Genetic Profiling and Your Health

Talking about differences among ethnic groups may feel politically incorrect, but in truth when it comes to ethnicity and health, there are real trends to be aware of. I’m not referring to diseases known to be inherited, like sickle cell anemia (common in people of African descent) and Tay-Sachs disease (most common in those with Ashkenazi Jewish heritage), but to statistical variance in how different ethnic groups are affected by other, more common illnesses and medical conditions. Here are some fascinating statistics on disproportionate health differences among a variety of ethnic groups compared with non-Hispanic white Americans…

• African Americans have higher rates of hypertension, heart disease mortality and diabetes.

• Mexican Americans experience high rates of diabetes.

• Puerto Ricans experience high rates of asthma and HIV.

• Asian Americans suffer from unusually high rates of tuberculosis.

• Native Americans experience high rates of heart disease, diabetes and stomach and liver cancer.

NATURE OR NURTURE?

The CDC has co-launched “Healthy People 2010,” which addresses racial and ethnic health disparities, particularly in relation to preventing disease, promoting health and delivering medical care. I spoke to Joel E. Dimsdale, MD, a professor of psychiatry at the University of California in San Diego, who has a major research interest in cultural factors in illness. He is author of “Stalked by the Past: The Influence of Ethnicity on Health” (Psychosomatic Medicine).

“Ethnicity has profound influences on health that go well beyond the illness itself,” Dr. Dimsdale posits. “It influences important health-promoting or health-destroying behaviors. It influences how comfortable patients are seeking medical evaluation and how adequate the communication is between patient and doctor. It influences access to care and, in many cases, the treatments patients are offered. And it seems to influence the body’s metabolism, too.”

However true those points may be, much remains unknown about the reasons why. Dr. Dimsdale says there’s a “fog of uncertainty” surrounding scientific studies of ethnicity and health. In his published report, Dr. Dimsdale wrote, “Ethnicity, if ignored, tends to obscure any vision. Ethnicity, if glorified, lists toward racism. On the other hand, by seeking to understand the implications of ethnicity, one has a chance of piercing through the fog and discerning reality.”

A REVIEW OF ETHNICITY AND HEALTH RESEARCH

A review of recent studies sheds light on some of the ways ethnicity shapes health. It’s an area of growing research interest for Dr. Dimsdale and many others. Here is a quick look at where research currently stands…

• Ethnicity and high blood pressure. High blood pressure is notoriously higher in African Americans than white Americans. Since differences in the autonomic nervous system (e.g., heart rates) might contribute to this disparity, Dr. Dimsdale and his colleagues studied the heart rate variability (HRV) of 57 African Americans and 78 Caucasian Americans, ages 23 to 54. They discovered that young African Americans had an HRV response similar to older Caucasian Americans, perhaps suggesting a “premature aging” of the autonomic nervous system.

• Ethnicity and type 2 diabetes. Researchers at the University of Washington looked at the results of a national health survey to measure how common type 2 diabetes is among Asian Americans. While this type of diabetes is associated with obesity, they found that Asian Americans were more likely to have diabetes at lower weights than other races and ethnicities. The researchers concluded that when comparing people with similar height and weight, diabetes was 60% more common in Asian Americans than non-Hispanic, white Americans.

• Ethnicity and heart disease. Fortunately the numbers don’t always tell a bleak story. In a study at St. John Hospital and Medical Center in Detroit, researchers set out to study heart disease in Mexican Americans. Despite higher rates of known risk factors such as diabetes and obesity. Mexican Americans are reportedly less likely to die from heart disease than Caucasian Americans. After conducting blood tests, echocardiograms and coronary artery calcium CT scans, researchers found that Mexican Americans experienced significantly lower levels of calcium in the arteries and less thickening of the heart.

ARE GENETICS DESTINY?

In light of how ethnicity seems to affect health risks, I asked Dr. Dimsdale for advice. Is there anything people can do to deal with their genetic predisposition to disease? His recommendation: Learn as much as you can about your ethnic heritage and relevant risk factors. I also asked what his advice would be for his fellow health care professionals. “Doctors need to make sure that their assessments of patients are not being influenced by bias or stereotype,” counsels Dr. Dimsdale. “We need to ask ourselves, ‘Would I suggest something else if the patient were from a different ethnic group?’ That’s the kind of core question we all need to consider.”

This is but one of the many reasons why it is important to work with a physician who sees and treats you as an individual, and takes the time necessary to discover and honor your idiosyncrasies. In the meantime, it makes sense to learn about your ethnic risk factors in addition to your personal ones… and continue to eat well, exercise often and manage your stress — advice that rings true no matter what your ethnic heritage might be.