With respect to program development and policy, we highlight three issues. (1) Genetic differences between individuals may influence risk for adverse outcomes, e.g., externalizing psychopathology. But a genetic predisposition does not represent an immutable risk. In fact, genetically mediated risks may be as treatable or more so than risks arising from environmental exposures. (2) The way the genome relates to outcomes is complicated and may depend on features of the environment that are amenable to policy intervention; in the Fast Track treatment group, the same allele predicting increased risk among control children predicted a two-thirds reduction in risk among treated children. Modifiable features of the environment that mitigate or amplify genetic risks are appealing intervention targets because changes to these environments benefit the population and provide added benefit to individuals carrying the genetic risk modified by the environmental change. (3) Policymakers and program developers should begin grappling with the ethical challenges that come with knowledge of how genetic differences between individuals may affect response to publicly financed interventions. Medical science is involved in ongoing debate over ethical means of incorporating
