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Michael J. Fine, MD, MSc

VA Pittsburgh Healthcare System, Pittsburgh, Pa

Advances in the field of genetics have vast potential to revolutionize the science of medicine and the prevention of disease. However, the role of genes in the complex relationship between race and health remains hotly debated. To advance knowledge at the intersection of these fields, national experts in genetics, environmental health, minority health, and health disparities convened in January 2005 for the Fifth Annual National Minority Health Leadership Summit to examine the roles of race, genetics, and the environment in national efforts to eliminate health disparities. This annual summit provides a national forum for academics, community leaders, and policymakers to develop effective strategies to promote health equity and measure progress toward the elimination of disparities in health and health care among racial/ethnic minorities in the United States.

While the articles featured in this issue acknowledge the promise genetics research holds for advancing the medical sciences, many also highlight the daunting challenges in translating these biomedical advances into medical or public health interventions that will improve racial equity in health and health care. For example, Lee discusses the pharmaceutical industry’s use of its economic force to leverage the widespread use of race as a biological marker in the field of pharmacogenomics. Lee cautions that using race as a proxy for genetic individuality could impede the promotion of health equity and increase competition for the fixed resources available to strengthen public health.

Thomas et al. examine the application of genomics to public health from the perspective of the Public Health Code of Ethics. They raise numerous ethical concerns about genomics research as it relates to the health and welfare of vulnerable communities. Although their work focuses on subject matter only tangentially related to Lee’s topic, Thomas and colleagues also suggest that genomics research has the potential to exacerbate rather than ameliorate existing disparities.

Krieger discusses the nonscientific, historical basis for the use of race as a biological concept in medical research. She believes that a necessary first step in addressing many of the deep-seated social causes of health disparities is a clear-cut understanding of the reasons why science has been inculcated with a fallacious, biological concept of race.

Although considerable time and energy have been devoted to understanding the associations between genes, race, and health disparities over the past decade, there is currently abundant evidence that a multitude of other nonbiological, nongenetic factors contribute to health disparities. These well-documented factors include diminished access to health care, low socioeconomic status, cultural preferences, low levels of health literacy, racial discrimination, poor doctor–patient communication, and environmental hazards and exposures. Despite the progress that has been made in understanding the genetic makeup of humans, genetics research does not yet have the capacity to explain or rectify observed racial disparities in health or health care. Thus, the jury remains out regarding the value of genes and genomics as tools for understanding and addressing health disparities.

Until further advances are made at the crossroads of genetic research and health disparities research, it is crucial that medical and public health workers and policymakers remain focused on addressing the known social causes of disparities and that social scientists and biologists continue to collaborate on ways to address the pervasive problem of health disparities in the United States and throughout the world.

This Article Extract Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fine, M. J. Search for Related Content PubMed Articles by Fine, M. J. Related Collections Genetics Other Race/Ethnicity