Ancestry, ethnicity, and race: explaining inequalities in cardiometabolic disease

Sophie V Eastwood; Gibran Hemani; Sarah H Watkins; Aylwyn Scally; George Davey Smith; Nishi Chaturvedi

doi:10.1016/j.molmed.2024.04.002

Ancestry, ethnicity, and race: explaining inequalities in cardiometabolic disease

Trends Mol Med. 2024 Apr 26:S1471-4914(24)00090-X. doi: 10.1016/j.molmed.2024.04.002. Online ahead of print.

Authors

Sophie V Eastwood¹, Gibran Hemani², Sarah H Watkins², Aylwyn Scally³, George Davey Smith², Nishi Chaturvedi⁴

Affiliations

¹ MRC Unit for Lifelong Health and Ageing at UCL Population Sciences and Experimental Medicine, Institute of Cardiovascular Sciences Faculty of Population Health Sciences, University College London, London, UK.
² Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
³ Department of Genetics, University of Cambridge, Downing Street, Cambridge, UK.
⁴ MRC Unit for Lifelong Health and Ageing at UCL Population Sciences and Experimental Medicine, Institute of Cardiovascular Sciences Faculty of Population Health Sciences, University College London, London, UK. Electronic address: n.chaturvedi@ucl.ac.uk.

PMID: 38677980
DOI: 10.1016/j.molmed.2024.04.002

Abstract

Population differences in cardiometabolic disease remain unexplained. Misleading assumptions over genetic explanations are partly due to terminology used to distinguish populations, specifically ancestry, race, and ethnicity. These terms differentially implicate environmental and biological causal pathways, which should inform their use. Genetic variation alone accounts for a limited fraction of population differences in cardiometabolic disease. Research effort should focus on societally driven, lifelong environmental determinants of population differences in disease. Rather than pursuing population stratifiers to personalize medicine, we advocate removing socioeconomic barriers to receipt of and adherence to healthcare interventions, which will have markedly greater impact on improving cardiometabolic outcomes. This requires multidisciplinary collaboration and public and policymaker engagement to address inequalities driven by society rather than biology per se.

Keywords: ancestry; cardiometabolic disease; ethnicity; inequality; race.

Publication types

Review