Blaming Your Genes for Your Health Problems? Not so Fast.

Today it is almost impossible to pick up a newspaper or open a Web browser without finding an article that links a specific gene to a certain medical condition. In fact, a simple Google search of "gene linked" in November last year pulled up hits with genes linked to depression risk, restless leg syndrome, autism, breast cancer, childhood asthma, and type 1 diabetes in children. This is only on the first page of results from a total of 30,600,000 hits.

Increasingly, genes are being linked in the mainstream press, on the Web and also in prestigious medical journals not only to medical conditions but also to behavioral conditions such as narcissism, aggressiveness, and in some instances to voting behavior. Linking disease to specific genes is becoming progressively more common among the American public, too. The increasing perception is that an individual's genes are the main cause of disease.

The "geneticizing" of disease is used most appropriately in those instances where we know that genes or gene variants alone can cause disease--such as Tay-Sachs disease, which is prevalent among the descendants of Eastern European Jews but not just this one ethnic group, or sickle cell anemia, which is common among Africans and African Americans but also in other ethnic groups that have faced the scourge of malaria over countless generations. Yet that is a real stretch in other instances when genes are linked to health conditions that become labeled as race specific, since this has the potential to distort the discussion on racial health disparities.

The implication in the press is that race is the determining factor in these and other possibly "race-based" diseases. Health professionals and the public must be wary of oversimplifying the idea that "x" gene equals "y" medical condition since millions of genetic variations may exist and identifying them all, and how genes interact with one another, has yet to be determined.

Indeed, researchers within the medical industry are wary of the oversimplification of geneticizing disease. Consider the growing concern among a consortium of scientists that genes are operating in a much more complex way than previously believed. Findings from the National Human Genome Research Institute, for example, suggest that it may be inaccurate to say that a gene can be linked to a single function like a predisposition to heart disease. This is critical information since the portrayal of genetic research and disease within the mass media often presents this information as mostly based on simple genetic predispositions.

If one examines the research on genes, race, and disease more closely, most research points only to a correlation of genes to disease, which is significantly different from a gene-based disease. Genes may predispose a person to certain health ailments, but health conditions are a combination of environment, lifestyle impositions, personal decisions, and access to affordable, quality health care. As geneticist Francis Collins observes, "associations often made between race and disease only occasionally have anything to do with DNA [and] most diseases are not single-locus genetic diseases and often are quite complex, involving many genetic loci as well as environmental factors."

In short, it has been well documented that disease is a combination of nature and nurture. Health care policymakers must ensure that a correlation between a gene pattern and a medical condition does not become a proxy for the causation of that medical condition as some in the medical and pharmaceutical industries move toward geneticizing and racializing disease.

Perhaps the issue of most concern in this shift to geneticize disease is the inclusion of race into the research and development of medications in an attempt to combat health disparities. The inclusion of race into medical research is not novel, nor is the controversy surrounding it. In fact, opposing sides of the debate use the same argument--those in favor of eliminating racial categories and those in favor of using racial categories in medical research argue that such a move is problematic. Yet both sides of the debate express legitimate concerns on whether to include race in medical research.