Isler Malika Roman, Sutton Karey, Cadigan R Jean, Corbie-Smith Giselle
Department of Social Medicine, UNC School of Medicine, and NC TraCS Institute-Community Academic Resources for Engaged Scholarship Unit, University of North Carolina at Chapel Hill, CB 7240, 342B MacNider Hall, Chapel Hill, NC 27599, USA.
N C Med J. 2013 Nov-Dec;74(6):470-6.
Increasing the engagement of racial and ethnic minorities in genomic research may help alleviate health disparities. This paper examines community perceptions of the relationships between race, genes, environment, and health disparities, and it discusses how such perceptions may influence participation in genomic research.
We conducted semi-structured interviews with 91 African American, Latino, and white lay community members and community leaders in North Carolina. Using constant comparison methods, we identified, compared, and developed linkages between conceptual categories and respondent groups.
Participants described gene-environment interactions as contributing to group differences in health outcomes, expressed the belief that genetic predisposition to disease differs across groups, and said that social conditions trigger group-level genetic differences and create poorer health outcomes among African Americans.
Given the regional presence of major research institutions and the relatively high education level of many participants, this sample may not reflect the perspectives of those most disparately affected by health disparities.
Members from multiple community sectors share perceptions and may respond to similar approaches when attempts are made to increase participation in genomic research. Researchers may inadvertently fuel the perception that health disparities experienced by minorities are rooted in the shared genomes of a particular group as distinct from those of other groups. The way researchers use race and ethnicity in recruitment, analysis, and communication of research findings inaccurately implies that there are genetic differences between races, when categories of social experience or ancestry may more accurately characterize health differences. Understanding these issues is crucial to designing effective community engagement strategies, recruitment plans, and messages about genomic research, which could ultimately help to lessen health disparities.
提高种族和少数民族群体参与基因组研究的程度,可能有助于缓解健康差距。本文探讨了社区对种族、基因、环境和健康差距之间关系的看法,并讨论了这些看法如何影响基因组研究的参与情况。
我们对北卡罗来纳州的91名非裔美国人、拉丁裔和白人社区成员及社区领袖进行了半结构化访谈。运用持续比较法,我们识别、比较并建立了概念类别与受访者群体之间的联系。
参与者认为基因与环境的相互作用导致了健康结果的群体差异,坚信不同群体对疾病的遗传易感性不同,并表示社会状况引发了群体层面的基因差异,导致非裔美国人的健康状况更差。
鉴于主要研究机构在该地区的存在以及许多参与者相对较高的教育水平,这个样本可能无法反映受健康差距影响最严重的人群的观点。
多个社区部门的成员有共同的看法,在试图提高基因组研究参与度时,可能会对类似的方法做出反应。研究人员可能无意中助长了这样一种观念,即少数群体经历的健康差距源于特定群体与其他群体不同的共享基因组。研究人员在招募、分析和传达研究结果时使用种族和族裔的方式错误地暗示了种族之间存在基因差异,而社会经验或血统类别可能更准确地描述健康差异。了解这些问题对于设计有效的社区参与策略、招募计划以及有关基因组研究的信息至关重要,这最终可能有助于减少健康差距。