New York’s Mount Sinai Health System has already started plugging patient data into what is now the world’s largest integrated health database. The National Institutes of Health announced June 30 that its All of Us research program has linked 535,000 whole genomes to 482,000 electronic health records. For local doctors, that means a chance to finally test treatments on patients who look like their own. 747,000 people have enrolled total.
But the number that matters for New York’s diverse population: the database is built to include people from all backgrounds. The UK Biobank, the prior leader, holds genomes and health records for about 500,000 participants.
Almost all of them are white Europeans. That limited who could benefit from the research. All of Us started in 2018.
It pairs genetic information with real-world data — electronic health records, wearable tech like Fitbits, health surveys on socioeconomic factors, and location-based exposure data including air quality. For a city where asthma rates vary block by block and air quality differs between Harlem and the Upper East Side, that location data could prove critical.
Alicia Martin, a statistical geneticist at the Broad Institute, already uses All of Us data. She called the diversity “one of the most exciting components.” The database, she said, “offers forward-thinking opportunities to try to understand not just who is at risk of disease, but also who is more likely to progress or have some exacerbated health condition, and who is going to respond to specialised treatments.” New York City has long been a testing ground for personalized medicine.
The city’s population is 29% white, 29% Hispanic, 22% Black, and 14% Asian, according to recent census estimates. A drug that works on a white European patient may not work the same way on a Black patient from Brooklyn. A genetic risk score built on UK data may miss a heart disease risk common in South Asian New Yorkers.
All of Us changes that math. Researchers can now investigate potential causes and treatments across a population that actually reflects the city’s makeup.
The database includes doctor’s notes, diagnoses, and testing results. That means a Mount Sinai cardiologist can search for how a specific genetic variant affects heart failure outcomes in Dominican patients. A Columbia oncologist can check whether a chemotherapy side effect hits West African ancestry patients harder.
The program is not finished. 747,000 participants is the current number. The NIH has said it aims for 1 million.
That would make the database even more useful for New York’s specific communities — Puerto Ricans in the Bronx, Chinese Americans in Flushing, Orthodox Jews in Borough Park. Wearable data adds another layer. Fitbits and similar devices track activity, sleep, heart rate in real time.
Combined with air quality data, a researcher could ask: does a spike in particulate matter trigger arrhythmias in people with a certain genetic profile? That question is uniquely relevant in a city where 1 in 10 children has asthma. The database is already open to approved researchers.
Martin at the Broad Institute builds risk prediction tools using it. Those tools will eventually land in clinics.
A doctor at NYU Langone might one day run a patient’s genome through a model trained on All of Us data and get a personalized prevention plan. That is the bottom line. This is a data set built for the personalized medicine era.
New York, with its patchwork of ethnic enclaves and its concentration of academic medical centers, stands to gain more than most places. The UK Biobank could not serve this city.
All of Us might.
