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May 9, 2017

Genomics, Health Disparities, and Missed Opportunities for the Nation’s Research Agenda

Author Affiliations
  • 1Department of Bioethics and Humanities, University of Washington, Institute for Public Health Genetics, Seattle
  • 2Department of Bioethics and Humanities, University of Washington, Seattle
JAMA. 2017;317(18):1831-1832. doi:10.1001/jama.2017.3096

The completion of the Human Genome Project occurred at a time of increasing public attention to health disparities. In 2004, Sankar and colleagues1 suggested that this coincidental timing resulted in an inappropriate emphasis on the contribution of genomics to health disparities, conflating racial patterns of disease with genetic ancestry, and distracting attention from the large and compelling body of scientific evidence pointing to social determinants of health disparities.2 For example, genomic research has emphasized discovery of genetic contributors to diabetes risk, but the recent increase in the prevalence of obesity and type 2 diabetes, which disproportionately affects minority populations, cannot be attributed to genetic changes and rather reflects social forces affecting diet, food access, and patterns in physical activity. The introduction of new genomic health technologies could also exacerbate disparities in access to high-quality health care, if specific genomic testing improved health and was only available to those who were affluent. Nonetheless, the claim persists that genomic research can reduce health disparities—if only participation by minority populations in genomic research could be increased.3