Rethinking Race, Ancestry and Ethnicity in Precision Medicine Research
Rarely has the importance of understanding race and socioeconomic disparities been more pressing. The topic is complex and emotionally charged. However, despite the “hot button” nature of the topic, for those interested in Precision Medicine, race, ancestry and ethnicity have very particular meanings and a crucial impact on the understanding of Social Determinants of Health.
To refine how Precision Medicine can be used to tackle health disparities, we asked experts in the fields of Social Sciences and Genetics to comment on their perceptions of race and ethnicity. Collaboration across disciplines, never an easy thing, is key to advancing our understanding of race and its impact on SDoH. In a “Fireside Chat”, Dr. Consuelo Wilkins moderates a discussion between, Dr. Hector Myers, a Professor of Medicine, Health, & Society and Psychology at Vanderbilt University, and Dr. Nancy Cox, Director of the Vanderbilt Genetics Institute. Their discussion continues to resonate as we seek to understand the nature of race and health disparities in America.
A key question for addressing Social Determinants of Health, is whether health disparities are the result of ancestral genetics, or created by social constructs that differentiate groups based on race and ethnicity. To understand the answer, we must first clarify the fundamental definitions of race and ethnicity and how those terms relate to precision medicine. Indeed, for this reason it may be more informative to talk about genetic ancestry rather than race. While there may be some correlation between what is considered race and genetic (or geographic), ancestry, according to Drs. Cox and Myers, it is an imperfect comparison at best. Both agree that race is better thought of not as a biological construct, but a social one.
Interestingly, Dr. Myers argues that ethnicity is more relevant than race, as it relates to culture. We all have ethnicity or culture, Dr. Myers argues, yet when collecting data on ethnicity, researchers often only identify the Hispanic culture, implying those who are not Hispanic have no ethnicity.
To determine what effect race and ethnicity have on health outcomes, common understanding of the concepts of race, ancestry, ethnicity and culture across the fields of Genetics and Social Sciences are necessary to help more readily determine the root causes of SDoH. Using massive databases, geneticists capture health disparities and work to tease apart which are determined by sociodemographic factors and which from genetic factors. A collaborative approach to research and training across social and genetic science could help unpack these issues.
Watch the full discussion with Drs. Wilkins, Cox, and Myers:
The video, as well as a transcript of the conversation in both English and Spanish, can also be viewed on the PMHDC website.