Commentary: Race, genetics, and disease— in search of a middle ground

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Abstract
In the article, ‘Race, genes, and health—new wine in old bottles?’ in this issue of the International Journal of Epidemiology, Dr Cooper1 presents an interesting perspective about the role of race in the study of genetics and disease. That paper is largely a critique of a recent paper in Genome Biology in which Risch et al.2 reported evidence supporting categorization based on five major categories of self-identified race (Africans, Caucasians, Pacific Islanders, Asians, and Native Americans) and suggested that identifying genetic differences between these groups was ‘scientifically appropriate’. Cooper counters that there is insufficient evidence that race or ‘continental ancestry’ has a biological (genetic) significance. He suggests that race is too crude a measure to have value in public health, and that finer-grained (sub-) categorizations (e.g. Scandinavians or Bantus) would be more informative than continental ancestry. He predicts that although populations show racial variation in genetic risk of rare, Mendelian diseases (e.g. Tay Sachs, sickle cell, thalassaemia), susceptibility allele distributions for the common, complex conditions that have world-wide distribution (e.g. diabetes or heart disease) are more likely ‘pan-ethnic’. Therefore, Cooper believes that racial differences for common, complex diseases do not have a genetic origin. He argues that evaluating the role of race in genomic research is premature given the current lack of understanding of the genetic susceptibility for common complex disorders. Cooper concludes ‘the concept of race is unlikely to have value in public health’.
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