The 23rd annual conference of the International Society of Nurses in Genetics is being held in Dallas, Texas this week.  I’m attending to present a paper on our Fit for Practice in the Genetics/Genomics Era work and present a poster about the British Heart Foundation evaluation of the Cardiac Genetics Nurses initiative. 

I’ve also chaired (and presented) a plenary panel of international speakers, each considering the issues around equity of access to genetics services in their country/region.  Countries represented included Brazil, Israel, Japan and the U.S. Visiting Professor Heather Skirton provided a European perspective.  This was a really stimulating session that generated a good discussion.  In my overview, I set out the factors that influence access to health services, and commented on the disparities both within and between countries.  There are clearly issues common to all countries, but it was interesting to hear about the more specific issues.  In Brazil for example, there is a very uneven distribution of health services by location, with marked inequity in access to public services, and concern about ethical practice in relation to commercial interests. In Israel, with a small population of just 7 million, inequities exist in relation to religion, location and socioeconomic status.  Japan is challenged by its demographics with an ageing population and low birth-rate and a scarcity of health professionals. The sheer size of the USA brings its problems too, whilst across Europe there is huge variation in access to services across just about every parameter!