Genetic research and reduction of health disparities

Abstract

The purpose of this paper is to evaluate whether genetic research is an adequate means to attain the very worthy goal of eliminating racial and ethnic healthcare inequalities. I argue that, in our present social and political context, even if genetic variation contributes to health disparities, and even if such knowledge allows us to develop new interventions, genetics and genomics research is unlikely to have any significant effect on their elimination or reduction. I explore also the possibility that attention to genetic research as the solution to persistent health inequalities might actually hinder our efforts to improve health status and healthcare outcomes for historically disadvantaged groups.

Keywords:

• genetics
• health disparities
• ethics

Acknowledgement

I would like to thank Craig Hanks for his help with prior versions of this paper.

Notes

1. I use here the terms “health disparities”, “health inequalities” and “health inequities” interchangeably.

2. My analysis here focuses on racial health disparities as they exist in the USA. Some of the contextual factors playing a role in the USA might not be relevant for other countries, e.g. issues of access to healthcare may be less prominent in countries where there is universal healthcare. Nonetheless, some of the factors might apply to other countries, e.g. effects on health and healthcare of socioeconomic status. In any case, my point here is to emphasize the importance of taking into account the particular social and political context in which research is being performed and implemented.

3. This is not an exhaustive description of social factors that contribute to racial and ethnic health disparities. My intention is to offer a summary of such factors so as to make my argument about genetic research in the next section.

4. My arguments here do not hinge on the example of hypertension. Other complex diseases or disorders can also be used to make the case.