![]() PGx and implications of genetic ancestryĪccording to the National Human Genome Research Institute, genetic ancestry is defined as the information about the people that an individual is biologically descended from, including their genetic relationship ( ). Here, we review some of the determinants of health disparities in the context of PGx research and implementation. As the United States becomes more diverse every day, without major advancements in the inclusion of underrepresented and excluded populations in health research, failing to reach these growing communities will only prove more costly over time” ( Bibbins-Domingo and Helman, 2022). The US congress-commissioned report published in 2022, addressing the representation in clinical trials and research states that: “Despite greater diversity, deep disparities in health are persistent, pervasive, and costly. Addressing these health disparities is not merely an issue of aspiring to achieve equity, but an investment into reducing avoidable health-care costs and towards building productive healthy societies. ![]() The grave toll of health disparities far exceeds the direct harm to the disadvantaged individual into the whole society in terms of lost productivity, increased health care costs, and excess morbidity and mortality ( LaVeist et al., 2011 Bush, 2018 Essien et al., 2021). ![]() These prejudices could be due to sex, age, location, occupation, race, ethnicity, religion, citizenship status, disability, and sexual orientation or gender identity ( CFR, 2022 Ivers, 2022). In the United States (US), federal regulations define socially disadvantaged individuals as those who have been subjected to racial or ethnic prejudice or cultural bias within the American society because of their identities as members of groups and without regard to their individual qualities. Health disparities are preventable differences in the burden of disease, injury or opportunities to achieve optimal health that are experienced by socially disadvantaged populations ( CDC. While the field has been growing exponentially over the last few decades with great potential, there is no evidence that the pattern of the implementation or utilization of PGx is predictive of a path guaranteeing health equity in such efforts. One of the most promising areas of precision medicine is pharmacogenomics (PGx), the science that utilizes genetic variation to individualize drug therapy. Without concerted efforts towards inclusion of minorities and disadvantaged populations in the research and development of such initiatives, what would have been potentially promising, could end up being a new roadblock that widens the already existing gaps. Precision medicine initiatives carry a lot of promise in addressing these disparities with the potential to reduce morbidity and mortality for millions of people, while decreasing the cost and improving the quality of health care ( Ginsburg and Phillips, 2018 Sisodiya, 2021). The root causes continue to be debated with the goal of identifying future applicable solutions ( Braveman and Gottlieb, 2014 Weinstein, 2017 Lee et al., 2020 Landrigan et al., 2021). The COVID-19 pandemic has helped expose the staggering rates of health disparities both domestically and world-wide, yet those disparities have long been demonstrated. ![]() Failing to identify, and hence address, these disparities in the context of the current and future precision medicine initiatives would leave an already strained health system, even more inundated with inequality. In our opinion, highlighting these disparities is imperative for the purpose of researching meaningful solutions. In this review, we glance at a few determinants of existing health disparities as they intersect with pharmacogenomics research and implementation. Attempting to address the existing disparities at the early stages of design and implementation of these efforts is the only guarantee of a successful just outcome. To harness the benefits of its initiatives, careful dissection of existing health disparities as they relate to precision medicine is of paramount importance. Precision medicine carries the potential of improving health outcomes at both the individual as well as population levels. Pharmacogenomics has been at the forefront of precision medicine during the last few decades.
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