Race, genes, and health—new wine in old bottles?

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Abstract
Technological advances that make it possible to identify nucleotide variants on a large scale are having an enormous impact on many fields in biology. This incursion of genetics is even being felt in the previously remote fields of epidemiology and public health. Yet while measuring the molecular basis of genetic variation will undoubtedly alter our understanding of the biological world, the implications for public health are much less clear. One of the most contentious areas involves the role of genetics in shaping health patterns among populations. In the ‘pre-genomic’ era race was the surrogate for genetic effects at the population level, and it must follow that molecular research will now largely transform that agenda. Although we are at the earliest stages several critical issues have already emerged, and a burgeoning literature exists in both epidemiology and genetics on the application of the new molecular technology to the study of race and health. While many new and unexpected findings have begun to emerge, there is also tension between constraints which tend to keep this advancing field within the existing assumptions and the impulse to re-examine prior assumptions as empirical data lead us in unexpected directions.