Eliminating the well-documented health disparities found within the United States population is a laudable public policy goal. Social justice demands that we understand the sources of health inequality in order to eliminate them. A central dilemma is: To what extent are health disparities the result of unequal distribution of resources, and thus a consequence of varied socioeconomic status (or blatant racism), and to what extent are inequities in health status the result of inherent characteristics of individuals defined as ethnically or racially different? How we conceptualize and talk about race when we ask these questions has profound moral consequences. Prior to the Human Genome Project (HGP), scientific efforts to understand the nature of biological differences were unsophisticated. The new technologies for genomic analysis will likely transform our thinking about human disease and difference, offering the promise of in-depth studies of disease incidence and its variations across human populations. In her opening remarks at a meeting of the President's Cancer Panel, which focused on health disparities in cancer treatment in the United States, Dr. Karen Antman noted that racial differences in cancer rates have been reported for decades, "but for the first time, science now has the opportunity to quantify such differences genetically." Will the light refracted through the prism of genomic knowledge illuminate straightforward explanations of disease etiology, offering simple solutions to health inequalities? Or are there consequences, currently hidden in the shadows, that require our attention?
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