children of people who develop common diseases at greater risk of these diseases than the general population? If so, what can be done to reduce their risk?

  • Why do some members of a family develop cancer or heart disease, or breast or prostate cancer, but others do not? If some genes make us more vulnerable, can we change something in our lifestyle or environment so that we are more protected? The aim of this research program is to answer some of these questions.

  • Why do particular medications work well for one person, when the same medication results in more side effects or doesn't work at all for someone else? This research program is designed to help us better understand which medications may work best for which people.

  • Among people who develop cancer, who is at risk of recurrence and who should receive the most aggressive treatment? How can diagnostic tests and treatment of different diseases be better targeted so that the people who really need them receive them?

  • 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?

The answers to these questions and many others may lie in understanding how the interactions between genes and environmental factors affect health. When we know the answers to these and similar questions about other diseases, it may be possible to change some factors or intervene early in order to make a difference in many people's health.

Kaiser Permanente members are 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. This will 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 population suitable for such an extensive effort. The membership is large, ethnically diverse and 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 volunteer to take part in the program.

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 United States has the high quality, comprehensive health information from large numbers of people. Electronic health records are a key component of this kind of research program. That was a major consideration when Kaiser Permanente research scientists decided to pursue the Research Program on Genes, Environment, and Health.