Genomics and the Dangers of Essentialism: Can Public Health Embrace Genomics without Fostering Inequality?

• In Event: 2261 - Current Issues in Health Policy

Abstract

Public health policymakers and social scientists have warned that clinical genomics might widen health inequalities, in part because genomics is reshaping ideas of risk and identity, and partly because of sharp disparities in access to healthcare services in the United States. This study examines 4 US public health agencies that have begun incorporating expert recommendations for genetic testing into their chronic disease prevention programs—our intent is to identify how these programs might impact inequalities in access to genetic services. We find that states have tailored chronic disease messaging to identify groups of people with genomic variants that increase disease risk, but that they have leveraged public health surveillance data to identify subgroups of people who have BOTH genetic markers of increased risk AND social vulnerabilities that compound those risks. Our findings also show significant variation across states, and that states have tailored their programs to meet the needs of specific communities (e.g., rural and medically underserved populations, racial and ethnic minorities, groups with specific cultural or linguistic concerns about medical care). These activities aimed to forestall the widening gap in health disparities. Our findings suggest that integrating genomics into public health practice need not necessarily usher eugenics in through the backdoor. While barriers in access to healthcare certainly have the potential to stymie the diffusion of new medical technologies and spur health inequalities, public health agencies have resisted narratives of biological determinism, by recognizing that increased biological risk does not necessarily correspond with increased need.

Authors

• Laura Senier, Northeastern University

• Catherine Do Tan, Southern Connecticut State University

• Rachael Lee, Northeastern University

• Leandra Smollin, State University of New York at Potsdam