On Genes & Diabetes Disparities

As I am constantly harping on genetic reductionism in the way we think about health and illness, esp. as to disparities, it was nice to see an Editorial written by Michael J. Montoya, an anthropologist at UC Irvine who works on the intersection of race, culture, medicine, and illness.  The title of the article is "Do genes explain diabetes health disparities between ethnic groups? Social taxonomies are not based on biology."

Here are some excerpts:

The question is not whether ethnic minorities are more susceptible than other groups. The question is whether we can infer genetic susceptibility if what is meant by “ethnic and racial minority” corresponds to sociocultural factors alone.

In spite of decades of trying, the actual genetic contributions for diabetes that explains the disease disparities between peoples of Northern European ancestry and Native American, African American, and Hispanic/Latino peoples remain elusive and likely do not exist. This apparent heterodoxy is less outlandish than it appears.

The crux of the matter is not whether genes are important. Rather, the issue is will genes ever explain all but a small fraction of the global prevalence of disparities between those groups most affected by diabetes?

[ . . . ]

Chief among the reasons that suspected diabetes genes found within ethnically or racially labeled groups cannot explain the recent rise of diabetes is that genotypes are stable while the social worlds of affected peoples are not.  How can ancient genes explain a 40-year-old epidemiological pattern? More to the point, genes cannot explain health disparities between human groups because the correspondence between social taxonomies and human biology is a fallacy.

This is deeper than the experimental search for correspondence between self-reports and specific markers.  In the nonexperimental world of DNA collection, the ascertainment of ethnicity or race is a profoundly social enterprise anchored in contemporary history.

I'm not going to quote any more of the article, nor offer much commentary, because there is absolutely nothing I can add and because anyone remotely interested in this topic really ought to read the entire article.

Highly recommended!