The Role of Race and Genetics in Health Disparities Research

Abstract

Over the past decade, 2 powerful scientific movements in the United States, population genetics and health disparities research, have re-ignited a contentious debate on the complex relationships between genes, race, and disease.1–3 The debate is fueled by the Human Genome Project, the increased technological capacity to map the entire human genome (the library of DNA building blocks), and the concerted national efforts to reduce racial disparities in health and health care. Many scientists believe that an understanding of the unique patterns of genes across patient populations defined by race will help identify populations at risk of developing particular diseases and ultimately enable the medical profession to tailor preventive medicine and therapies to those most likely to respond.4 A central premise of this field of investigation is that race is an inherent biological characteristic that accurately reflects human ancestry and the flow of common threads of genetic material in biologically distinct populations over time and geography. Health disparities research focuses on understanding the complex associations between race, health, and health care. Stimulated by the Healthy People 2010 initiative5 and an Institute of Medicine report documenting inequities in medical treatment among racial minorities,6 many health services, social sciences, and public health investigators have come to view race as a social and cultural construct, not a biological construct to be used in studies of race and human illness. Differences of opinion on the appropriate way to apply the construct of race in biomedical and health services research raise 3 important questions for medical and public health practitioners, scientists, policymakers, and funding agencies committed to advancing both biomedical and health disparities research agendas: What are the arguments for and against using a biological definition of race in medical research? What is the best way to articulate a comprehensive health disparities research agenda? What are the current and future roles of genetics in advancing the health disparities research agenda?