The Raymond Pearl memorial lecture, 1992: Ethnicity and disease-more than familiality.

It has long been recognized that the prevalence of many, possibly most diseases differs among different ethnic groups, and it is further known that cultural differences among people affect the acceptability of measures to prevent or ameliorate a given disease process. Major public health challenges of our time are the delineation and understanding of how these differences in prevalence arise, and the fashioning of acceptable and effective intervention strategies. The web of causation is undoubtedly complex and in the unraveling there will be a need to examine new paradigms, new models of how genes and environments interact in the evolution of disease. These models must recognize the levels within the disease process where interactions can occur. This will demand a holistic rather than the reductionist approach that has obtained in the past. However, there are promising developments at the molecular and cellular levels, and the methods of data analysis grow progressively more sophisticated. This presentation briefly describes the methods of and problems confronted by genetic epidemiology in the context of studies of ethnic differences in disease. © 1993 Wiley-Liss, Inc.