A near future vision of midtown: much of Manhattan's wealth has fled to better boroughs and the stretch along 6th Avenue North of Grand Central is now a dingy retail corridor. An enterprising young synthetic microbiologist has started a chain direct-to-consumer health service for the rapid sequencing and augmentation of the human micro-biome, capitalizing on the desire of the lower and middle class denizens of Manhattan to improve their standing by improving their health rating. In an inspired stroke, he has bought up many of the city's empty consumer banking spaces, repurposing them as biological collection and evaluation facilities.
The lowered cost of personalized medical technologies like Genetic and Metagenomic testing and the public acceptance of data collection and monitoring has brought an end to privacy even in the traditionally off-limits area of personal health. Because this data was already being widely distributed and used by companies to hedge against citizens in insurance and employment situations, the NIH passed a law standardizing testing protocol and assigning an overall health score (similar to the credit score), which would quantify the health of one's inner bacterial ecosystem, genetic traits, and behavioral factors.
Known as the SICO (Sickness Inventory Corollaries and Outcomes) score, this new ratings system inputs a wide variety of known and fixed data (such as DNA, family history, behavior, diet, environmental stressors, etc) with annually updated data about the demographics of the over 100 trillion bacteria in and on a person's body. Because shifts in the human microbial makeup have been shown to be the most reliable early indicators of the development of chronic disease, the SICO number is now required in all sorts of situations where a person's value as a prospective investment need to be assessed. Because it's one of the easiest things to alter, this portion of the SICO score has become a target for the medical services industry, big pharmaceutical companies, and anyone else who can figure a way to profit off of people's desire to game their scores and improve their lives.