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Allen CG, Olstad DL, Kahkoska AR, Guan Y, Ramos PS, Steinberg J, Staras SAS, Lumpkins CY, Milko LV, Turbitt E, Rahm AK, Saylor KW, Best S, Hatch A, Santangelo I, Roberts MC. Extending an Antiracism Lens to the Implementation of Precision Public Health Interventions. Am J Public Health 2023; 113:1210-1218. [PMID: 37651661 PMCID: PMC10568499 DOI: 10.2105/ajph.2023.307386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 09/02/2023]
Abstract
Precision public health holds promise to improve disease prevention and health promotion strategies, allowing the right intervention to be delivered to the right population at the right time. Growing concerns underscore the potential for precision-based approaches to exacerbate health disparities by relying on biased data inputs and recapitulating existing access inequities. To achieve its full potential, precision public health must focus on addressing social and structural drivers of health and prominently incorporate equity-related concerns, particularly with respect to race and ethnicity. In this article, we discuss how an antiracism lens could be applied to reduce health disparities and health inequities through equity-informed research, implementation, and evaluation of precision public health interventions. (Am J Public Health. 2023;113(11):1210-1218. https://doi.org/10.2105/AJPH.2023.307386).
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Affiliation(s)
- Caitlin G Allen
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Dana Lee Olstad
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Anna R Kahkoska
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Yue Guan
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Paula S Ramos
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Julia Steinberg
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Stephanie A S Staras
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Crystal Y Lumpkins
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Laura V Milko
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Erin Turbitt
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Alanna K Rahm
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Katherine W Saylor
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Stephanie Best
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Ashley Hatch
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Isabella Santangelo
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Megan C Roberts
- Caitlin G. Allen and Ashley Hatch are with the Department of Public Health Sciences, College of Medicine, and Paula S. Ramos is with the Departments of Medicine and Public Health Sciences, Medical University of South Carolina, Charleston. Dana Lee Olstad is with the Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Anna R. Kahkoska is with the Department of Nutrition, Laura V. Milko is with the Department of Genetics, and Megan C. Roberts is with the Eshelman School of Pharmacy, University of North Carolina, Chapel Hill. Yue Guan and Isabella Santangelo are with the Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA. Julia Steinberg is with The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia. Stephanie A. S. Staras is with the Department of Health Outcome and Biomedical Informatics, College of Medicine, and Institute for Child Health Policy, University of Florida, Gainesville. Crystal Y. Lumpkins is with the Department of Communication, Huntsman Cancer Institute, University of Utah, Salt Lake City. Erin Turbitt is with the Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia. Alanna K. Rahm is with the Department of Genomic Health, Geisinger Medical Center, Danville, PA. Katherine W. Saylor is with the Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Stephanie Best is with the Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Middleton A, Costa A, Milne R, Patch C, Robarts L, Tomlin B, Danson M, Henriques S, Atutornu J, Aidid U, Boraschi D, Galloway C, Yazmir K, Pettit S, Harcourt T, Connolly A, Li A, Cala J, Lake S, Borra J, Parry V. The legacy of language: What we say, and what people hear, when we talk about genomics. HGG ADVANCES 2023; 4:100231. [PMID: 37869565 PMCID: PMC10589723 DOI: 10.1016/j.xhgg.2023.100231] [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: 06/05/2023] [Accepted: 08/07/2023] [Indexed: 10/24/2023] Open
Abstract
The way we "talk" about genetics plays a vital role in whether public audiences feel at ease in having conversations about it. Our research explored whether there was any difference between "what we say" and "what people hear" when providing information about genetics to community groups who are known to be missing from genomics datasets. We conducted 16 focus groups with 100 members of the British public who had limited familiarity with genomics and self-identified as belonging to communities with Black African, Black Caribbean, and Pakistani ancestry as well as people of various ancestral heritage who came from disadvantaged socio-economic backgrounds. Participants were presented with spoken messages explaining genomics and their responses to these were analyzed. Results indicated that starting conversations that framed genomics through its potential benefits were met with cynicism and skepticism. Participants cited historical and present injustices as reasons for this as well as mistrust of private companies and the government. Instead, more productive conversations led with an acknowledgment that some people have questions-and valid concerns-about genomics, before introducing any of the details about the science. To diversify genomic datasets, we need to linguistically meet public audiences where they are at. Our research has demonstrated that everyday talk about genomics, used by researchers and clinicians alike, is received differently than it is likely intended. We may inadvertently be further disengaging the very audiences that diversity programs aim to reach.
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Affiliation(s)
- Anna Middleton
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
- Kavli Centre for Ethics, Science and the Public, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge CB4 8PQ, UK
| | - Alessia Costa
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Richard Milne
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
- Kavli Centre for Ethics, Science and the Public, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge CB4 8PQ, UK
| | - Christine Patch
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Lauren Robarts
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Ben Tomlin
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Mark Danson
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Sasha Henriques
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
- Kavli Centre for Ethics, Science and the Public, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge CB4 8PQ, UK
| | - Jerome Atutornu
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
- Kavli Centre for Ethics, Science and the Public, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge CB4 8PQ, UK
| | - Ugbaad Aidid
- Wellcome Connecting Science, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK
- Kavli Centre for Ethics, Science and the Public, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge CB4 8PQ, UK
| | - Daniela Boraschi
- Kavli Centre for Ethics, Science and the Public, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge CB4 8PQ, UK
| | - Catherine Galloway
- Kavli Centre for Ethics, Science and the Public, Faculty of Education, University of Cambridge, 184 Hills Road, Cambridge CB4 8PQ, UK
| | - Keith Yazmir
- Maslansky and Partners, 200 Varick Street, Suite 601, New York, NY 10014, USA
| | - Sachi Pettit
- Maslansky and Partners, 200 Varick Street, Suite 601, New York, NY 10014, USA
| | - Tegan Harcourt
- Maslansky and Partners, 200 Varick Street, Suite 601, New York, NY 10014, USA
| | - Alannah Connolly
- Maslansky and Partners, 200 Varick Street, Suite 601, New York, NY 10014, USA
| | - Amanda Li
- Maslansky and Partners, 200 Varick Street, Suite 601, New York, NY 10014, USA
| | - Jacob Cala
- Maslansky and Partners, 200 Varick Street, Suite 601, New York, NY 10014, USA
| | - Shelby Lake
- Maslansky and Partners, 200 Varick Street, Suite 601, New York, NY 10014, USA
| | - Julian Borra
- The Thin Air Factory Ltd, 71-75 Shelton Street, London WC2H 9JQ, UK
| | - Vivienne Parry
- Genomics England, Queen Mary University of London, Dawson Hall, London EC1M 6BQ, UK
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