Washington — Washington
IT might be called the Bermuda Triangle of medical research: the intersection of genes, race and disease.
Politically dangerous yet medically alluring, it is drawing into its center a growing number of scientists, backed by the federal government and now joined by a respected African American institution in the nation's capital.
This summer, Howard University Medical School in Washington announced it will begin building a first-of-its-kind gene bank. Although other gene banks would be larger -- such as Iceland's DeCode project or the United Kingdom's proposal to bank the DNA of about 500,000 Britons -- Howard University's initiative is unique. It proposes to collect and store the DNA only of those who identify themselves as African American.
Over the next five years, the project would gather the genetic codes, along with personal and family health histories, of about 25,000 people. Once up and running, Howard's "biobank" could help solve the enduring medical mystery: why African Americans seem to fall ill with so many diseases -- hypertension, heart disease, prostate and breast cancer, asthma, glaucoma and obesity -- more frequently than do white Americans and most major ethnic groups in the United States.
At a time when the nation stews over the practice of racial profiling and debates whether race continues to have any real meaning, Howard's biobank -- along with a welter of other initiatives -- points toward a provocative conclusion: that some racial differences are encoded in the genes, and those differences can make people of one skin color inherently more or less susceptible to certain diseases than people whose complexion is different. In short, in matters of health, it seems that race matters.
Racism and poverty have long been seen as the reasons for the disparities between the health of black and white Americans, and so the idea that genes might play a role raises deep suspicion. Some fear that race will again be seen as a meaningful dividing line, not just an anachronistic social distinction. Suddenly, they say, it might be fair game to look into the genes for more controversial racial divides in areas such as intelligence, criminality and addiction.
"Whether you're African American, no matter what you are, when you talk about research on genetics, the antenna will go up. It will go up for anyone. It will go up even higher in the African American community," says Dr. Floyd Malveaux, president of Howard University College of Medicine. "There's a great deal of suspicion, and I think that's healthy suspicion."
But at hospitals and research institutions across the country, the linkage of genes, race and disease is met with less and less skepticism. Rates of common chronic ailments such as heart disease, diabetes and asthma are significantly higher among African Americans than among non-Latino whites (although Native Americans and Latinos actually suffer higher rates of diabetes than do African Americans). And death rates for such diseases show even greater racial disparities. African American women are more likely to suffer more aggressive forms of breast cancer than white women, are three to four times more likely to develop lupus and are up to nine times more likely to develop uterine fibroids. Obesity is 60% more prevalent in the African American population than among white Americans.
Researchers had long believed that the social, environmental and economic stresses of lower-income and minority status explained those differences, but they could not ignore a growing mountain of research. Studies that compared the incidence of disease among twins, blood relatives and spouses, and among African Americans in different economic strata, all suggested that inheritance plays a key role in the development, course and outcome of certain diseases.
"We know that genetic differences between groups with different racial identities are very minimal -- 99.9% of the genome is similar," says Dr. W. Timothy Garvey, a University of Alabama diabetes researcher who launched one of the nation's first genetic studies of disease and race, among the Gullah-speaking African Americans of South Carolina. "But there's something about that 0.1% that is conferring some additional risk of certain diseases."
Tailoring drug research
In recent years, independent researchers and pharmaceutical company researchers have begun to identify broad differences in the ways that Caucasians and African Americans respond to certain medications, suggesting that fundamental physical processes -- not strictly environmental factors -- are at work.