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Bear Don't Walk OJ, Paullada A, Everhart A, Casanova-Perez R, Cohen T, Veinot T. Opportunities for incorporating intersectionality into biomedical informatics. J Biomed Inform 2024; 154:104653. [PMID: 38734158 PMCID: PMC11146624 DOI: 10.1016/j.jbi.2024.104653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/06/2024] [Accepted: 05/08/2024] [Indexed: 05/13/2024]
Abstract
Many approaches in biomedical informatics (BMI) rely on the ability to define, gather, and manipulate biomedical data to support health through a cyclical research-practice lifecycle. Researchers within this field are often fortunate to work closely with healthcare and public health systems to influence data generation and capture and have access to a vast amount of biomedical data. Many informaticists also have the expertise to engage with stakeholders, develop new methods and applications, and influence policy. However, research and policy that explicitly seeks to address the systemic drivers of health would more effectively support health. Intersectionality is a theoretical framework that can facilitate such research. It holds that individual human experiences reflect larger socio-structural level systems of privilege and oppression, and cannot be truly understood if these systems are examined in isolation. Intersectionality explicitly accounts for the interrelated nature of systems of privilege and oppression, providing a lens through which to examine and challenge inequities. In this paper, we propose intersectionality as an intervention into how we conduct BMI research. We begin by discussing intersectionality's history and core principles as they apply to BMI. We then elaborate on the potential for intersectionality to stimulate BMI research. Specifically, we posit that our efforts in BMI to improve health should address intersectionality's five key considerations: (1) systems of privilege and oppression that shape health; (2) the interrelated nature of upstream health drivers; (3) the nuances of health outcomes within groups; (4) the problematic and power-laden nature of categories that we assign to people in research and in society; and (5) research to inform and support social change.
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Affiliation(s)
- Oliver J Bear Don't Walk
- Department of Biomedical Informatics and Medical Education, University of Washington, United States.
| | - Amandalynne Paullada
- Department of Biomedical Informatics and Medical Education, University of Washington, United States
| | - Avery Everhart
- Department of Geography, Faculty of Arts, University of British Columbia, Canada
| | - Reggie Casanova-Perez
- Department of Biomedical Informatics and Medical Education, University of Washington, United States
| | - Trevor Cohen
- Department of Biomedical Informatics and Medical Education, University of Washington, United States
| | - Tiffany Veinot
- School of Information and School of Public Health, University of Michigan, United States
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2
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Caron NR, Adam W, Anderson K, Boswell BT, Chongo M, Deineko V, Dick A, Hall SE, Hatcher JT, Howard P, Hunt M, Linn K, O'Neill A. Partnering with First Nations in Northern British Columbia Canada to Reduce Inequity in Access to Genomic Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105783. [PMID: 37239512 DOI: 10.3390/ijerph20105783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/08/2023] [Accepted: 03/12/2023] [Indexed: 05/28/2023]
Abstract
Indigenous-led, culturally safe health research and infrastructure are essential to address existing inequities and disparities for Indigenous Peoples globally. Biobanking, genomic research, and self-governance could reduce the existing divide and increase Indigenous participation in health research. While genomic research advances medicine, barriers persist for Indigenous patients to benefit. In northern BC, Canada, the Northern Biobank Initiative (NBI), with guidance from a Northern First Nations Biobank Advisory Committee (NFNBAC), has engaged in consultations with First Nations on biobanking and genomic research. Key informant interviews and focus groups conducted with First Nations leaders, Elders, Knowledge Keepers, and community members established culturally safe ways of biobanking and exploring genomic research. Strong support for a Northern British Columbia First Nations Biobank (NBCFNB) that will promote choice, inclusion, and access to health research opportunities emerged. The acceptance and enthusiasm for the development of this NBCFNB and its governance table highlight the shift towards Indigenous ownership and support of health research and its benefits. With engagement and partnership, community awareness, multigenerational involvement, and support from diverse and experienced healthcare leaders, the NBCFNB will establish this culturally safe, locally driven, and critically important research priority that may serve as an example for diverse Indigenous groups when designing their unique biobanking or genomic research opportunities.
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Affiliation(s)
- Nadine R Caron
- UBC Northern Medical Program and Department of Surgery, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- UBC Centre for Excellence in Indigenous Health, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- First Nations Health Authority Chair in Cancer and Wellness at UBC, UBC Health and Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Wilf Adam
- Elder Advisor, Burns Lake, BC V0J 1E0, Canada
| | - Kate Anderson
- School of Public Health, University of Queensland, Brisbane, QLD 4067, Australia
| | - Brooke T Boswell
- Community Health Sciences, University of Northern British Columbia (UNBC), Prince George, BC V2N 4Z9, Canada
| | - Meck Chongo
- University of Saskatchewan, Saskatoon, SK S7N 5A2, Canada
| | - Viktor Deineko
- Northern Biobank at the University Hospital of Northern BC, Northern Health, George, BC V2M 1S2, Canada
| | - Alexanne Dick
- First Nations Health Authority Chair in Cancer and Wellness at UBC, UBC Health and Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Shannon E Hall
- First Nations Biobank, Department of Surgery, Faculty of Medicine, Vancouver Campus, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jessica T Hatcher
- UBC Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Patricia Howard
- First Nations Health Authority, Northern Region, Prince George, BC V2L 5R8, Canada
| | - Megan Hunt
- First Nations Health Authority, Northern Region, Prince George, BC V2L 5R8, Canada
| | - Kevin Linn
- First Nations Health Authority Chair in Cancer and Wellness at UBC, UBC Health and Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ashling O'Neill
- UBC Northern Medical Program, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- School of Health Sciences, University of Northern British Columbia, Prince George, BC V2N 4Z9, Canada
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3
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Fleskes RE, Bader AC, Tsosie KS, Wagner JK, Claw KG, Garrison NA. Ethical Guidance in Human Paleogenomics: New and Ongoing Perspectives. Annu Rev Genomics Hum Genet 2022; 23:627-652. [PMID: 35537469 DOI: 10.1146/annurev-genom-120621-090239] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Over the past two decades, the study of ancient genomes from Ancestral humans, or human paleogenomic research, has expanded rapidly in both scale and scope. Ethical discourse has subsequently emerged to address issues of social responsibility and scientific robusticity in conducting research. Here, we highlight and contextualize the primary sources of professional ethical guidance aimed at paleogenomic researchers. We describe the tension among existing guidelines, while addressing core issues such as consent, destructive research methods, and data access and management. Currently, there is a dissonance between guidelines that focus on scientific outcomes and those that hold scientists accountable to stakeholder communities, such as descendants. Thus, we provide additional tools to navigate the complexities of ancient DNA research while centering engagement with stakeholder communities in the scientific process. Expected final online publication date for the Annual Review of Genomics and Human Genetics, Volume 23 is October 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Raquel E Fleskes
- Department of Anthropology, University of Connecticut, Storrs, Connecticut, USA;
| | - Alyssa C Bader
- Department of Anthropology, University of Colorado Boulder, Boulder, Colorado, USA; .,Sealaska Heritage Institute, Juneau, Alaska, USA
| | - Krystal S Tsosie
- Native BioData Consortium, Eagle Butte, South Dakota, USA; .,College of Arts and Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Jennifer K Wagner
- School of Engineering Design, Technology, and Professional Programs; Institute for Computational and Data Sciences; and Department of Biomedical Engineering, Pennsylvania State University, University Park, Pennsylvania, USA;
| | - Katrina G Claw
- Division of Biomedical Informatics and Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA;
| | - Nanibaa' A Garrison
- Institute for Society and Genetics, Institute for Precision Health, and Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, California, USA;
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4
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Menéndez LP, Paul KS, de la Fuente C, Almeida T, Delgado M, Figueiro G, Jorgensen K, Kuzminsky S, López-Sosa MC, Nichols J, Roksandic M, Scott GR, O'Rourke D, Hubbe M. Towards an interdisciplinary perspective for the study of human expansions and biocultural diversity in the Americas. Evol Anthropol 2022; 31:62-68. [PMID: 35043498 DOI: 10.1002/evan.21937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Lumila P Menéndez
- Department of Anthropology of the Americas, University of Bonn, Bonn, Germany.,Theoretical Biology Unit, Department of Evolutionary Biology, University of Vienna, Vienna, Austria
| | - Kathleen S Paul
- Department of Anthropology, University of Arkansas, Fayetteville, Arkansas, USA
| | | | - Tatiana Almeida
- Clinical Laboratory & BigData and Analytics, Hospital Israelita Albert Einstein, São Paulo, Brazil.,Laboratório de Estudos em Antropologia Biológica, Bioarqueologia e Evolução Humana, Universidade Federal do Rio Grande, Rio Grande, Brazil
| | - Miguel Delgado
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), República Argentina (CONICET), División Antropología, Facultad de Ciencias Naturales y Museo, Universidad Nacional de La Plata, La Plata, República Argentina.,Ministry of Education Key Laboratory of Contemporary Anthropology Collaborative Innovation Center of Genetics and Development, School of Life Sciences and Human Phenome Institute Fudan University, Shanghai, China
| | - Gonzalo Figueiro
- Departamento de Antropología Biológica, Universidad de la República, Montevideo, Uruguay
| | - Kelsey Jorgensen
- Department of Anthropology, Wayne State University, Detroit, Michigan, USA
| | - Susan Kuzminsky
- Department of Anthropology and Applied Archaeology, Eastern New Mexico University, Portales, New Mexico, USA.,Anthropology Department, University of California, Santa Cruz, California, USA
| | | | - Johanna Nichols
- Department of Slavic Languages and Literatures, University of California, Berkeley, California, USA
| | - Mirjana Roksandic
- Department of Anthropology, University of Winnipeg, Winnipeg, Manitoba, Canada
| | | | - Dennis O'Rourke
- Department of Anthropology, University of Kansas, Lawrence, Kansas, USA
| | - Mark Hubbe
- Department of Anthropology, Ohio State University, Columbus, Ohio, USA.,Instituto de Arqueología y Antropología, Universidad Católica del Norte, Antofagasta, Chile
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5
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Ruckstuhl K. Trust in Scholarly Communications and Infrastructure: Indigenous Data Sovereignty. Front Res Metr Anal 2022; 6:752336. [PMID: 35098013 PMCID: PMC8790018 DOI: 10.3389/frma.2021.752336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Many Indigenous people have a deep mistrust of research, with some describing research as one of the “dirtiest” words in Indigenous language. The histories and experiences behind such mistrust are long and painful. Given what has been perceived as Indigenous objectification at the hands of largely Anglo-European others for research from which they fail to benefit, many communities now refuse research unless it is undertaken under certain, Indigenous-defined circumstances. Such refusal is a move away from others purposes and a move towards autonomy and self-determination. For some, this is a statement of sovereignty and it applies to all areas of endeavour, including the new frontiers of research and the structures that support them, such as datification of knowledge. This article examines data sovereignty from the perspective of Indigenous peoples. While data sovereignty has become a ubiquitous concern, Indigenous data sovereignty arises from contexts specific to Indigenous peoples. The focus of this article is to provide a brief overview of recent data sovereignty developments, along with the context that lies behind these activities. Through this examination, implications for trust in scholarly communications will be discussed.
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6
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Palmer S, Dearden PK, Mercier OR, King-Hunt A, Lester PJ. Gene drive and RNAi technologies: a bio-cultural review of next-generation tools for pest wasp management in New Zealand. J R Soc N Z 2021. [DOI: 10.1080/03036758.2021.1985531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Symon Palmer
- Te Kawa a Māui – School of Māori Studies, Te Herenga Waka – Victoria University of Wellington, Wellington, New Zealand
| | - Peter K. Dearden
- Genomics Aotearoa, Bioprotection Research Centre, and Biochemistry Department, University of Otago, Dunedin, New Zealand
| | - Ocean R. Mercier
- Te Kawa a Māui – School of Māori Studies, Te Herenga Waka – Victoria University of Wellington, Wellington, New Zealand
| | - Alan King-Hunt
- Te Kawa a Māui – School of Māori Studies, Te Herenga Waka – Victoria University of Wellington, Wellington, New Zealand
| | - Phillip J. Lester
- School of Biology, Te Herenga Waka – Victoria University of Wellington, Wellington, New Zealand
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7
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Erickson RP. Autosomal recessive diseases among the Athabaskans of the southwestern United States: anthropological, medical, and scientific aspects. J Appl Genet 2021; 62:445-453. [PMID: 33880741 PMCID: PMC8057858 DOI: 10.1007/s13353-021-00630-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/31/2021] [Accepted: 04/05/2021] [Indexed: 11/30/2022]
Abstract
The peopling of the Americas by Native Americans occurred in 4 waves of which the last was Nadene language speakers of whom Athabaskans are the largest group. As the Europeans were entering the Southwestern states of the USA, Athabaskan hunting-gathering tribes were migrating South from Canada along the Rocky Mountains and undergoing potential bottlenecks reflected in autosomal recessive diseases shared by Apaches and Navajos. About 300 years ago, the Navajo developing a sedentary culture learned from Pueblo Indians while the Apache remained hunter-gathers. Although most of the tribe was rounded up and forced to relocate to Bosque Redondo, the adult breeding population was large enough to prevent a genetic bottleneck. However, some Navajo underwent further population bottlenecks while hiding from the brutal US Army action (under Kit Carson’s guidance). This led to an increased frequency of other autosomal recessive diseases. Recent advances in population genetics, pathophysiology of the diseases, and social/ethical issues concerning their study are reviewed.
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8
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D'Angelo CS, Hermes A, McMaster CR, Prichep E, Richer É, van der Westhuizen FH, Repetto GM, Mengchun G, Malherbe H, Reichardt JKV, Arbour L, Hudson M, du Plessis K, Haendel M, Wilcox P, Lynch SA, Rind S, Easteal S, Estivill X, Thomas Y, Baynam G. Barriers and Considerations for Diagnosing Rare Diseases in Indigenous Populations. Front Pediatr 2020; 8:579924. [PMID: 33381478 PMCID: PMC7767925 DOI: 10.3389/fped.2020.579924] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/02/2020] [Indexed: 12/16/2022] Open
Abstract
Advances in omics and specifically genomic technologies are increasingly transforming rare disease diagnosis. However, the benefits of these advances are disproportionately experienced within and between populations, with Indigenous populations frequently experiencing diagnostic and therapeutic inequities. The International Rare Disease Research Consortium (IRDiRC) multi-stakeholder partnership has been advancing toward the vision of all people living with a rare disease receiving an accurate diagnosis, care, and available therapy within 1 year of coming to medical attention. In order to further progress toward this vision, IRDiRC has created a taskforce to explore the access barriers to diagnosis of rare genetic diseases faced by Indigenous peoples, with a view of developing recommendations to overcome them. Herein, we provide an overview of the state of play of current barriers and considerations identified by the taskforce, to further stimulate awareness of these issues and the passage toward solutions. We focus on analyzing barriers to accessing genetic services, participating in genomic research, and other aspects such as concerns about data sharing, the handling of biospecimens, and the importance of capacity building.
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Affiliation(s)
- Carla S. D'Angelo
- IRDiRC Scientific Secretariat, National Institute for Health and Medical Research, Paris, France
| | - Azure Hermes
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT, Australia
| | | | - Elissa Prichep
- Precision Medicine, Platform on Shaping the Future of Health and Healthcare, World Economic Forum, San Francisco, CA, United States
| | - Étienne Richer
- Institute of Genetics, Canadian Institutes of Health Research, Government of Canada, Ottawa, ON, Canada
| | | | - Gabriela M. Repetto
- Facultad de Medicina, Center for Genetics and Genomics, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Gong Mengchun
- Institute of Health Management, Southern Medical University, Guangdong, China
| | - Helen Malherbe
- KwaZulu-Natal Research Innovation and Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa
- Rare Diseases South Africa, Johannesburg, South Africa
| | - Juergen K. V. Reichardt
- Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, QLD, Australia
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Victoria, BC, Canada
| | - Maui Hudson
- Faculty of Maori and Indigenous Studies, University of Waikato, Hamilton, New Zealand
| | | | - Melissa Haendel
- Oregon Clinical and Translational Research Institute, Oregon Health and Science University, Portland, OR, United States
| | - Phillip Wilcox
- Department of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Sally Ann Lynch
- National Rare Disease Office, Mater Misericordiae University Hospital, Dublin, Ireland
- Academic Centre on Rare Diseases, University College Dublin, Dublin, Ireland
| | - Shamir Rind
- Western Australian Register of Developmental Anomalies, Perth, WA, Australia
| | - Simon Easteal
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT, Australia
| | - Xavier Estivill
- Quantitative Genomics Laboratories (qgenomics), Esplugues de Llobregat, Barcelona, Spain
| | - Yarlalu Thomas
- Western Australian Register of Developmental Anomalies, Perth, WA, Australia
| | - Gareth Baynam
- Western Australian Register of Developmental Anomalies, Perth, WA, Australia
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
- Faculty of Health and Medicine, Division of Pediatrics, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Faculty of Medicine, University of Notre Dame, Fremantle, WA, Australia
- Faculty of Science and Engineering, Spatial Sciences, Curtin University, Perth, WA, Australia
- Faculty of Medicine, Notre Dame University, Perth, WA, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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