The enormous promise of precision medicine to advance science and speed new, highly targeted therapies to patients is exceeded only by its potential to achieve something even more important: To help bring equity to medicine.
Juneteenth is a critically important date in American history, it’s both a celebration of the end of slavery and the promise of a more equitable future. But the killing of George Floyd and the Black Lives Matter protests last year showed how far we still must go to achieve a brighter, more just society for all. And academic medicine needs to play a meaningful role in creating that future.
For too long, advances in science and medicine have disproportionately benefitted those who could afford them or who could access them in their own communities. Collectively, the scientific and medical communities need to do a better job of including diverse communities in clinical research, to encourage diversity in medical schools and graduate programs, to hire people of diverse backgrounds – and provide the kind of mentorship that can kick-start lifelong careers.
The Covid-19 pandemic illustrated some of the inequities in medicine. According to the U.S. Centers for Disease Control and Prevention, “The COVID-19 pandemic has brought social and racial injustice and inequity to the forefront of public health. It has highlighted that health equity is still not a reality as COVID-19 has unequally affected many racial and ethnic minority groups, putting them more at risk of getting sick and dying from COVID-19.”
Medical equity can begin by listening and prioritizing patient-reported needs. We need to listen to our patients, we need to listen to the needs of at-risk communities, and we need to hear the complaints that many medical students of color have expressed about a lack of respect for diversity. We can prioritize unmet needs that have been ignored, improving clinical diagnostics, prognostics and ensuring once equity in access to precision medicine is achieved, equity in utility is also met.
We can direct our skills, passions, and technology to improve the lives of the most disadvantaged and create equity here and around the world. For example, our colleagues Drs. Melissa B. Davis and Lisa Newman recently published a study in Scientific Reports that found two gene variants in African American women may explain why they are more likely to be diagnosed with triple negative breast cancer (TNBC) than white women of European ancestry. These findings may have implications for developing better risk assessment tools for TNBC in African American women and for understanding why they have poorer TNBC outcomes.
Their work in Africa and across the African diaspora has been equally impressive and inspiring. Together with their colleagues from the International Center for the Study of Breast Cancer Subtypes, they have been teaching, performing breast cancer research, and implementing capacity building protocols for biospecimen collections, currently in use at Weill Cornell Medicine.
“We’re trying to establish why these aggressive forms of triple-negative tumors are prevalent, particularly in these regions. As we investigate the tumors in these African women, those tumor phenotypes will uncover mechanisms that can help us identify genetic drivers that may become targeted therapies,” said Dr. Davis in an EIPM website News article.
Juneteenth is an excellent occasion to reflect on how we are actively engaged in achieving equity and health justice with our Precision Medicine research initiatives. At this time, in the wake of the historical events in the past year, it is as imperative as ever to refocus our efforts with a lens of inclusion and justice. As we continue to establish synergistic collaborations among our diverse community of investigators, we will create a more equitable community for students, patients, and society. With your help, we can do our part and hopefully inspire others.
Olivier Elemento, Ph.D.