title: Finding a place for genomics in health disparities research.
abstract: The existence of pronounced differences in health outcomes between US populations is a problem of moral significance and public health urgency. Pursuing research on genetic contributors to such disparities, despite striking data on the fundamental role of social factors, has been controversial. Still, advances in genomic science are providing an understanding of disease biology at a level of precision not previously possible. The potential for genomic strategies to help in addressing population-level disparities therefore needs to be carefully evaluated. Using 3 examples from current research, we argue that the best way to maximize the benefits of population-based genomic investigations, and mitigate potential harms, is to direct research away from the identification of genetic causes of disparities and instead focus on applying genomic methodologies to the development of clinical and public health tools with the potential to ameliorate healthcare inequities, direct population-level health interventions or inform public policy. Such a transformation will require close collaboration between transdisciplinary teams and community members as well as a reorientation of current research objectives to better align genomic discovery efforts with public health priorities and well-recognized barriers to fair health care delivery.
authors.affiliation: Department of Bioethics and Humanities, and Center for Genomics and Healthcare Equality, University of Washington, Seattle, WA 98195, USA. smfllrtn@uw.edu
authors.forename: S M
authors.initials: SM
authors.lastname: Fullerton
authors.forename: S
authors.initials: S
authors.lastname: Knerr
authors.forename: W
authors.initials: W
authors.lastname: Burke
mesh_terms: D001249:Asthma / Q000235:genetics; D003695:Delivery of Health Care; D015195:Drug Design; D015894:Genome, Human; D023281:Genomics; D006297:Health Services Accessibility; D006302:Health Services Research; D006304:Health Status; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000235:genetics; D047928:Premature Birth / Q000235:genetics; D011634:Public Health / Q000379:methods*