Genomic medicine and racial/ethnic health disparities: promises, perils, and the challenges for health care and public health policy.

Scientific and policy debates following new genetic discoveries have been intense and emotional when they have involved questions about the causes of, and solutions for, racial and ethnic health disparities in the United States. The difference in prevalence of diseases, allele frequency and genotype frequency among racial/ethnic groups are well known. The genomic profile for a given disease could have different genetic variants for different racial/ethnic groups. Do these results indicate that we have to consider different genetic tests and different genomic medicine for different racial/ethnic groups? If we do this, what is the impact on ethnic and class disparities in health care services in the United States? Current advances in genetic medicine are very promising; however, we must consider the possible impacts of these findings on health disparities, and how genetic medicine can be extended to everyone, not just those who can pay the often high price. If genomic medicine is to be a valid and reliable technology for all citizens regardless of wealth, race, ethnicity, or other determinants of social disadvantage, public health policymakers have to consider a number of policy issues and implications.