This generation of college graduates will be stepping out not only into the "real world," but into a global community that is more closely connected than ever before – especially when it comes to food, germs and genes.

This connectivity bridges conditions in distant, war-torn countries with behavioral habits in the United States, greatly impacting the spread of new infectious diseases and the development of chronic diseases like obesity and diabetes.

The next few decades will only see the world continue to shrink as technology and travel span continents with increasing rapidity.

"When I graduated college in the early 1980s, there was this feeling that what happens health-wise in the U.S. was very separate from the rest of the world," said Janet Pregler, a professor of medicine at the David Geffen School of Medicine at UCLA and director of the Iris Cantor-UCLA Women's Health Center.

"But we've really seen a globalization of health issues. We're not an island, and we have to understand that what's happening in the world will ultimately affect us," Pregler added.

But with many of these issues, awareness can be the most powerful tool for the prevention of global epidemics – whether they are caused by invading pathogens or personal lifestyle choices.

"Most younger kids think they're healthy and untouchable," said professor of medicine Ian Yip. "But you want to change your lifestyle and be healthy now, rather than after your first heart attack when you're 50 years old."

One health concern of worldwide brunt is exemplified by the global domination of fast food and the endless export of golden arches.

"Anywhere in the world that McDonald's starts to open, you start seeing a lot of overweight kids, you start seeing weight loss centers for kids," Yip said.

Many diseases, such as heart disease and cancer, are exhibiting alarming rises in incidence due to unhealthy behavioral factors and a relatively newfound obsession with eating.

"The current generation has to be shying away from thinking there is any magic out there – you just have to watch your portions, eat healthy and increase activity," Yip said.

"We've really seen a globalization of health issues. We're not an island, and we have to understand that what's happening in the world will ultimately affect us."

With increased awareness and education starting at a younger age, perhaps the problem can be halted before it – and the population – gets any bigger.

"Once people become obese, the treatment for that is very unsuccessful, so we really have to be in a prevention mode," Pregler said. "We have to have the will as a society to do something about that."

Pregler hopes that future generations, perhaps starting with this one, may eventually maintain that will.

Campaigns that changed public attitude toward a potentially worsening epidemic have worked in the past and continue to work today, Pregler said.

"We can get there because we've gotten there before with alcohol, with smoking, and we can get there with food," she said.

Humans have also been brought in closer proximity to other diseases – like SARS and HIV – by the sprawl of cities into environments normally inhabited by animals.

"We're going to continue to see the emergence of new agents that we either didn't know about or we didn't realize could cause disease in human population," said Roger Detels, the chair of the department of public health.

The spread of these diseases is also greatly impacted by the shrinking state of the world.

Last March, the world watched as a "mystery illness" jumped from Hong Kong to Toronto in a matter of days.

But medical advancements are tirelessly pursuing at the heels of microbial efficiency.

A united effort by 11 labs in nine countries collaborated in a flurry to identify and develop a diagnostic test for the pathogen that caused SARS.

"We have better networks for identifying emerging infections, but there is still a tremendous amount of work that needs to be done in this area," said Judith Currier, a professor of medicine in the division of infectious diseases.

And though scientific developments have proceeded at an amazing speed in the last decade, medicine is ultimately still at the mercy of individual awareness.

"We can come up with biologic strategies for treating chronic and infectious diseases, but in the end, it's going to be the behavioral factors that determine the success of those," Detels said. "The hardest thing in the world to change is behavior."

The new possibilities becoming available through genomic technology and genetic tests may also factor into lifestyle choices for the next decade.

The spread of these diseases is also greatly impacted by the shrinking state of the world.

Treatments for diseases like cancer may one day become tailored specifically to an individual's family history and genetic makeup.

"We will have the opportunity to know more about what people's individual risks are for certain types of diseases," Currier said.

"People will be able to understand more about their risk for developing diseases and maybe that will allow them to do things to prevent the problems," she added.

As the applications of genetics are expected to come increasingly into the everyday public sphere, the next decade will also bring with it many new ethical concerns.

Techniques like cloning and cytoplasmic donation may engender more questions than they resolve.

"The genetic technology will advance, and this will cause us to change our definitions of really basic things – like families," said Linda McCabe, adjunct assistant professor in the departments of human genetics and pediatrics.

"People are pursuing what's technologically possible, but they don't always consider the ethical implications until the technology is there."

The current trends in science and health will hold a heftier, more worldwide impact, increasing the need for college students and those entering the job market to maintain an awareness of the latest developments.

"People just have to be much more aware of the problems facing the world and not only be considering what's relevant to them in that microcosm they're living in," Currier said. "After people graduate college, they start to recognize their place in the world and they realize the places that they are more likely to impact."






Contributed by Jeyling Chou, Daily Bruin Senior Staff. Reprinted with permission from the Author. This article originally appeared in The Daily Bruin Online on June 14, 2004.

To read another Global Envision article about global health, see In Need of a Global Health Insurance Plan.